End of life counseling veto

[WC_lun]

How is the Obama healthcare reform rationing healthcare? It is actually providing healthcare for more people, though perhaps at contreversial higher upfront cost of some people who do not at the moment need health care. Please don't quote some political hack or radio host. Please tell me how you feel it is rationing healthcare.

 

[billc]

The above was not a political hack, but the brother of Rahm Emanuel, Ezekiel Emanuel and he is a former advisor to the President on Health care reform. These are his beliefs about the U.S. health care system, not Rush's, Beck's, Hannity's or Coulter's. They have already tipped their hand with the exams for breast cancer and the chemotherapy drug Avastin. It is only going to get worse as Obama care gets implemented.

 

[Archangel M]

People wouldn't fall for this..that would be like believing in eugenics, or a master race, or...

Oh...wait...

 

[ballen0351]

End of life counseling has nothing to do with people dying?


.

Then why did you bring it up? The very first post you put on this thread was "Have you ever watched someone you love die?" if it has nothing to do with end of life counseling then why bring it up?

 

[Bill Mattocks]

I see nothing nefarious in "End of Life Counseling," per se. However, having been defeated in Congress, I am more than a little upset at seeing it snuck in through bureaucratic rule-writing tactics by the agency in question...

http://www.washingtonpost.com/wp-dyn/content/article/2010/12/30/AR2010123004409.html

Rep. Earl Blumenauer (D-Ore.), 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."

It is the underhandedness of the issue I find objectionable. I don't really care one way or the other if Medicare reimburses doctors for offering such counseling. I do not see it as the 'Death Panels' that last year's weepers and whiners were sniffling on about, nor do I think it will necessarily become mandatory. However, the continued end-run around Congress by the Administration's lackeys that run the various departments has me more than a little concerned.

On Dec. 23, the Interior Department issued Secretarial Order 3310, reversing a 2003 decision and giving itself the authority to designate public lands as "Wild Lands." A clever twofer: (1) a bureaucratic power grab - for seven years up through Dec. 22, wilderness designation had been the exclusive province of Congress, and (2) a leftward lurch - more land to be "protected" from such nefarious uses as domestic oil exploration in a country disastrously dependent on foreign sources.

If the Administration cannot achieve their goals in Congress, nor in the court of public opinion, behind-the-scenes rule-writing to do it anyway just flat out ticks me off. It's wrong, it's dishonest, and anyone who supports such things is a crook in my opinion. The ends (it's good for you, as the hand-wringing lefties say) do not justify the means. But the right-wing kooks can kindly take a flying leap as well. They make intelligent people who happen to be conservatives look very bad.

 

[ballen0351]

If the Administration cannot achieve their goals in Congress, nor in the court of public opinion, behind-the-scenes rule-writing to do it anyway just flat out ticks me off. It's wrong, it's dishonest, and anyone who supports such things is a crook in my opinion. The ends (it's good for you, as the hand-wringing lefties say) do not justify the means. But the right-wing kooks can kindly take a flying leap as well. They make intelligent people who happen to be conservatives look very bad.

You would think both the Left and Right would be upset by this but like everything else if the back dooring fits your agenda its ok until the other side uses the same tactic.

Id write my Senator but it wont do anygood.

 

[Flea]

Here is a question. For those who believe Bush violated the constitution, lied us into war with iraq and killed a million people for this oil, what makes you think that this millitary, industrial, beauracratic complex will hesitate to encourage your loved one to not take the steps to preserve their life if it saves this corrupt government a few pennies? This is why the government should stay out of end of life counseling, it is only going to lead to bad things.

This is something of a tangent, and a rhetorical one, but worth pointing out. By your rationale, Medicare and Medicaid would be actively pushing contraception and abortion for the phenomenal money-saver it is. No pregnancy = no prenatal care = no birth or c-section = no pediatrics and vaccinations = etc. And ultimately, end of life counseling for fewer recipients. If they wanted to cut costs by encouraging non-existence, that would be the big money.

I'm not really interested in jumping into this particular fray, but I felt this was worth mentioning. Back to your regularly scheduled program ...

 

[ballen0351]

This is something of a tangent, and a rhetorical one, but worth pointing out. By your rationale, Medicare and Medicaid would be actively pushing contraception and abortion ...

We push abstinence its the only sure fire effectlve way to not get pregnant and not get an STD, and best of all you dont have to kill any babys in the process.

 

[WC_lun]

Okay, regardless of who the author of the article might be, please tell me how you feel it is rationing healthcare.

Bill Mattocks, I might not agree with you, but at least your arguement is a well reasoned one. I can completly understand not liking anything being snuck in through procedural trickery.

 

[billc]

As Obamacare kicks in, our already broke government is going to have to spend more money to cover the medical costs of 30 million new recipients. Add on to that the waste, fraud and abuse in any government activity and the system is going to be a disaster. Medicare and Medcaid are already broke. Obamacare is going to make it worse. How do you pay for all the medical care, you have to ration the care. They already spoke about cutting out breast exams for women until they reach, I don't remember exactly, age 50 maybe, I need to look it up. Since it was before the election when that little fact came out, they decided that that particular recomendation was a non-starter. the problem is they recommended it. ONce Obamacare sets in, these things are going to start happening. The drug Avastin is a cancer fighting drug. It's expensive, so they want to discontinue its use. Rationing has to happen because the government has no money to spend now. It won't get better with obamacare.

Zeke Emanuel's paper talks about the way you would need to ration care, with the most consideration going to 15-40 year olds. The new head of Medicare, the guy put in through the recess appointment loves the U.K. NHS, and believes that more general practitioners are needed over specialist. People in the medical field will tell you that general practitioners tell you you have a problem, it is the specialist that gets the problem fixed. By focusing on general practitioners you are increasing the risk to patient survival, especially for heart disease and cancer. The focus on general practitioners is how the rationing comes in under the radar. Specialists also cost more money. Another way to ration under the radar, decrease the number of specialists.

 

[ballen0351]

Okay, regardless of who the author of the article might be, please tell me how you feel it is rationing healthcare.

.

Did you watch the clip in the OP that was cited? They talk about it. One of the main goals of this "end of life" is for doctors to try to cut costs in this new bill by talking elderly people out of costly medical treatment.
I personally dont think most Doctors would do this. They take an Oath help people not talk them into dying faster. I would not however put it past the Fed to step in and have Govt employee "counselor" whos job it will be to ration the care. But I dont see that taking place either because I believe the Heath Care bill will be over turned in the Supreme Court

 

[billc]

I don't remember which health care advisor said it but one of them spoke about how doctors are trained incorrectly. They pay too much attention to the hippocratic oaths ideal of doing everything they can to help their patient. This guy said doctors need to be trained to look at the health care system as a whole, not as individual patients.

 

[billc]

Here it is:

"True reform, he argues, must include redefining doctors' ethical obligations. In the June 18, 2008, issue of JAMA, Dr. Emanuel blames the Hippocratic Oath for the "overuse" of medical care: "Medical school education and post graduate education emphasize thoroughness," he writes. "This culture is further reinforced by a unique understanding of professional obligations, specifically the Hippocratic Oath's admonition to 'use my power to help the sick to the best of my ability and judgment' as an imperative to do everything for the patient regardless of cost or effect on others."

 

[WC_lun]

As Obamacare kicks in, our already broke government is going to have to spend more money to cover the medical costs of 30 million new recipients. Add on to that the waste, fraud and abuse in any government activity and the system is going to be a disaster. Medicare and Medcaid are already broke. Obamacare is going to make it worse. How do you pay for all the medical care, you have to ration the care. They already spoke about cutting out breast exams for women until they reach, I don't remember exactly, age 50 maybe, I need to look it up. Since it was before the election when that little fact came out, they decided that that particular recomendation was a non-starter. the problem is they recommended it. ONce Obamacare sets in, these things are going to start happening. The drug Avastin is a cancer fighting drug. It's expensive, so they want to discontinue its use. Rationing has to happen because the government has no money to spend now. It won't get better with obamacare.

Zeke Emanuel's paper talks about the way you would need to ration care, with the most consideration going to 15-40 year olds. The new head of Medicare, the guy put in through the recess appointment loves the U.K. NHS, and believes that more general practitioners are needed over specialist. People in the medical field will tell you that general practitioners tell you you have a problem, it is the specialist that gets the problem fixed. By focusing on general practitioners you are increasing the risk to patient survival, especially for heart disease and cancer. The focus on general practitioners is how the rationing comes in under the radar. Specialists also cost more money. Another way to ration under the radar, decrease the number of specialists.

Okay, so this program gives access to affordable health care for over 10 million people who do not have it now. While in the program, there are certain restrictions to what it will pay due to medical doctor's reccomendation, like ANY OTHER INSURANCE PROGRAM. At this moment, people who become ill with catastrophic illnesses are removed from thier insurance through increasingly raised premium and deductable cost or just plain denial of coverage because they had the misfortune of becoming sick..which is why people buy insurance in the first place. This won't happen under the new program. Medical care is already being rationed. The new progam is actually increasing the availability to more people. That is not rationing.

The goal age for breast exam coverage is 32, not 50. I haven't seen anything about Avastin. I have seen where coverage for generic drugs is going to be preferred over name brand because they are cheaper. This is nothing new as every insurance company does the same and there is no risk in it since the drugs are the exact same. I also saw where immonosuppresant drugs, which are very, very, expensive will be covered. Most insurance companies will not cover them, especially if you need or have a transplant before you seek insurance.

You aren't understanding why the use of general practitioners are desired. Right now most doctors go into a specialization because it is more luctrative. When you become ill, you bouce from one specialist to another, each paying attention to his own narrow study field. Unfortunately this leads to the left hand not knowing what the right hand is doing. You get repeated test by different specialist, missed diagnosis, and hit or miss healthcare because there is no central ad organising doctor. General pratitionors fill that roll. Hospitals have realised this and for years have beeen assigning patients a general pratitioner even when thier illness is specific to things like cancer or organ failure. This is not something new to "Obamacare." It is true that a side effect of this better patient coverage is indeed lower cost.

There are things wrong with the health care reform bill, in my opinion. The rationing of healthcare isn't one of them. It is a scare tactic used by people who have a vested interest in the reform failing, much like death panels.

 

[billc]

I guess for this debate we will just have to wait and see. It will eventually play itself out.