Healthcare Hypocricy?

[1979Shocker]

There's been a lot of responses lately. I have a question. Are Republicans in the Senate against end-of-life counseling because they don't want the government intruding into our lives? Or is there some other reason?

[rZ]

I would rather entrust my future to an individualist elitist doodie head who is saliva impaired then to a thousand bureaucrats taking orders from Washington.

Pretty sure we're in the same boat on this one.

[Maggie]

There's been a lot of responses lately. I have a question. Are Republicans in the Senate against end-of-life counseling because they don't want the government intruding into our lives? Or is there some other reason?

Fair question.

Obviously, I can only speak for myself. Part of my problem with this particular section does have to do with government encroachment but I also have a moral objection, etc. I don’t have the time, right now, to properly formulate my thoughts – and, frankly for some reason, I feel odd being compelled to formulate how I feel, on a certain level, about this issue in the first place.

Unfortunately, I have a go out tonight – if you want I’ll try to respond on Sunday or Monday.

[Maggie]

I would rather entrust my future to an individualist elitist doodie head who is saliva impaired then to a thousand bureaucrats taking orders from Washington.

Pretty sure we're in the same boat on this one.

I think you should trust your instincts. By the way, you made some good points, for example:

I for one would love to have a civil debate regarding the political nature of our country today versus the principles upon which it was founded. Unfortunately, I believe today more so than ever, people are unable and unwilling to separate a debate of political ideology from an attack on the individual person.

[1979Shocker]

MEDICARE PRESCRIPTION DRUG, IMPROVEMENT, AND MODERNIZATION ACT OF 2003

Conference Agreement

The conference agreement provides coverage of certain physician's services for certain terminally ill individuals. ...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.

The only difference between this bill and what's in the current health care bill is this bill was only for certain terminally ill individuals.

Incidently, Senator Grassley voted for this bill along with 41 other Senate Republicans and 204 House Republicans.

[1979Shocker]

'End Of Life' Controversy Misunderstood

DES MOINES, Iowa -- Confusion and misinformation leads to fear over an end-of-life counseling provision included in the health care reform proposal.

The legislation would allow Medicare to reimburse doctors for voluntary counseling sessions about end-of-life care, but critics have described it as a way to cut costs by encouraging terminal or elderly patients to accept minimal or no care.

The measure has caused so much confusion that key senators have decided to drop it from a version of the health care reform plan up for debate in the Senate.

Without end-of-life counseling, Hospice of Central Iowa argues that patients would spend more money and may not receive the best care.

"What happens is you get the extreme cases like Terri Schiavo, where people get care they may not have wanted," Wade said.

[ISASO]

So now the administration must resort to demonizing or lying about support from the insurance industry, THE AMERICAN PEOPLE, the AARP, cable news and again The American People in order to ram this crap down out throats.

The libs were counting on the public not caring enough to educate themselves on what it really meant. They were simply praying that they could get this passed before the voters could figure out how disastrous it really would be to the future of this nation.

[1979Shocker]

Jimmy Fallon 'Thank You' note:

"Thank you insurance company Death Panels for unplugging grandma and freeing up an outlet for our new Chevy Volt."

[shocklight]

Jimmy Fallon 'Thank You' note:

"Thank you insurance company Death Panels for unplugging grandma and freeing up an outlet for our new Chevy Volt."

That's funny, but sad just the same.

[kcshocker11]

The libs were counting on the public not caring enough to educate themselves on what it really meant.

I suppose if you begin educating yourself now, in a few weeks youll support HR676. 8)

[ShockCity]

The libs were counting on the public not caring enough to educate themselves on what it really meant.

I suppose if you begin educating yourself now, in a few weeks youll support HR676. 8)

Haaaaa!!! Nice. He's frantically googling it as we speak...

[ISASO]

Actually, no I haven't. I'll wait for a liberal explanation of it then I'll see if it's worth my time.

[kcshocker11]

Actually, no I haven't. I'll wait for a liberal explanation of it then I'll see if it's worth my time.

I admire that driving curiousity! 8)

[RoyalShock]

. . . and Royal, who I will add in, is a radical individualist .

As Christian comedian Mike Warnke so eloquently stated, "if you ain't radical, you ain't spit!"

:good:

[Maggie]

There's been a lot of responses lately. I have a question. Are Republicans in the Senate against end-of-life counseling because they don't want the government intruding into our lives? Or is there some other reason?

What is, or I suppose at least for now was, in my judgment problematic about the “end of life consultation” provision is that, to be discussed seriously, it must be viewed within the context of limiting health-care expenses (which is the often stated goal of the President, etc.).

Viewed in this rubric, there is a considerable difference between encouraging citizens to voluntarily and affirmatively seek out independent counsel with regard to drafting living wills and powers of attorney to ensure that their wishes are honored and the government providing monetary incentives for health-care professionals to approach, presumably while they are in a hospital or doctor’s office, etc., to “discuss” these very sensitive matters. The former minimizes coercion while the latter creates an environment in which coercion is in fact encouraged.

Conservatives, including Palin, are not alone in making this, rather obvious, observation. For example, here are two commentators who call attention to this issue and can hardly be called conservative:

Mickey Kaus in Slate:

http://www.slate.com/blogs/blogs/kausfiles/archive/2009/08/12/will-you-won-t-you-be-on-my-death-panel.aspx

And, in pertinent part, Charles Lane in The Washington Post:

Section 1233, however, addresses compassionate goals in disconcerting proximity to fiscal ones. Supporters protest that they're just trying to facilitate choice -- even if patients opt for expensive life-prolonging care. I think they protest too much: If it's all about obviating suffering, emotional or physical, what's it doing in a measure to "bend the curve" on health-care costs?

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.

What's more, Section 1233 dictates, at some length, the content of the consultation. The doctor "shall" discuss "advanced care planning, including key questions and considerations, important steps, and suggested people to talk to"; "an explanation of . . . living wills and durable powers of attorney, and their uses" (even though these are legal, not medical, instruments); and "a list of national and State-specific resources to assist consumers and their families." The doctor "shall" explain that Medicare pays for hospice care (hint, hint).

Admittedly, this script is vague and possibly unenforceable. What are "key questions"? Who belongs on "a list" of helpful "resources"? The Roman Catholic Church? Jack Kevorkian?

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. (emphasis added).

As it happens, I have a living will and a durable power of attorney for health care. I'm glad I do. I drew them up based on publicly available medical information, in consultation with my family and a lawyer. No authority figure got paid by federal bean-counters to influence me. I have a hunch I'm not the only one who would rather do it that way.

In short, Palin’s rhetoric might have been over the top (and I would concede it was) but she has a point.

I’ll cross post this in the “Death Panel” thread.