Stanek Sunday funnies 1-2-11: Death panels
Flashback: Listed as #2 of the “Top 10 Dumbest Sarah Palin Quotes”…
The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care. Such a system is downright evil. – Sarah Palin in a message posted on Facebook about Obama’s healthcare plan, Aug. 7, 2009
~~~~~~~
Important news pro-lifers may have been missed in the hustle and bustle of the h0liday season is that death panels are back in Obamacare. Wrote Charles Krauthammer in the Washington Post on December 31, which I’m interspersing between this week’s top cartoon picks:
Most people don’t remember Obamacare’s notorious Section 1233, mandating government payments for end-of-life counseling. It aroused so much anxiety as a possible first slippery step on the road to state-mandated late-life rationing that the Senate never included it in the final health-care law.
Well, it’s back – by administrative fiat. A month ago, Medicare issued a regulation providing for end-of-life counseling during annual “wellness” visits. It was all nicely buried amid the simultaneous release of hundreds of new Medicare rules.
by John Deering at GoComics.com…
Rep. Earl Blumenauer (D-OR), author of Section 1233, was delighted. “Mr. Blumenauer’s office celebrated ‘a quiet victory,’ but urged supporters not to crow about it,” reports the New York Times. Deathly quiet. In early November, his office sent an e-mail plea to supporters: “We would ask that you not broadcast this accomplishment out to any of your lists… e-mails can too easily be forwarded.” They had been lucky that “thus far, it seems that no press or blogs have discovered it…. The longer this [regulation] goes unnoticed, the better our chances of keeping it.”
by Nate Beeler at Townhall.com…
So much for the Democrats’ transparency – and for their repeated claim that the more people learn what is in the health-care law, the more they will like it. Turns out ignorance is the Democrats’ best hope.
Jill Stanek is a nurse turned speaker, columnist and blogger, a national figure in the effort to protect both preborn and postborn innocent human life.
Good grief, you get Sarah Palin doing some frankly kooky stuff on Facebook, combined with the tendency toward political demagoguery on the part of some politicians who aim their message at those too uninformed to know better, and this is what we get….
There is not unlimited money to spend on every patient – that is the bottom line. To pretend otherwise is silly, as silly as maintaining that there is some diabolical plot underway by Democrats.
This is true now, and it was true in 2003, when Bush Jr. was President, and when 42 Republican Senators and 204 Republican Housemembers voted for the Medicare bill of 2003.
From the text of the bill:
Beneficiaries entitled to these services are those who have not elected the hospice benefit and have not previously received these physician’s services. Covered services are those furnished by a physician who is the medical director or employee of a hospice program. The covered services are: evaluating the beneficiary’s need for pain and symptom management, including the individual’s need for hospice care; counseling the beneficiary with respect to end-of-life issues and care options, and advising the beneficiary regarding advanced care planning. Payment for such services equals the amount established for similar services under the physician fee schedule, excluding the practice expense component.
Coverage of certain physician’s services for certain terminally ill individuals would be authorized. Persons entitled to these services would be individuals who have not elected the hospice benefit and have not previously received these physician’s services. Covered services would be those furnished by a physician who is the medical director or employee of a hospice program. Services would include evaluating the individual’s need for pain and symptom management, counseling the individual with respect to end-of-life issues and care options, and advising the individual regarding advanced care planning. Payment for such services would equal the amount established for similar services under the physician fee schedule, excluding the practice expense component. The provision would apply to consultation services provided by a hospice program on or after January 1, 2004.
This stuff is nothing new, and yes – it was dumb thing that Palin said.
Video Starting at 7:22 Dr. Krauthammer says that he is a doctor and and a dr. has incredible authority over a patient especially one who is in pain or elderly. While maybe not death panels, it is the first step in rationing
What’s wrong with end-of-life counseling?
Doug, you’re recycling an old – failed – nonsmoking gun. The fact remains that under pressure the “death panel” provision was dropped from Obamacare but has been quietly restored by executive fiat through a Medicare regulation. Read the New York Times, for heaven sakes: http://www.nytimes.com/2010/12/26/us/politics/26death.html
This is the quite possibly the dumbest issue since the “birthers” ran with that issue.
Why is it back for a person to talk about what sort of care they would like to receive at the end of their life? Is this board, Sarah Palin, and other far-righters hoping for more Terry Schiavo type situations where care is unknown and left in the hands of whoever the court appoints?
Jill – did you read that whole article you linked to? Has anybody else actually read 1233? How Palin can get her whole scenario regarding Down Syndrome out of the text of that…she’s either the stupidest person in the world, or she’s quite frankly sinning – dishonest to the core, lying through her teeth. It is a shame that anybody would give this woman a platform to lie from.
It is not “dumb” to require the man who wants to be President to prove he is eligible for the office he seeks.
Jill, I certainly agree that it’s a political issue now, but the idea is the same, and the reality is the same – that there is not unlimited money to be spent on every patient – as it was when Bush Jr. was President and all those Republican Senators and Representatives voted for it.
Really, the idea that “we can’t do everything for everybody without limit,” would seem to be a great fit for the far-Right, politically. Senator Johnny Isakson of Georgia, a pro-life Republican, has been pushing for this stuff for a long time. In 2007, he sponsored the Medicare End-Of-Life Planning Act.
People are up in arms about the current provisions? Well good grief – read what has been proposed in the past, by Republicans as well as by Democrats.
Oh Joe…and I suppose the birth announcements were smuggled in by his grandparents into the Hawaii newspapers in case he ran for President 30 some years later.
Or maybe, evil Nancy Pelosi went back in time, and planted those announcements.
Birth announcements? Cute.
Most of you here are going to end up economic roadkill; you don’t even know why.
Enjoy your ignorance.
Doug,
Obamacare/(HillaryCareThruThe Puppet) was a bad idea. Here we are talking about another impending economic doomsay worse than the one in 2008 unless we raise the debt ceiling again and let the government keep spending us into ruin “for our own good cause they know better”. Are you drinking the kool-aid with Ex-RINO and claiming that Obamacare will save us money? Good grief Charlie Brown. The Democrats who stand against repeal will be roadkill in 2012.
ex asks:
” Has anybody else actually read 1233? ”
http://open.salon.com/blog/fred_pirone/2009/08/13/healthcare_the_actual_language_of_section_1233_of_hr_3200
Have you? If so, did you do a thorough reading–following every citation to its source? I have tried–not easy–a person may have to spend weeks following citations and references and then the citations within those citations ad infinitum…would there be an end?? And even if we did manage to get through it all–it is still a bunch of legalese that a team of lawyers would have to be consulted as to what it all means.
But a layperson can read the language without sidelining to the citations. Once they do that and process it through their cranium it is not unreasonable to conclude that it does not meet the smell test re the actual and implied powers being assigned to government agencies and those doing their bidding.
ex claims in speaking of Palin:
“….she’s either the stupidest person in the world, or she’s quite frankly sinning – dishonest to the core, lying through her teeth. It is a shame that anybody would give this woman a platform to lie from.”
My friend, if you could just get down from your self appointed moral high ground and look around you may find commentators on both sides of the political spectrum entertaining serious concerns about the meaning of 1233.
I suggest you tone it down a little about Palin being “stupid” and “sinning” when what she is doing is interpreting the text according to her best judgment and from her knowledge of how government works. She may have a wee bit more insight on that than the average person, including you and me. Last I looked there are only a handful of people that can claim experience as chief executives of state governments.
Besides, it is a good thing to have a healthy distrust of government. As Ronald Reagan would say–the scariest words in the English language are: “I am from the government and I am here to help”.
Apparently there is even enough to question about the section that some of your favorite libs in the media have raised concerns:
The Washington Post’s Charles Lane:
Though not mandatory, as some on the right have claimed, the consultations envisioned in Section 1233 aren’t quite “purely voluntary,” as Rep. Sander M. Levin (D-Mich.) asserts. To me, “purely voluntary” means “not unless the patient requests one.” Section 1233, however, lets doctors initiate the chat and gives them an incentive — money — to do so. Indeed, that’s an incentive to insist.
Patients may refuse without penalty, but many will bow to white-coated authority. Once they’re in the meeting, the bill does permit “formulation” of a plug-pulling order right then and there. So when Rep. Earl Blumenauer (D-Ore.) denies that Section 1233 would “place senior citizens in situations where they feel pressured to sign end-of-life directives that they would not otherwise sign,” I don’t think he’s being realistic.
. . . Ideally, the delicate decisions about how to manage life’s end would be made in a setting that is neutral in both appearance and fact. Yes, it’s good to have a doctor’s perspective. But Section 1233 goes beyond facilitating doctor input to preferring it. Indeed, the measure would have an interested party — the government — recruit doctors to sell the elderly on living wills, hospice care and their associated providers, professions and organizations. You don’t have to be a right-wing wacko to question that approach.”
Followed by the Posts’ Eugene Robinson:
“That’s the reason people are so frightened and enraged about the proposed measure that would allow Medicare to pay for end-of-life counseling. If the government says it has to control health-care costs and then offers to pay doctors to give advice about hospice care, citizens are not delusional to conclude that the goal is to reduce end-of-life spending.”
As the lead in of this story proves the question all boils down to who controls the directives and verbiage coming out of the regulating bodies. This is THE defining question because what is to be yet decided is certainly unknown. Obamacare gives incredible latitude to the secretary of HHS and regulatory bodies (yet to be staffed) as to the “how’s and whys” and interpretation of the statutes going forward. Experience tells us what we see at this point in Obamacare will in the end be much different once the legislation is distilled through layers of bureaucrats and regulatory mandates.
To truly reform health care we must take government out of it altogether.
All of this “liberal” and “conservative” garbage is highly entertaining.
The S&P500 index has risen over 40% since Obama was inaugurated.
If that’s “socialism,” I want more of it.
Hey Truthseeker, old buddy. : )
They’ve been raising the debt ceiling for how many years? 150? 200? I don’t like it, and I don’t like deficit spending, but it’s been a political fact in the US for hundreds of years, most pronouncedly in the past 4 decades. There was a pretty good jacking-up of it after the Great Depression and for World War II, as well.
There is a lot I don’t know about the new Health stuff. I heard there are 2700 pages of it. : ( I doubt it is any economic benefit for me and my wife in our situation. I think that if an employer chooses not to comply with certain regulations, they can pay a $2000 fine per affected employee, and that’s it – the employees would not fall under the coverage then. Also have heard that something was struck down by a judge – something concerning the gov’t being able to force people to buy coverage.
In the long run, I don’t know what would save the most money with respect to health care. It surely is a big question.
But this “death panel” stuff is silly, kooky Palin-type lunacy. There are valid questions to be asked, and common-sense issues to be addressed, and they have come up before, from Republicans and Democrats alike.
Doug said,
“In the long run, I don’t know what would save the most money with respect to health care. It surely is a big question.”
Doug, there is there is no such thing as “free” health care to millions; and removing life time caps and removing denials for pre-existing conditions is going to raise everybodys cost even more. That is why I asked you if you were drinking the kool-aid.
Yes they have raised the debt ceiling in the past but now we are reaching a tipping point where continuing to feed government on credit cards or our government itself becomes a ponzai scheme.
Did you know at the peak of this last crisis we loaned over three trillion dollars to European banks so that our mortgage derivative scheme didn’t take them down with us? Nobody knows where that money came from cause it came out thin air. Timothy Geitner deemed it into being.
“… removing life time caps and removing denials for pre-existing conditions is going to raise everybodys cost even more.”
So, you’re in favor of death panels.
“Did you know at the peak of this last crisis we loaned over three trillion dollars to European banks so that our mortgage derivative scheme didn’t take them down with us?”
Those were repo agreements to add $US liquidity to the European banking system. They weren’t “loans” in the conventional sense.
And, the Federal Reserve undertook those measures after a full vote of the Federal Open Market Committee. Geithner had nothing to do with it.
Now, you’re in my area of expertise. Get your facts straight.
(Jerry, quoting): “That’s the reason people are so frightened and enraged about the proposed measure that would allow Medicare to pay for end-of-life counseling. If the government says it has to control health-care costs and then offers to pay doctors to give advice about hospice care, citizens are not delusional to conclude that the goal is to reduce end-of-life spending.”
Jerry, good post and yes – there is a reasonable point there. But this is not a new thing. Again, in 2003, 42 Republican Senators and 204 Republican Housemembers voted for the Medicare act which provided for a hospice consultation about end-of-life care for those diagnosed with a terminal illness. I presume some Democrats supported it as well. We simply cannot spend unlimited amounts of money on everybody, and it’s been recognized by our legislators for over 7 years, if not longer.
If we want to see real “death panel” stuff in action, look to the state of Arizona, where the Legislature has cut organ-transplant funding. This is essentially a death sentence for quite a few low income people, and the Governor has thus far refused to put the money back in. Now some have died, and it’s made for controversy. These are, presumably, people for whom organ transplants would mean additional years of life.
http://azdailysun.com/news/opinion/editorial/article_e49f5382-08e3-11e0-9127-001cc4c03286.html
I’m not making any pronouncements on the morality of the Arizona deal. At the least it points up that health care can have large costs, and that there is not unlimited money to go around.
“I’m not making any pronouncements on the morality of the Arizona deal.”
I pronounce it despicable.
“This stuff is nothing new, and yes – it was dumb thing that Palin said.”
Was it dumb thing? Palin said dumb thing? ;)
In all seriousness, though, while Palin may have been skipping some steps, this sort of rationale (that it’s acceptable for your doctor to receive cash incentive to encourage that you issue an end-of-life health directive) can reasonably be thought to lead to a lessened respect for the sanctity of human life. And we already know that lowered respect for life increases the mortality rate for those society deems less productive (hence, 90% abortion decision for known downs children). Eventually, we all make it onto the less productive list. Is it a chance you want to take, Doug?
(Truthseeker): Doug, there is there is no such thing as “free” health care to millions; and removing life time caps and removing denials for pre-existing conditions is going to raise everybodys cost even more. That is why I asked you if you were drinking the kool-aid.
Well T., am having a really good Cabernet at the moment. I certainly agree that there is a limit to what can be spent, as you note – it would seem to be right up the alley of economic conservatives. Medicare spends 25 to 30% of all its money on people in their last year of life, so, and especially given what you said, you ought to understand that policitians of both parties realize we have to try and control costs there.
Yes they have raised the debt ceiling in the past but now we are reaching a tipping point where continuing to feed government on credit cards or our government itself becomes a ponzai scheme.
It’s been a Ponzi scheme for a long time, period. I think that mp may have a better handle on some facts than you do, but I agree that in essence the gov’t “creates money out of nothing,” as long as the govt’s borrowing keeps going up.
mp – please feel free to comment.
The fractional reserve banking system can do the same thing. There once was a 15% reserve requirement, i.e. the banks could loan out 85% of their deposits.
So, you deposit $100 and the bank loans $85 to me. Now, due to the debt I have, there now is $185 in the system where once there was only $100. And I could deposit the $85, which could bring another loaning-out of $72, i.e. as long as the total amount of debt is increasing, the money supply can too, “out of nothing.” When the debts are repaid, money can “vanish” by the reverse process.
And, the Federal Reserve undertook those measures after a full vote of the Federal Open Market Committee. Geithner had nothing to do with it. Now, you’re in my area of expertise. Get your facts straight.
Here is Geithners job description in his role as the Secretary of the Treasury.
“Geithner’s position includes a large role in directing the Federal Government’s spending on the financial crisis of 2007–2010, including allocation of $350 billion of funds from the Troubled Asset Relief Program enacted during the previous administration. At the end of his first year in office, he continued to deal with multiple high visibility issues, including administration efforts to restructure the regulation of the nation’s financial system,[2] attempts to spur recovery of both the mortgage market and the automobile industry, demands for protectionism, President Obama’s tax changes, and negotiations with foreign governments on approaches to worldwide financial issues.
Thanks for input mp. But you really can’t say he had nothing to do with it. All of that money has to come from somewhere doesn’t it? If Geithner isn’t printing it then where did it come from?
“In all seriousness, though, while Palin may have been skipping some steps, this sort of rationale (that it’s acceptable for your doctor to receive cash incentive to encourage that you issue an end-of-life health directive) can reasonably be thought to lead to a lessened respect for the sanctity of human life.”
Yes, by all means, let’s get serious.
First of all, your doctor wouldn’t be offered an “incentive” to counsel. The doctor is being “compensated” for his time. Doctors don’t work for nothing, you know.
Secondly, an end-of-life directive shows the utmost respect for the sanctity of life in that the document ensures that a person’s personal wishes will be respected.
Why is that such a difficult concept to grasp?
The Continental Congress borrowed money before the United States was established. In fact, they even defaulted on some of the debt. I know because one of my ancestors ended up in a Pennsylvania debtors prison because Congress did not repay what they owed to him.
The issue is not the debt itself, but the size of the debt relative to the country’s gross domestic product. The highest levels were reached at the end of World War II and the debt was, more or less, steadily paid down until the 1980s, when it began to balloon again. The national debt doubled in the first decade of the 21st century.
The debt is now in excess of 90% of GDP and will soon be 100%. Researchers Reinhart and Rogoff have shown that, once a nation’s debt exceeds 100% of GDP, the economy’s growth rate slows. The reason for this is that a larger share of the national income is used to pay interest rather than being re-invested in economically productive uses.
The US, however, holds a special position in that the $US is the world’s reserve currency. A privilege associated with this special status is it can assume more debt as a percent of GDP than can other nations.
As to money, it is constantly created and destroyed. There is no such thing as “hard money” in modern economies. That’s why the United States, and every other nation, has a central bank. It is their job to regulate the creation and destruction of money.
mp said:
“And, the Federal Reserve undertook those measures after a full vote of the Federal Open Market Committee. Geithner had nothing to do with it. Now, you’re in my area of expertise. Get your facts straight.”
mp, here is Geithners job description in his role as the Secretary of the Treasury paraphrased from Wikipedia. “Geithner’s position includes a large role in directing the Federal Government’s spending on the financial crisis of 2007–2010, including negotiations with foreign governments on approaches to worldwide financial issues.
So you really can’t say he had nothing to do with it. All of that money has to come from somewhere doesn’t it? If Geithner isn’t printing it then where did it come from?
“So you really can’t say he had nothing to do with it. All of that money has to come from somewhere doesn’t it? If Geithner isn’t printing it then where did it come from?”
The ONLY institution in the United States that controls the creation and destruction of money is the Federal Reserve System. They can, quite literally, create money with a keystroke and they regularly do so to accomodate the transaction of commerce.
The United States Treasury is a FISCAL office. They do not create money, but they do PRINT it. So, please look at what it says on the currency in your pocket. It says:
FEDERAL RESERVE NOTE
Your money is not “hard money,” it is a CLAIM against the United States. It is backed by the “full faith and credit of the United States.”
Not gold, not silver, not real estate, but “full faith and credit.”
Hi MaryRose. : )
Yes, I meant to say, “a dumb thing,” but noticed my error only after the time period for correcting my post had expired.
this sort of rationale (that it’s acceptable for your doctor to receive cash incentive to encourage that you issue an end-of-life health directive) can reasonably be thought to lead to a lessened respect for the sanctity of human life. And we already know that lowered respect for life increases the mortality rate for those society deems less productive (hence, 90% abortion decision for known downs children). Eventually, we all make it onto the less productive list. Is it a chance you want to take, Doug?
Well, speaking of expiring, ; ) were I diagnosed with a terminal illness, there is a point past which I don’t want to be kept alive by medical means, and a point past which I don’t think it’s worth it to spend vast sums of money on me.
This applies whether its my own money, that of my family, or that of the gov’t. The reality is that as a society, we cannot spend unlimited sums on health care, and there is not the political willingness to spend them for terminal patients, and I do not think there should be. Medicare is spending 25 to 30% of all its money on people in the last year of life, and it is simply economic reality that costs must be controlled, especially given the demographics of Medicare and our population.
Doug and mp,
With this kind of banking there isn’t even any US note to be used as a claim. A wire transfer with a couple extra bytes of zeroes and whullah….
What do you or mp think about the fact that the Obama administration and his “full faith and credit” Congress hasn’t bothered passing any budgets since taking office? Everything has been emergency funding with the threat of worldwide economic collapse and shutting down the US government. They pass HUGE entitlements of new bureaucracy and they completely screwed up Medicare and borrow from Medicaid just to work voodoo on the cost of the pig . Like I said, the people have woken and those who vote against repeal will be repealed with Obama in 2012.
Of course, I couldn’t let it pass XP
So I am trying to fully grasp what you mean when you say that costs must be controlled. Is it that my healthcare, being relatively inexpensive and low-maintenence, while I am contributing heartily to society, is somehow more acceptable than my great-grandmother’s healthcare, as her life is nearer expiration and her body is therefore more fragile? Or because she is a greater financial “burden”?
Have you never made a choice which you later came to regret simply because you were counseled to do so by a professional with more schooling/experience than yourself? Is it not prudent to question the wisdom of encouraging doctors to counsel end-of-life decisions without the patient initiating the exchange? Here’s the thing: I have a directive. My husband has a directive. I’m not going to share the details but we have considered end-of-life decisions and have made appropriate arrangements. I would be wary of a doctor bringing the subject to me, however.
My problem is certainly not in the encouraging of all individuals regardless of age or health to think about end-of-life care. My problem is specifically in the targeted approach to this particular Section.
And mp, it’s payment if the doctor is asked to perform a service and received compensation for it. In the case where a doctor is initiating the service, it’s an incentive.
The US fiscal year begins on October 1 and ends on September 30.
The 2009 US budget was already enacted when Obama took office in January 2009.
The TARP, for example, was enacted before Obama took office and was passed as an emergency addendum to the 2009 budget.
The 2010 budget–Obama’s first budget in office–was passed.
“And mp, it’s payment if the doctor is asked to perform a service and received compensation for it. In the case where a doctor is initiating the service, it’s an incentive.”
I call it good planning. The patient receives counselling before they’re incapable of receiving it.
If you want to call that an “incentive,” feel free.
Frankly, if I was a doctor, an “incentive” or “compensation” wouldn’t be required. I’d offer my time free of charge due to a, quite possibly, altruistic sense of duty to my patient.
But, this being a capitalist society, feel free to call it an incentive.
“The patient receives counselling before they’re incapable of receiving it.”
…and before they necessarily want it.
“…and before they necessarily want it.”
No one, at least none I’m aware of, wants to be confronted with the likelihood of death.
That’s why I having a living will (end of life instructions) and have published them to my lawyer and my doctor.
That’s what every resposible person should do.
Sadly, some folks don’t.
And that’s why we have to “incentivize” doctors to help the patient do what they should have done themselves.
I see, mp. Taking care of the human population, are you? On a mission to make people do what you feel they should, regardless of whether or not they consider it a priority?
As I stated before, I have my directive filed. My husband has his, as well. We have discussed our decisions with each other & immediate family. We are healthy mid-twenties young adults. I have encouraged friends and family members to think about their end-of-life decisions. I wouldn’t be happy to have a doctor bring it up however unless I was expressing a good, related reason for them to do so… or about to undergo surgery or something of the sort. The whole, “Start up conversations about death plans & we’ll pay you this much” concept seems questionable to me.
Again, as I’ve mentioned, I don’t see a problem with encouragement through other means. Paying a doctor to target a specific group for end-of-life counseling is where I begin questioning motives.
“The whole, “Start up conversations about death plans & we’ll pay you this much” concept seems questionable to me.”
I guess you’ve never sold life insurance.
MP,
Nope. But I went out and got an insurance plan. See, I have this whole “hold people responsible” theory. ;)
“See, I have this whole “hold people responsible” theory.”
And so do I, but I’ll not hold someone confronting death responsible because of their own ignorance, or because they failed to read the fine print, or because they couldn’t afford a good lawyer.
It was meant in jest, anyway. I honestly just don’t trust doctors who have been “incentivized” (lol) to encourage people in good directions in all cases. I don’t trust this program to encourage healthy dialogue rather than just to focus more heavily on minimizing loss and *attempting to* maximize profits.
“I see, mp. Taking care of the human population, are you?”
Oh, I see. It’s OK for you to care about all of the unborn, but not OK for me to care about those who already are?
I notice you didn’t use the remainder of that quote. My point was that you’re out to force them to make a decision. Allowing the unborn to live to make any choices versus pushing an elderly person into a discussion about when to “pull the plug” so to speak. You’ll forgive me for not equating the two.
“Allowing the unborn to live to make any choices versus pushing an elderly person into a discussion about when to “pull the plug” so to speak. You’ll forgive me for not equating the two.”
How about giving the elderly the opportunity to answer those questions themselves?
And, as to quoting you: you asked the question.
I provided an answer.
LMAO! Nice try. I have no intention of stopping anyone from making those decisions for themselves. I fully support the concept of creating greater social awareness of the importance of a living will. As I already mentioned repeatedly, I am all for organizations that want to increase awareness of the reasons to create a life plan. That said, I don’t trust the concept that we should pay doctors to initiate the conversations with a targeted group of people. I’m starting to sound like a broken record. lol
“That said, I don’t trust the concept that we should pay doctors to initiate the conversations with a targeted group of people.”
What about paying life insurance salesmen to talk with you about your estate planning?
What about paying mechanics to tell you what’s wrong with your car?
What about paying plumbers to tell you why your plumbing won’t drain?
MaryRose, I don’t necessarily disagree with you – but something *has* to be done. Obama’s new stuff or not, Medicare faces insurmountable liabilities in the long run, and costs will be controlled one way or another. I think that politicians in both parties at least realize that end-of-life care is often vastly expensive, and that there are choices to be made.
Really, my forecast is that the problems will by and large not be addressed, and the politicians will let the system itself falter, rather than vote to cut services or impose sufficient new fees, in the main. This is true not only for the health care system but for gov’t services as a whole, and in the end a system like ours only gets rid of the excesses/weaknesses/ structural instabilities one of two ways – it either outright defaults on its liabilities or it hyperinflates them out of existence, i.e. the debts may technically be “paid,” but it will be in increasingly worthless currency.
Nothing I have seen from either political party indicates they will accept the default option, and thus I think it’s full speed ahead on the status quo of continually rolling over gov’t debt and the devaluation of our currency, a process that while within we may yet have years yet, we are already far down the road.
Doug, I’ll tell you something: if this country has enough money to prevent a domino from falling in Southeast Asia, or has enough money to search for non-existent weapons of mass destruction in a place like Iraq, or has enough money to chase ghosts in the Afghan desert, or has enough money to bail out the entire US banking system then, by God, we’ve got enough money to care for our own people.
Truthseeker, the US is the biggest debtor nation in the world, and is bankrupt by many normal (non-federal gov’t) measures. This has been the case for a long time – it’s not like Obama came and *poof* some new magical reality appeared.
Reagan was the last President to really make an effort to cut spending, and while he only slowed the rate of growth during his first two years, I do salute him for that. During his last 6 years, he threw in the towel on it, and Bush Sr. and Bush Jr. both really increased spending and the federal gov’t’s debt as well.
The people have short memories, and it’s normal for a President’s party to lose seats in Congress. Bush Jr. had already begun some of the bailouts that Obama continued, and Medicare was in a pickle before the last Presidential election. There would be no President that would not have done ‘something’…
Personally, I won’t mind if the new health care stuff will be repealed, though that is a tall order. But talking about “death panels” and making a political football out of it is silly – the idea of making plans and knowing what one wants and knowing what patients want ahead of time is a sound one, one that politicians of both parties have heretofore been in favor of.
As for “the full faith and credit of the US gov’t,” yeah, man, that’s really all we have behind our currency and our debt obligations, and I’m surprised that our foreign lenders haven’t begun to demand higher payment (increased interest rates) for the increased risk they have.
They’re in a tough spot too – they want to support our economy and purchasing power, as we are their biggest customer, so they are willing to accept some amount of loss to achieve it. But not forever, and not without limit, and when the day comes that the Japanese or Chinese “dump their US bonds,” it will rock our world.
Doug, I’ll tell you something: if this country has enough money to prevent a domino from falling in Southeast Asia, or has enough money to search for non-existent weapons of mass destruction in a place like Iraq, or has enough money to chase ghosts in the Afghan desert, or has enough money to bail out the entire US banking system then, by God, we’ve got enough money to care for our own people.
mp, point taken, but we don’t really have enough money to do any of those. We cannot be “the world’s policeman,” if we have to pay for it. And unless we change the Medicare system, there will have to be big cuts in benefits, or big tax hikes, or both.
The 2009 Social Security and Medicare Trustees Reports tell us that the unfunded liability of Medicare and Social Security is almost $107 trillion. That’s like 7 times the size of the whole US economy. Medicare has the lion’s share of this, over $89 trillion.
Something has got to give.
Jerry – I’ve read through 1233 before – and while it is a tough read, I don’t see how a logical person, or a truthful person, could ever come to the conclusion that Palin is without using the phrase “slippery slope” or “future legislation”. It simply isn’t anywhere near close to what is in the bill.
It just seems to me, that again, the GOP and yourself want it both ways. You don’t want people getting in between patients and doctors, yet in this case, you don’t want doctors involved that know the patients best. And you are concerned about patients taking their doctors word for it and being pushed around, yet the alternative is to have no conversation, and leave it to the hands of people who are just guessing.
Doug, let’s be clear about this. As you said, the problem is Medicare, but Social Security has absolutely nothing to do with it.
Social Security has NEVER been in deficit in its entire history. In fact, Social Security has a SURPLUS in the neighborhood of $2 trillion. The system itself is fully solvent until at least 2034.
The problem is that Social Security was moved “off the books” during the Reagan administration and they borrowed from Social Security to pay for programs they didn’t want to include in the general budget.
Now, it’s payback time. Neither the Republicans, nor the Democrats, want to admit what they did to Social Security. I vividly remember when Bush II was given a tour of the Social Security Administration and he was shown the filing cabinets in which Social Security’s treasury bonds were stored. He simply laughed and said, “They’re just pieces of paper.”
He wouldn’t have said that if he’d been in China and those bonds were in THEIR filing cabinets. The fact is, the American people have been bamboozled by their own leaders, left and right, Republican and Democrat.
As far as Medicare and Medicaid go, the only way to fix them is with a program that’s underwritten at the national level. I think you see that, but most folks don’t. They’re hung up on ideology.
But, the important point is: they can be fixed.
mp,
What was the date that the Democratically controlled congress actually passed Obama’s 2010 budget? And is it true that the 2011 budget year started last year in October? Has the Obama administration and our Democratically controlled congress even bothered to propose 2011 budget yet? I seem to remember one of Obama’s budget proposal including 70 billion dollars in savings due to Obamacare. He is magic isn’t he? Did that estimate include take into account the millions of employees that were allowed to opt out of their Obamacare savings this year? ugh!
MP,
A plumber, a mechanic, and a life insurance salesman. How ironic yet telling that you would choose these three examples.
Of course, that’s the point, though. Not all doctors will take advantage of their patients, but those who follow a loose moral code could be playing with their patients’ lives, with the government sanctioning and paying for their immoral behavior.
You unintentionally hit the proverbial nail on the head. :)
“What was the date that the Democratically controlled congress actually passed Obama’s 2010 budget?”
http://www.opencongress.org/wiki/FY_2010_U.S._federal_budget
“And is it true that the 2011 budget year started last year in October?”
Yes.
“Has the Obama administration and our Democratically controlled congress even bothered to propose 2011 budget yet?”
http://www.whitehouse.gov/omb/budget
“I seem to remember one of Obama’s budget proposal including 70 billion dollars in savings due to Obamacare.”
You’re referring to a study conducted by the Congressional Budget Office.
http://cbo.gov/
“He is magic isn’t he?”
COMMENT IGNORED.
“Did that estimate include take into account the millions of employees that were allowed to opt out of their Obamacare savings this year?”
I don’t know.
“Of course, that’s the point, though. Not all doctors will take advantage of their patients, but those who follow a loose moral code could be playing with their patients’ lives, with the government sanctioning and paying for their immoral behavior.”
And that, dear lady, is the story of capitalism.
It is also why we have laws, regulations, regulatory agencies, and policemen.
My point is simply that it’s not ethically sound for our government to encourage and benefit from the morally deprived actions of some doctors.
“My point is simply that it’s not ethically sound for our government to encourage and benefit from the morally deprived actions of some doctors.”
You’re being very idealistic. Consider, for example, there are “morally deprived” doctors who perform unnecessary surgeries every day of the year and are paid for them by insurance companies.
There are policemen who violate their oath of office by “going on the take.”
There are politicians who accept money under the table in order to please some interest or another.
There are spouses who kill each other because one of them is a named beneficiary on the other’s life insurance policy.
It’s called greed; capitalism is controlled greed. It’s part of human nature and every human endeavor, regardless of what it is.
And that’s why we have have laws and law enforcement.
I asked mp “Did that estimate include take into account the millions of employees that were allowed to opt out of their Obamacare savings this year?”
mp said: “I don’t know.”
mp, you can’t call yourself an expert on budgetary issues and duck a simple question like that. Yes you do know mp. Of his original budget proposed did NOT include the opt outs, or the continuation of unemployment; or keeping taxes at there current levels. There never was and still is not any 2010 budget. It has just been proposals that are wildly off the mark. Government is living off of emergency funding resolutions and the hallmarks of the emergency funding resolutions are things that weren’t even in any budget proposals; like extending unemployment benefits and leaving the Bush tax cuts in place. ugh
“Yes you do know mp.”
If you really know what I do and don’t know, that makes you a pretty special person.
“mp, you can’t call yourself an expert on budgetary issues and duck a simple question like that.”
I do not call myself an expert on budgetary issues. I am a financial and economic analyst, and a damned good one.
The difference here, MP, is that lives are at stake and the government would be encouraging and benefiting from the potential pressure to end life earlier. The only example you gave involving death is the spousal death insurance fraud, which we investigate heavily, and we prosecute when we are able to make a case. So I’m arguing, we shouldn’t encourage unethical behavior. It’s going to happen, yes, but should we be paying for it??
See my point? Your examples have laws restricting them. This scenario benefits the government if the (potential) law is abused.
Mary Rose, as someone who has been involved in financial matters for over forty years, I can tell you that unethical behavior is encouraged whenever money is involved.
It doesn’t matter what the issue is and there is no escaping it.
I can just as easily construct scenarios in which an elderly person can be abused, and the government can benefit, by not offering them end of life counsel.
mp,
It was you claimed goverment budgets and monetary policy are your “area of expertise”. I guess we both must have just underestimated my own level of expertise then since I already knew that Obamcare’s proposed costs has already and will continue to skyrocket beyond projections. You do see that now don’t you?
“It was you claimed goverment budgets and monetary policy are your “area of expertise”.”
I did not. I am a financial and economic analyst. My particular area of expertise is in monetary policy.
I am not a budget analyst.
MP,
I guess I just disagree with unethical law particularly when lives are also involved. :-/
(Sidenote, easy mistake but it’s MaryRose. No space.) :)
“Government is living off of emergency funding resolutions and the hallmarks of the emergency funding resolutions are things that weren’t even in any budget proposals; like extending unemployment benefits and leaving the Bush tax cuts in place.”
Government is about making sausage. Obama wanted to extend unemployment benefits and the Bush tax cuts for the bottom 98% of taxpayers. The price he paid for that was a total extension of the Bush tax cuts, discontinuing the Making Work Pay tax credit, continuation of the estate tax cuts, and a cut in payroll taxes. It was a bipartisan measure and it passed.
Your government at work. It adds approximately $2 trillion to the deficit over the next two years.
Although most don’t know it yet, taxpayers earning about $25 thousand per year or less are going to end up paying more in taxes than they did last year because the Making Work Pay credit is ending. Sure, they’ll get the 2% on the payroll tax side, but it won’t make up the difference of what the direct credit would have been. As I said, it’s about making sausage.
I think I could make a better tasting sausage a lot cheaper than the government can. Do you have any idea what is the total amount of deficit spending Obama and the Democratic sausage making machine have punished us with in the two years since he was inaugurated? Obamacare is a budget buster.
“And what was the projected deficit before Obama and the lame duck Democraticly controlled house and senate approved the additional two trillion dollars in “emergency” deficit spending?”
If you’re referring to the measure passed last month, it was passed with bipartisan support.
I explained that in my 12:28 comment.
You can find full details at the CBO’s website. The bill was HR4853.
“Thank God for GOP control of congress.”
They will protect their interests.
“Do you have any idea what is the total amount of deficit spending Obama and the Democratic sausage making machine have punished us with in the two years since he was inaugurated?”
You can find it all at the CBO’s website.
mp,
Would you agree that Obamacare is exactly the wrong medicine for bringing government spending under control?
“Would you agree that Obamacare is exactly the wrong medicine for bringing government spending under control?”
I think Obama’s health care program is a mis-step in the right direction to bring health care spending under control, but it’s at least a step.
I say this as a former Goldwater Republican who has had no politics for 38 years.
Make of that what you will.
CBO analysis of HR4853
http://cbo.gov/ftpdocs/120xx/doc12020/sa4753.pdf
It’s really amusing to see the furor over these so called “death panels” which are beneficial end of life counseling sessions regarding things like durable power of attorney, living wills, etc. – the kind of things that can prevent another Terri Shiavo situation. But what’s really amusing is the irony. The folks who object to “death panels” because the doctor might intrude into a family decision are the same folks who want the government to get between a woman and her doctor when it comes to abortion with mandatory government created scripts about “life,” mandatory ultrasounds, mandatory waiting periods, etc. These measures are designed to purposefully change the woman’s mind regarding the “murder” of her baby. How is this any different from the argument that doctors will try to influence the outcome of end of life planning? If end of life decisions are private, so is what a woman does with her body.
The Dems had to remove this end of life counseling from the Obamacare bill in order to get it passed. Then in regulations, the Dems offered to pay docs to persuade patients to reject medical treatment each YEAR at their wellness check, rather than once every five years as was originally written in the bill.
With limited funds, the rationing will be placed in the hands of the federal government. Obamacare is already behind schedule and over budget during the beginning stages of its implementation.
Death panels exist in many forms. After the Sanitation dept union in New York admitted to a purposeful work slowdown……… the possibility that longer transportation paralysis in that city might be seen as fiscally beneficial became apparent.
Very few of the deaths by “natural” causes, caused by the slowdown of snow removal will be reported in the news.
http://themorningafter.us/new-yorks-union-death-panel/
It’s usual for a marked reduction of hospital visits during times when the roads are snow covered. Snow doesn’t stop the chest pain, strokes, diabetic keto-acidosis, childbirths, and other medical emergencies.
They just don’t make it to the hospital.
There is a huge mis-understanding here: there is an understanding that the US government was involved in HEALTH REFORM. In actuality, Obamacare is HEALTH FINANCE/INSURANCE REFORM. Only someone silly could arrive at the conclusion: they mean the same thing – THEY DON’T, not even close! Doug seems all fretful about the 25-30% costs of end-of-life care. [I almost up-chucked: it’s end-of-life care WITH PRESENT MEDICAL TECHNIQUES that is this expensive. I know of cogent (some banned in the US) medical strategies that would be a tiny fraction of what an American pays. And this is not the exorbitant drug fees you guys have. ( http://www.lef.org ) Imagine that: much better medicine for much, much less cost.
I am nauseous with fury about this. My MIL has private insurance, and yet, during the Terri Schiavo thing, she wanted both her son- my husband- and me- to sign living will documents. I had to argue her into having her pastor sign one, since I know he knows her better than I do. I felt that I had been asked to sign a contract to commit a homicide on an innocent old woman, who had been harassed by the AARP into believing she “owed” us a good death.
When one goes into hospice care, aggressive treatment stops. It just stops. Most people, in their last year of life- they have six months or so of rocky, bad health. It’s the time when they get everything settled. I know my grandfather did not want his six months of going into and out of the hospital. But it bought him enough time to have his entire family come and say goodbye. It gave him time to lay his hands on his grandchildren, to bless them. It gave him time in the hospital where each member of his sunday school came, and visited. He was able to take measure of his life, and we were able to thank him for it.
For that matter- scalability. Hospices are shoe- string operations as it is. The “high-tech” fixes he touted for health-care at first- were like Hitler touting new “super-weapons.” They were not, at all, scalable. I know. I worked at one of the “high-tech” places he thought could solve the nation’s problems. We were still working out the kinks. States are still trying to figure out how to integrate computers into care. That’s responsible federalism- fifty experiments leading to best practices- not national “follow that unicorn!: hope and change by declaration!”
Has Obama actually talked to any doctors? They get into the job for healing and helping, not to kill people. The ones who enjoy killing, end up a tv special. Is there any way that the whole white house is a tv special?
please. somebody. declare the gov’t bankrupt, so we can quit having these crazy, wrong, ideas funded.
Yes needling the patients to death with morphine is cheapest. But it’s why the people of Northern Europe are afraid to go to the nursing homes.
The U.S. patients subsidize the cheaper prices which are paid in other countries for drugs developed in the U.S. Once that stops, those drug prices will go up in Europe and elsewhere.
The U.S. is responsible for about 80 percent of novel drug development. After Obamacare, this will slow down considerably. Don’t hold your breath waiting for the rest of the world to take up the slack.
Movement of health care finance to the public sector will cause the U.S. to have filthy hospitals and poor infection control, same as in Europe.
Why do leaders of foreign countries come to the U.S. for their health care needs?
Why are they not running to the UK for this instead?
Why is Canada sending its high risk maternity patients south to the U.S.? Where will those Canadians go after Obamacare?
Hi pharmer,
I really like most of what you say, but this call to re-enforce ‘orthodox’ medical practice sucks. Ever heard of homeopathy? The old saying ‘Necessity is the mother of invention.’ seems apt for Cannuks (like me).
People manage their own end of life care and have for generations with no help from the gov’t. These were matters discussed with doctors, family members, and clergy. There are living wills and end of life directives. Families, my inlaws in particular, make agonizing decisions to remove life support and other important decisions.
I want to see patients given whatever is needed to keep them comfortable and in the amounts needed. This includes heroin and medical marijuana. Certainly large doses of pain medication may end up killing the patient. If they are comfortable and at peace I say let them have it.
People who want to kill themselves desperately enough will do it, they need no assistance. Stopping them is the challenge.
LOL! I love all this heavy discussion about death panels and healthcare triggered by Sarah Palin. Sarah thank you for uncovering or as some have posted unearthing what is already in place. For the pro-aborts I think there can never be enough “death panels” to push “more for the fit, less of the unfit” (does this quote from Margaret Sanger come to mind?). I will leave it to the economist and financial experts to hash out the financial details but as a healthcare worker with family who are physicians (who are actually healers and not butchers), we see the handwriting on the wall (great Biblical analogy from Belshazzar, King Nebuchadnezzar’s son in Babylon to what is going on right now, read Daniel Chapter 5). We have some death panel stuff going on right now but not with a federal mandate and cash register cha-ching for bringing it up annually. You ain’t seen nothing yet if this Obamacare crap goes through. Yes, we have needed to reform healthcare in this nation for years but this bill is not it, this bill is really about “transforming America” (quoting BHO) not about bringing down cost and helping uninsured and underinsured people. Wait until you see the federal govt. rationing expansion that the “Federal Coordinating Council for Comparative Effectiveness Research” will implement when this gets going at full throttle, physicians like my family members KNOW what this really means, RATIONING AND DEATH PANELS.
Excellent interview on Fox News this morning (yes the devil’s station to liberals) by Dr. Seigel (I think that’s his name), he says pushing for and paying for annual reviews of end-of-life decisions is ridiculous, good docs already have this discussion, don’t need to be paid to do it and don’t need to do this every single year. But it’s ok the Obamacare proponents will not concede this is a crock and a push to get grandma to see how much of a burden she is to her family and to the “system”, but those on the frontlines of healthcare know better.
mp said,
“I think Obama’s health care program is a mis-step in the right direction to bring health care spending under control, but it’s at least a step.”
mp, “a mis-step in the right direction”, sounds like liberal mind bending. Is that kind-of like a correct step in the wrong direction? The fact of the matter is that Obamacare does NOTHING to lower the costs of health care. It increases the cost of health care by forcing some to subsidize the cost for others. You have bought into the big lie of Obamacare. Even simple things that were in the bill like lowering our cost for medication were stripped out. I would challenge you to name the medical procedures that “cost less” now then they did pre-Obamacare. My deductibles and co-pays went way up this year and this pig doesn’t even kick in until 2014.
“You have bought into the big lie of Obamacare.”
You asked for my opinion, and I offered it, even though I have no dog in this hunt.
I will say that, unlike you, I’m not burdened by the need to believe in either side.
Thanks for your time.
ex says:
“It just seems to me, that again, the GOP and yourself want it both ways. You don’t want people getting in between patients and doctors, yet in this case, you don’t want doctors involved that know the patients best. And you are concerned about patients taking their doctors word for it and being pushed around, yet the alternative is to have no conversation, and leave it to the hands of people who are just guessing.”
I think the key here is that the presumptive will of the patient to want to live and for the state to protect the interests of that individual will be undermined by regulatory bodies making up and IMPOSING rules as they go along. Obamacare has language and directives that enable boards and committees to create rationing parameters that will have an inherent bias against those suffering from multiple illnesses, age, and, in the case of Sarah’s son, his birth condition. Look–society has already written off the right to life of the unborn (especially Downs syndrome at 90% abortion rates) and it is a small step to “relax” rules safeguarding their rights.
Remember–with Obamacare we now have the politicization of health care like we have never had before. Everything from hangnails to heart surgery is now the domain of public scrutiny–and when the bills start piling up there is no question that rationing will begin in earnest.
I would prefer that gov get out of ANY health care decisions–they just have too much power. The best way to reform health care and provide health care to those whom we have committments (vets and medicare/medicaid) and to those who cannot afford it is through vouchers and medical savings accounts that let the individual shop for and purchase a product that best fits their needs. Everyone’s needs are different and subject to change. Government programs by definition always seek to arrive at the most common denominator–thus they end up paying for some things people don’t want or need, and coming up short on other things.
Jerry – the abstract conversations get tough on me – could you send the exact component of the health care reform you are talking about when you say “Obamacare has language and directives that enable boards and committees to create rationing parameters that will have an inherent bias against those suffering…” The language is what I am interested in.
I understand your point – to a degree, I agree with your point. Here’s the deal. Health care is/was on a runaway train that was a massive threat to the US’s position in the global economy (ie US automakers competing against foreign automakers). It is not cost efficient and is far outpacing inflation and has been for years. Furthermore, it is/was becoming something that fewer and fewer had – but since we pay for emergency care for everyone, we had a massively inefficient universal coverage system.
I’m glad Health Care reform took some steps there. I don’t agree with all of the steps – you don’t agree with all of the steps. But I’m glad it took some steps. I agree with the Mayo, Gunderson, Franciscan Skemp – continue to revise the law and make it better. Unfortunately, folks think the old status quo is the way to go, hence the house moving to repeal. I simply wish they’d state their alternative. Protest is good – but alternatives are better.
truth – so you say that the bill has rationing and death panels, but then say (in caps), that the bill does nothing for cost control? In the interest of at least making a fair effort and sounding intelligent on the issue, you should do a little research on it – especially on the Medicare side and changes in the bill. To say that it does NOTHING is so wrong that is dismisses everything else you say – it just shows you’ve never actually seen anything about the bill other than what your right wing friends are telling you.
Do a little research as an American – as an intelligent person – and then come back with something better please.
Prolifer – one issue with your post I spotted – it is every five years – not a yearly review:
“the individual involved has not had such a consultation within the last 5 years. Such consultation shall include the following…”
Neither “yearly” or “annual” even show up in section 1233.
I disagree with most of what you post – but that part was simple fact we can both agree on.
mp, I thank you for your input. You did teach me things about monetary policy that I was unaware of.
Ex-RINO, death panels are NOT health care. What I said is it that Obamacare does not reduce the cost of any health care in terms of procedures, drugs, operations etc. It is true that there is savings for insurance companies built into this law. Obamacare uses the muscle of federal government to codify a reduction/denial of health services; services that insurance companies previously could not have denied to the people.
Truth – what about the IPAB? Directly related to Medicare funding – part of the reason is stays solvent for much longer with the bill.
No argument there Ex-RINO. There is some cost savings built in to death panels. The savings though are not realized through a reduction in the cost of health care; but rather through the denial of health care. The IPAB is all about saving money by reducing/denying services to certain people they decide are not worthy of treatment. And their illness is due to pre-existing conditions but treatment is denied anyway….. Oops, how did that happen?
Ex-GOP you are talking about the original Obamacare bill not the new addition that has been just slipped into Obamacare by Medicare regulation go back and READ Jill’s article at the beginning of this thread which does say “annual”. Dr. Seigel was just today on Fox News referring to the NEW addition to the bill asking for annual not 5 year reviews (I don’t believe Dr. Seigel is so stupid to be commenting on something that was not current regulation). BTW I would be shocked if you agreed with my post, but miracles could happen. I won’t hold my breath but I will pray for your change of heart. Happy New Year.
And IPAB is a permanent unelected board making statutes that govern our health care eligibility. Yikes!!!
The Democratic senators will need to decide if they want to be 2012 roadkill or if they want to let let their fearless leader hang himself by vetoing the repeal. Salute and walk the plank. Hail Obama!
Thanks truthseeker. IPAB and the “Federal Coodinating Council for Comparative Effectiveness Research denial of care and rationing of care sounds similar. Hmmm.
Hannity show tonight on this new Medicare regulation slipped in on the American people.
(JohnnyM): Doug seems all fretful about the 25-30% costs of end-of-life care. [I almost up-chucked: it’s end-of-life care WITH PRESENT MEDICAL TECHNIQUES that is this expensive. I know of cogent (some banned in the US) medical strategies that would be a tiny fraction of what an American pays.
John, the only thing to be, when looking at the long-term, is to be “fretful” about all the costs. They are unsustainable.
You have frequent affection for fanciful ideas, but some of them are pipe-dreams, and in any case, we are looking at reality, not “what might be.” If cheaper/better things are available, then great – and they should be not be objectionable.
In the here-and-now real world, the end-of-life care is very expensive, and if cuts are to be made – and they will have to be, as recognized by US politicians of both major parties – then the most expensive period of time is obviously going to be on the table.
Doug, it is true that end-of-life care is expensive. It is not right for the government or the insurance companies to deny the care because the patient has paid them so much money throughout their lifetime. As far as I know insurance companies have been surviving fine.
The problem is that Social Security was moved “off the books” during the Reagan administration and they borrowed from Social Security to pay for programs they didn’t want to include in the general budget.
Now, it’s payback time. Neither the Republicans, nor the Democrats, want to admit what they did to Social Security. I vividly remember when Bush II was given a tour of the Social Security Administration and he was shown the filing cabinets in which Social Security’s treasury bonds were stored. He simply laughed and said, “They’re just pieces of paper.”
He wouldn’t have said that if he’d been in China and those bonds were in THEIR filing cabinets. The fact is, the American people have been bamboozled by their own leaders, left and right, Republican and Democrat.
As far as Medicare and Medicaid go, the only way to fix them is with a program that’s underwritten at the national level. I think you see that, but most folks don’t. They’re hung up on ideology.
But, the important point is: they can be fixed.
mp, good comments, and you are certainly right about our elected leaders raiding the Social Security Trust Fund.
Yeah, I guess you can say that they can be fixed, but that’s like saying our deficits and debt can be fixed. In no way do I see even a small portion of the necessary political will to do that, nor do I think the populace is really behind it; rather, the people want their pet programs and perks maintained while they expect “the other guy” to take the cuts.
(Truthseeker): Doug, If the government were not taking these decisions over you would have no business in other peoples business either.
For Pete’s sake, T – Medicare has been around a long time, and during Bush Jr’s Presidency the same concerns came up, then with many Republicans supporting cost-control attempts. There is a huge problem with Medicare, and that was true before Obama became President or any of his health system changes were made.
truth – and I see it a different way. Poll after poll showed that people wanted politicians to focus on the economy. Furthermore, many polls lately have shown the majority of people want to give reform a chance (including Cnn/opinion research late December). Now, the GOP that said “we’re going to focus on the economy” is staging a symbolic vote with no alternative offering of their own. Should be interesting.
Prolifer -you are right – the wellness visits are annual, and those voluntary discussions can take place in those visits.
Hopefully more people will draw up living wills as a result of this and we can avoid a lot of the confusion that takes place now – http://www.palmbeachpost.com/money/medicare-covers-end-of-life-discussions-1153163.html?cxtype=ynews_rss
Doug, it is true that end-of-life care is expensive. It is not right for the government or the insurance companies to deny the care because the patient has paid them so much money throughout their lifetime. As far as I know insurance companies have been surviving fine. These issues do not need to be regulated by you or the government. If you are willing to forego end-of-life care then I bet they would sell you a much cheaper policy.
truth – do you believe any citizen should get whatever care they want during end of life? 90 year old wants a heart transplant – do you believe we should give that to them?
Ex-RINO sais: “truth – and I see it a different way. Poll after poll showed that people wanted politicians to focus on the economy.”
Reducing the size and reach of government into private business/repealing Obamacare is the single biggest thing we can do right now to return our economy around. It sucks being in this position but before we can implement more prudent changes to entitlements like Paul Ryan’s roadmap we have to begin by undoing what Obama has done.
Hi Ex-GOP,
Poll after poll showed that people wanted politicians to focus on the economy. Furthermore, many polls lately have shown the majority of people want to give reform a chance (including Cnn/opinion research late December). Now, the GOP that said “we’re going to focus on the economy” is staging a symbolic vote with no alternative offering of their own. Should be interesting.
:P Like the Chinese curse, eh – “May you live in interesting times”?
The majority “wants to give reform a chance”? Heh – just what do they think will be done? We’ve got like $200,000 or $300,000 of debt and unfunded liability for each American.
We have not been able to reduce the federal gov’t debt by even one penny in around 50 years. (Clinton didn’t have a surplus – when the “off-budget” items are included, the gov’t was running red ink all along…)
Moreover, we have not been able to make any meaningful progress on even reducing the rate of growth of our debt.
Do people really expect the politicians to do much on this, at this late date? It’s like closing the barn door after the horse already ran out, went down the road, ate some daisies and then later died of old age, ten years ago.
Ex-RINO said: “truth – do you believe any citizen should get whatever care they want during end of life? 90 year old wants a heart transplant – do you believe we should give that to them?”
It would depend. Do they carry insurance that covers it? Is there a heart available? Do they want one? Are they otherwise healthy? etc
(Truthseeker): It is not right for the government or the insurance companies to deny the care because the patient has paid them so much money throughout their lifetime.
Then, T, do you say that people who have not paid in so much should not get the care?
As far as I know insurance companies have been surviving fine.
; ) Agreed, for some of them. Not the AIG’s etc., who were run by idiots, like our government has been as far as fiscal matters. And the good insurance companies didn’t feel compelled to “buy votes” regardless of the long-term costs along the way.
These issues do not need to be regulated by you or the government.
Again, for Pete’s sake – how long do you think Medicare has been around? C’mon, man….
Doug said: “Then, T, do you say that people who have not paid in so much should not get the care?”
Not necessarily, but I definitely do say that the people who paid into health insurance deserve it.
Doug said: Again, for Pete’s sake – how long do you think Medicare has been around? C’mon, man….
Doug, I am not that up on Medicare so I couldn’t tell you exactly how they regulate end-of-life care (There were no panels getting involved in my father’s end-of-care). I assume that is because the decision is left up to the patient and their doctor etc. But the point I am making is that it is not good to have the government making these kinds of decisions. That is why I think private insurance is the best way to go.
(Truthseeker):I definitely do say that the people who paid into health insurance deserve it.
The problem is still there – how much do they have to pay? Medicare is paying much more during the final year of some people’s lives than the person put in during all their years. And what of people, the disabled, the developmentally-impaired, etc., who have never been able to contribute, or to contribute much?
Left on their own, don’t you think that private insurance companies limit payments?
Almost all of us would draw the line somewhere. You seriously can’t want Terry Schiavo-type situations where a human body is kept alive by expensive medical means, this time at taxpayer expense, can you?
Even if you do, I think you would still draw the line somewhere. We don’t want orphans to starve, for example, but again – there is not unlimited money to spend on everybody, or even just those who have “paid in” or “paid a lot in.”
As a country, we have lived beyond our means, financially, for a long time. Now we are faced with not just returning to “normal” but with only being able to spend what would have been less than “normal,” had we not accumulated so much debt. For a long time, it’s been “more and more,” but eventually it will be not only “not more,” but actually “less.”
Doug said:
“The problem is still there – how much do they have to pay.”
Doug, how much they should have to pay should depend upon the policy you purchase. For example last year I had a policy that had a lifetime maximum and I didn’t mind having a lifetime maximum on my policy l cause it saved me money. Now Obamacare has mandated EVERY policy must have no lifetime maximum and because of that I am paying more for my policy. See how government mandates screw up peoples choices?
Doug said: “Medicare is paying much more during the final year of some people’s lives than the person put in during all their years.”
Doug, maybe Medicare overall would be doing well if they had left our funds making interest and compunding for the past fifty five years. Especially with all the people who pay in and croak before retirement. The biggest problem with Medicare is that the government spent all the money on things other than our medical care. That is one more BIG problem with Obamacare is that it contains no provision to stop them from doing the same thing they did with Medicare and raiding the funds from Obamacare premiums and penalties that are levied to citizens who do not buy their plan.
reposting the above comment due to editing problems.
Doug said:
“The problem is still there – how much do they have to pay.”
Doug, how much they should have to pay should depend upon the policy you purchase. For example last year I had a policy that had a lifetime maximum and I didn’t mind having a lifetime maximum on my policy cause it saved me money. Now Obamacare has mandated EVERY policy must have no lifetime maximum and because of that I am paying more for my policy. See how government mandates screw up peoples choices?
Doug said: “Medicare is paying much more during the final year of some people’s lives than the person put in during all their years.”
Doug, that is true, but Medicare overall might be solvent if they had left our funds making interest and compunding for the past fifty five years. Especially with all the people who pay in and croak before retirement. The biggest problem with Medicare is that the government spent all the money on things other than our medical care. One more BIG problem with Obamacare is that it contains no provision to stop them from doing the same thing they did with Medicare and raiding the funds. They would abscond with all those Obamacare premiums and penalties that are levied to citizens who do not pay into their exchanges.
These Democratic politicians are so drunk on the power they had for the past two years that they have no qualms coming right out and telling you that you have to buy their policy and you have to accept their terms and that eligibility for care is determined by a panel of lifetime political ‘appointees’ (not even elected). Many of the Democratic senators who denied the will of the people in town hall meeting and voted for Obamacare are now gone. Many more still remain in denial even after the people told them again last election. Those senators who vote against repeal this year will be sent packing with Obama come November 2012.
truth –
The darn irony of it all – is if you actually did a little research, one of the biggest criticisms of Ryan’s plan is that it would be massive rationing of Medicare. The growth of his vouchers would be less than the growth of medicare – thus care would be cutback. Google “paul ryan medicare rationing” – you’ll find plenty of information.
To follow-up on your earlier question – one has Medicare, the other private insurance (they are an older person married to a younger person that works at your company – so they are in your general pool coverage). 90 years old – transplant might give them another 6 months to a year of life.
Doug
It sure is an interesting cycle. Poll after poll (exit polls) showed that people want the economy looked at and the debt. So now the GOP is going after reform first. Problem is, I don’t think they have a meaningful plan on the debt – a couple of earmarks here and there – but when they have power, they spend worse then the Democrats do. Maybe they’ll get a repeal and do another medicare expansion (unpaid for of course).
Ex-RINO said: “The darn irony of it all – is if you actually did a little research, one of the biggest criticisms of Ryan’s plan is that it would be massive rationing of Medicare.”
Ex-RINO, The Ryan plan leaves Medicare benefits where they are for the current/older population and gets rid of Medicare all together and replaces it with private health savings that individuals control for themselves and the value of their health savings is transferrable to their children. My understanding is that the Ryan plan is to get the younger generation off Medicare all together, not ration it.
truth – a couple of things here. First – a good interview with Ryan (from Klein, quoted on the first page earlier today – includes the quote from Ryan that rationing happens today and says either the Government will ration care, or we’ll essentially ration it for ourselves)
http://voices.washingtonpost.com/ezra-klein/2010/02/rep_paul_ryan_rationing_happen.html
Ryan’s plan, if acted upon now, would affect you and me (I think we aren’t too far off age wise if I remember right). Instead of getting Medicare when you are old enough, you’d get a voucher from the government. That voucher decreases over time – and with that voucher, you are to buy insurance.
From the CBO on Ryan’s plan with Medicare. Essentially, you and I will either need a chunk of extra change to get full coverage, or we’ll have worse coverage then Medicare folks do now – meaning that if we don’t get better coverage, we’ll need to skip care (thus rationing):
last year I had a policy that had a lifetime maximum and I didn’t mind having a lifetime maximum on my policy cause it saved me money. Now Obamacare has mandated EVERY policy must have no lifetime maximum and because of that I am paying more for my policy. See how government mandates screw up peoples choices?
: P Truthseeker, you’re suddenly concerned about choice, now? ; )
I really don’t know what is best for the most people, in this deal. There is so much arguing and posturing, and we have not even really gotten into the rough going as far as health care costs. I heard this morning that the health care law is 2300+ pages. I thought it was over 2700, but that’s still a heck of a thing.
Doug said:
“There is so much arguing and posturing, and we have not even really gotten into the rough going as far as health care costs. I heard this morning that the health care law is 2300+ pages.”
That is the pity Doug. They pushed so hard to force through 2300 pages of mandates but there is no reduction of health care costs in those 2300 pages. This is proven by the fact that the feds had to grant some 230 large unions and corporations waivers fom the law or they would have had to drop coverage for 100’s of thousands of employees. Oops! I guess that was pretty poor planning to pass a law that would strip peoples insurance away. And other individuals like me are paying increased deductibles and co-pays and premiums due to Obamacare.
I also here that they are regulating some insurance companies out of the market (and health insurance agents out of their jobs) by mandating they use no more than 15% of premiums to pay for administrative costs. This is the kind of regulatory crap that those 2300 pages are loaded with.
Ex-RINO, I read the Ryan plan and I didn’t see where the government takes back any vouchers. Are those vouchers in addition to your private health savings account that you can leave to your kids if you don’t use it?
I’m sure it will horrify you to learn that end of life counseling is standard procedure in virtually all nursing homes. On the plus side, it has absolutely nothing to do with rationing care or giving the government any power to make those decisions.
I used to be a social worker at a nursing home, and end of life counseling was a standard part of every intake that I conducted. It involves laying out the options for each person, and does not involve any sort of coercion or pressure whatsoever. If the person chose a Do Not Recussitate order it is only valid if signed by themselves, a witness not employed by the facility, and the doctor after certifying the person is competent. It’s all about giving people more control over the end of their lives, not less.
And newsflash, almost every elderly resident chose a Do Not Recussitate order. The attitude I most commonly found was “When it’s my time, just let me go.”
I’m not sure if the misinformation you’re pushing here is due to ignorance or a wilfull desire to misinform, but you desparately need to acquire either some education or a sense of shame.
truth – you really continue to amaze me. One of the coolest features of the new law – and I haven’t seen people upset about this – is the fact that it says that large insurance companies need to pay at least 85% of the money that comes in on actual care. The “administrative costs” are actual admin costs, but marekting, bonuses, etc. It is partially in response to inequities around the country – for instance, in Wisconsin and Minnesota, most plans were around that 90%. In other parts of the country, plans are spending as low as 70% of the money they get in on actual care. I mean, $1000 in monthly premium, and 30% going to marketing and admin costs? Seriously?
Don’t you think that is a crock of poo?
Truth – right from Ryan’s plan. You get money – you purchase insurance – when you can’t afford, you can’t afford (rationing – exactly what you are hammering on):
Medicare Payment. For future Medicare beneficiaries who are now under 55 or younger (those who first become eligible on or after 1 January 2021), the proposal creates a standard Medicare payment to be used for the purchase of private health coverage. Currently enrolled Medicare beneficiaries and those becoming eligible in the next 10 years (i.e. turning 65 by 1 January 2021) will see no changes in the current structure of their Medicare benefits. The payment will be made directly to the health plan designated by the beneficiary (similar to the administration of the refundable health care tax credit), with the beneficiary receiving any leftover amount as a payment from the health plan, or assuming financial responsibility for any difference in the payment and the total cost of the premium. This allows the Medicare beneficiary to invest the leftover amount in a Medical Savings Account [MSA] to pay for other medical expenses, or to purchase long-term care insurance.
Each Medicare beneficiary becomes eligible for the payment by enrolling in a health insurance plan. Medicare will publish an annual list of plans that are “Medicare certified.” Medicare enrollees are able to use their payment to pay for one of the Medicare certified plans, or any other plan, such as those offered by former employers or available from the private market.
When fully phased in, the average payment is $11,000 per year (the average amount Medicare currently spends per beneficiary), and is indexed for inflation by a blended rate of the CPI and the medical care component of the CPI. For affected beneficiaries, the payment replaces all components of the current Medicare Program (Medicare fee-for-service, Medicare Part B, Medicare Advantage, and Medicare Part D). Payment amounts are income-related and risk-adjusted. They also are partially geographically adjusted, with the geographic adjustment phasing out over time.
Newsflash Boo, Its not the decision of wether or not you want them to pull the plug, it the decision to deny you eligibility for say a bone marrow transplant cause they deem you would only get 6 months to year of additional life. It is real and it is scary that a panel of bureaucrats would be given lifetime appointments making those end-of-life decisions and rationing care. That seriously doesn’t bother you?
Ex-RINO, Of course people being moved off Medicare and onto the new health plan would get weaned off Medicare benefits. Thats the whole idea! It is not rationing.
Ex-RINO, 2300 pages and the coolest feature of the new law is a mandate that dictates to insurance companies how they must spend their money. What is next, dictating the type of furniture they can have in their waiting rooms? What, you couldn’t find anything cool in the plan like something that actually lowers the cost for health care? ugh
I understand that the White House is now supposed to take the reinsertion of annual end-of-life (aka Death Panel) discussion Dr. payments out of the new Medicare regulations that they just put in. So they were for it when they put it in the original Obamacare bill then because of public outcry they pulled it out of the bill final bill and now after they snuck it back in by Medicare regulation, they are now going to pull it out again. You could not make up this stuff. God help us.
truth – I’m so confused. So you think if an insurance company or government denies payment of a type of service (that you could get on your own with money) is rationing – but it is not rationing if can’t afford coverage to begin with so you skip services? With all due respect, what the stink is the difference. Do you have any clue what health care rationing really is? The whole point of Paul’s plan is to cover less – therefore, people when they are older won’t get as much care as they do now. That is rationing.
It doesn’t even make sense for me to get into cost control methods if you don’t understand the simple terms of the argument. I’m trying to be nice here, but it is getting old explaining everything along the way. Google “health care reform cost containment (or control)” – save me some work.
And do a little research on health care rationing while you are at it.
“truth – I’m so confused.”
I know you are Ex-RINO. Stop drinking the Kool-aid and things will gradually get clearer for you again. It is a really simple concept. Effective “health care reform cost containment” LOWERS THE COST of health care. Government has never been effective in lowering the cost of anything. Even toilet seats cost the government thousands of dollars.
Do you know anybody other than the US government and Saddam Hussein who has paid thousands of dollars each for toilet seats? At least Saddam’s was made of gold so you could argue his was not wasteful spending.
Again Ex-RINO, the key here that we, as a people, need to lower the cost of health care. Our government has a glaring track record of fiscal irresponsibility and wasteful spending. It is irrational to put them in charge of anything and expect it to become more efficient or to cost less.
Truthseeker, I’m personally okay with the new law being repealed. There are a lot of pros and cons to it, and some things will indeed be more costly while other things become cheaper.
I think that overall my wife and I will probably be better with a repeal. There are also the millions of people who would lose coverage, though…
Doug, what happens to those people now. They don’t go to the doctor as often and when they do they pay the $80 in cash for the visit. I think most of these people who would lose coverage would actually save a lot of money because they otherwise would have to make mandatory monthlt premiums into an Obamacare exchange. So they may not be able to afford all of that ‘free’ health insurance.
I know in 2010 I paid $20 copay per doctors visit and in 2011 it will be a $45 copay per doctor’s visit. and my family’s per person deductible doubled from $1500 annually to $2500 annually and they dropped the out-of-plan option all together and my premiums went up. I can’t afford all this health reform cost control either…wtf are they doing? They are insane.
Not to mention all the unfunded Medicaid liabilities Obamacare throws onto the states. You would likely find many states that would opt out anyway and all the really sick people would move to California or Illinois or some other liberal bastion until those states went completely belly up. It is happening to states already and Obamacare is bad medicine for the state’s budgets.
And what about all those people that could afford health insurance in 2010 but would have had their insurance policies dropped if their employers were not given waivers so they would not have to follow the new law. This is a cluster-
Well, Truthseeker, the cost of health care is a big problem for many people, no matter what. I’ve seen the changes in the past 20 years…. Wonder what it’s going to be like in another 20. Not really hopeful, there.
One thing I’m for is tort reform – some states where judgments are not limited are loosing doctors rapidly – malpractice insurance is so expensive, like $100,000 per year of more, that they just don’t want to work there.
Not saying that it should be impossible to sue a doctor, but we’ve seen some insane judgments for the plaintiffs. And most of them don’t make it past the appeals process, and in the main people are not really collecting the billion-Dollar judgments or the hundred million Dollar ones, but it’s still ending driving doctors away from some areas.
One other really obvious reform would be removing the government controls that force US citizens to pay twice as much as Canadian citizens pay for the same prescription drugs. It was a sham when that got taken out of Obamacare.
Well, T, seems to me the drug companies are pretty good at getting what they want….
: P