posted August 11, 2009 05:04 PM            

Sarah Palin, the former governor of Alaska, urged her supporters to oppose Democratic plans for health care reform on her Facebook page.

"As more Americans delve into the disturbing details of the nationalized health care plan that the current administration is rushing through Congress, our collective jaw is dropping, and we’re saying not just no, but hell no!" wrote Palin in a note posted Aug. 7, 2009.

She said that the Democrats plan to reduce health care costs by simply refusing to pay for care.

"And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. 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."

We agree with Palin that such a system would be evil. But it's definitely not what President Barack Obama or any other Democrat has proposed.

We have read all 1,000-plus pages of the Democratic bill and examined versions in various committees. There is no panel in any version of the health care bills in Congress that judges a person's "level of productivity in society" to determine whether they are "worthy" of health care.

Palin's claim sounds a little like another statement making the rounds, which says that health care reform would mandate counseling for seniors on how to end their lives sooner. We rated this claim Pants on Fire! The truth is that the health bill allows Medicare, for the first time, to pay for doctors' appointments for patients to discuss living wills and other end-of-life issues with their physicians. These types of appointments are completely optional, and AARP supports the measure.

Palin also may have also jumped to conclusions about the Obama administration's efforts to promote comparative effectiveness research. Such research has nothing to do with evaluating patients for "worthiness." Rather, comparative effectiveness research finds out which treatments work better than others.

The health reform bill being considered in the House of Representatives says that a Comparative Effectiveness Research Center shall "conduct, support, and synthesize research" that looks at "outcomes, effectiveness, and appropriateness of health care services and procedures in order to identify the manner in which diseases, disorders, and other health conditions can most effectively and appropriately be prevented, diagnosed, treated, and managed clinically."

The idea here, which Obama and his budget director Peter Orszag have discussed many times, is to make it easier for doctors, health care workers, insurance companies and patients to find out which treatments are the most effective, as determined by clinical studies and other research.

Obama has said he believes a comparative effectiveness commission should advise health care workers, not require them to follow certain treatments.

"I actually think that most doctors want to do right by their patients. And if they’ve got good information, I think they will act on that good information," Obama said during an interview with the New York Times on April 28, 2009.

He also specifically addressed end-of-life care for seniors, discussing the last week of his grandmother's life in 2008, and how her family and doctors decided on treatment for her.

"It is very difficult to imagine the country making those decisions just through the normal political channels," Obama said. "And that's part of why you have to have some independent group that can give you guidance. It's not determinative, but I think has to be able to give you some guidance. And that's part of what I suspect you'll see emerging out of the various health care conversations that are taking place on the Hill right now."

And in fact, the House bill states in the section creating the Comparative Effectiveness Research Center and an oversight commission, "Nothing in this section shall be construed to permit the Commission or the Center to mandate coverage, reimbursement, or other policies for any public or private payer." In other words, comparative effectiveness research will tell you whether treatment A is better than treatment B. But the bill as written won't mandate which treatment doctors and patients have to select.

Palin's statement seems extreme, but other Republicans, like Newt Gingrich, are backing her up. "You're asking us to trust turning power over to the government, when there clearly are people in America who believe in establishing euthanasia, including selective standards," Gingrich said in an interview on This Week with George Stephanopolous on Aug. 9, 2009.

We've looked at the inflammatory claims that the health care bill encourages euthanasia. It doesn't. There's certainly no "death board" that determines the worthiness of individuals to receive care. Conservatives might make a case that Palin is justified in fearing that the current reform could one day morph into such a board.

But that's not what Palin said. She said that the Democratic plan will ration care and "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." Palin's statement sounds more like a science fiction movie (Soylent Green, anyone?) than part of an actual bill before Congress. We rate her statement Pants on Fire!

posted August 12, 2009 10:02 AM            

This is what happens when a Socialist front organization like the St Petersburg Times attempts an exercise in thought.

The facts are in the proposed so called health care bills.

In order to pay for a Socialist health care system O'Bomber proposes to take more than $500,000,000,000 out of Medicare. For the non counters, that's more than half a TRILLION dollars.

The natural consequences of this hair brained scheme will be health care rationing for the elderly and for those disabled who are on Social Security Disability.

Further, there are provisions in all these Socialist health care bills to screen health care through the prism of a cost benefits analysis with petty bureaucrats making medical decisions...instead of doctors and patients.

This will lead to rationing of health care and refusal to treat common illnesses and diseases.

Plain is right. Polifacts is, as usual wrong or lying through their teeth...as is the Marxist Socialist Bomber and his Socialist buds in Congress.

posted August 12, 2009 12:28 PM            

Dr. Ezekiel Emanuel, the medical ethicist and oncologist who advises President Obama, does not own a television, and if you catch him in a typically energized moment, when his mind speeds even faster than his mouth, he is likely to blurt out something like, "I hate the Internet." So it took him several days in late July to discover he had been singled out by opponents of health-care reform as a "deadly doctor," who, according to an opinion column in the New York Post, wanted to limit medical care for "a grandmother with Parkinson's or a child with cerebral palsy." (Read an interview with Obama on health care.)

"I couldn't believe this was happening to me," says Emanuel, who in addition to spending his career opposing euthanasia and working to increase the quality of care for dying patients is the brother of White House chief of staff Rahm Emanuel. "It is incredible how much one's reputation can be besmirched and taken out of context." (See pictures of health care for the uninsured.)

It would only get worse. Within days, the Post article, with selective and misleading quotes from Emanuel's 200 or so published academic papers, went viral. Minnesota Representative Michelle Bachmann, a fierce opponent of Obama's reform plans, read large portions of it on the House floor. "Watch out if you are disabled!" she warned. Days later, in an online posting, former Alaska Governor Sarah Palin attacked Emanuel's "Orwellian thinking," which she suggested would lead to a "downright evil" system that would employ a "death panel" to decide who gets lifesaving health care. By Aug. 10, hysteria had begun to take over in places. Mike Sola, whose son has cerebral palsy, turned up at a Michigan town-hall meeting to shout out concerns about what he regarded as Obama and Emanuel's plans to deny treatment to their family. Later, in an interview on Fox News, Sola held up the Post article. "Every American needs to read this," he declared. (Read "What Health-Care Reform Really Means.")

By this point, Emanuel, who has a sister who suffers from cerebral palsy, had arrived in northern Italy, where he planned to spend a week on vacation, hiking in the Dolomites. Instead, he found himself calling the White House, offering to book a plane home to defend his name. "As an academic, what do you have? You have the quality of your work and the integrity with which you do it," he said by phone from the Italian Alps. "If it requires canceling a week's long vacation, what's the big deal?" (Read TIME's cover story "Can Obama Find a Cure?")

The attacks on Emanuel are a reminder that there is a narrow slice of Americans who not only don't trust government, but also have come to regard it as a dark conspirator in their lives. This peculiar brand of distrust helps create the conditions for fast-moving fear-mongering, especially on complex and emotionally charged topics like the life and death of the elderly and infirm. Prairie fires of that kind are hard to douse when the Administration's own plan for health care remains vague, weeks away from being ready for a public rollout. The health-care bill that recently passed the House does not contain, as some have suggested, any provisions that would deny treatment to the elderly, infirm or disabled like Sola's son. One provision allows doctors to be reimbursed for voluntary discussions of so-called living wills with patients, but does not in any way threaten to deny treatment to dying patients against their will. The legislation anticipates saving hundreds of billions of dollars by reforming the health-care system itself, a process that would try to increase the efficiency of medical care by better connecting payments to health outcomes and discouraging doctors from unnecessary tests and procedures. The Obama Administration hopes that many of these reforms will be made in the coming years by independent panels of scientists, who will be appointed by the President and overseen by Congress. (See 10 health-care-reform players.)

This is where the criticism of Emanuel enters the picture, since he is just the sort of scientist who might be appointed to one of those panels. For decades, Emanuel has studied the ethics of medical care, especially in situations where a scarcity of resources requires hard decisions to be made. His work sometimes deals with the hardest possible decisions, like how to choose who gets a single kidney if there are three patients in need, or the reasons that doctors order tests with little medical value. Emanuel's reputation ranks him among the top members of his field. He is published often in the best journals; he has been given multiple awards for work to improve end-of-life care. At the White House, he has taken a free-floating role at the Office of Management and Budget, advising on a wide range of health issues.

But in a country where trust is in short supply, Emanuel has become a proxy for all the worst fears of government efforts to rein in costs by denying care. "The fundamental danger is that the American people are being asked to delegate all these life-influencing decisions," explains Betsy McCaughey, the conservative scholar who wrote the New York Post attack on Emanuel. "There is a lack of transparency here."

In her Post article, McCaughey paints the worst possible image of Emanuel, quoting him, for instance, endorsing age discrimination for health-care distribution, without mentioning that he was only addressing extreme cases like organ donation, where there is an absolute scarcity of resources. She quotes him discussing the denial of care for people with dementia without revealing that Emanuel only mentioned dementia in a discussion of theoretical approaches, not an endorsement of a particular policy. She notes that he has criticized medical culture for trying to do everything for a patient, "regardless of the cost or effects on others," without making clear that he was not speaking of lifesaving care but of treatments with little demonstrated value. "No one who has read what I have done for 25 years would come to the conclusions that have been put out there," says Emanuel. "My quotes were just being taken out of context."

For Emanuel, the entire experience has been a painful education in the sometimes brutal ways of politics, something his brother has long endured and dolled out. "I guess I have a better appreciation for what Rahm had to go through for years and years," Emanuel says. But that appreciation does not solve the question raised by the controversy. There is universal understanding that the nation's fiscal course is doomed without major changes to health care, but whom will the American people trust to carry it out?

Emanuel, for his part, plans to continue his work, which is focused on finding the most equitable and ethical way for this reform to be carried out, even if he has opted against returning from the Italian Alps. "I am an Emanuel," he says. "We are pretty thick-skinned. I am not going to change my colors. I am not going to crawl under a rock."

Read "The Five Biggest Hurdles to Health-Care Reform."

See TIME's health and medicine covers.

posted August 12, 2009 02:37 PM              

"http://www.ibdeditorials.com/IBDArticles.aspx?id=333933006516877
Published: Aug 10, 2009
Author: Toocowardlytosignit
Post Date: 2009-08-10 16:03:19 by Mekons5
Keywords: None
Views: 433
Comments: 12

At a town hall meeting at AARP headquarters in Washington, D.C., President Obama was asked by a woman from North Carolina if it was true "that everyone that's Medicare age will be visited and told they have to decide how they wish to die."

At first, the president joked that not enough government workers existed to ask the elderly how they wanted to die. The idea, he said, was to encourage the use of living wills and that critics were misrepresenting the intent of the "end of life" counseling provided for in the House bill. He did not say, "No, they wouldn't be contacted."

This administration, pledging to cut medical costs and for which "cost-effectiveness" is a new mantra, knows that a quarter of Medicare spending is made in a patient's final year of life. Certainly the British were aware when they nationalized their medical system.

The controlling of medical costs in countries such as Britain through rationing, and the health consequences thereof are legendary. The stories of people dying on a waiting list or being denied altogether read like a horror movie script.

The U.K.'s National Institute for Health and Clinical Excellence (NICE) basically figures out who deserves treatment by using a cost-utility analysis based on the "quality adjusted life year."

One year in perfect health gets you one point. Deductions are taken for blindness, for being in a wheelchair and so on.

The more points you have, the more your life is considered worth saving, and the likelier you are to get care.

People such as scientist Stephen Hawking wouldn't have a chance in the U.K., where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless."

the last paragraph attracted a little ridicule so it has been deleted and replaced with some equally stupid assertions about dr emmanuel's intentions...

why was it deleted? because stephen hawking objected IN PRINT to the allegations that the national health in the UK would ration his care...after all he has lived there and USED the national health all his life (well since it started when he was 6 years old)

posted August 12, 2009 02:40 PM              

Since its birth in 1948 Britain's National Health Service (NHS) has been a model for the rest of the world. It's been a national system of publicly owned and accountable hospital and community services funded from central taxation - where hospital doctors and nurses are salaried, under national terms and conditions of service.
Universal healthcare, provided free and fairly, released the population from fear of the risks and costs of care. Before the NHS more than half the population - mainly women, children and the elderly had no health coverage.

However, a relentless concern with cost-cutting and market-defined 'efficiencies' over the last two decades has drastically eroded the central premises of universal healthcare in Britain. The undermining of central taxation as the funding base has been accompanied by governments shifting the costs and risks to patients and their families. The internal market introduced by Margaret Thatcher in the 1980s was the most visible aspect of these changes, but Tony Blair's Labour Government has followed the same privatizing path. The 1948 contract with the people is slowly being shredded.

In 2000 the Government launched a 10-year 'reform' programme called the NHS Plan which continued the market-oriented, probusiness policies begun under the Tories. The Blair administration maintains that it doesn't matter who provides care - so long as it is publicly funded. And the extra costs of private profits? They're to be offset by increased efficiency and access, a claim which has been neither tested nor subject to scrutiny. The reality is that under the new plan people will pay more tax for fewer services and be hit with extra patient charges, plus the cost of private insurance. The NHS will be funder and regulator - but business will run the show.

Choice and competition: that's the promise. With 'money following the patient', competition between providers is intended to improve both efficiency and quality of care. Doctors, nurses, hospital and community services will be more responsive to patient needs.

The Government claims that the NHS is centralized, bureaucratic and inflexible - a claim which has little evidence other than popular myth to support it. The Health Secretary, Alan Milburn, talks about 'redefining' the National Health Service: 'Changing it from a monolithic, centrally run, monopoly provider to a system where different healthcare providers - public, private, voluntary and not-for-profit - work to a common ethos, common standards and a common system of inspection... This is the modern definition of the NHS.'

In 1992 the Conservatives created the Private Finance Initiative (PFI) as a scheme for luring private capital into new hospitals, instead of using tax money. It e seems simple. Bankers. builders and service operators (like cleaning, catering and laundry firms) produce the cash and in return they get to lease the building back to the Government or to sell their services to the hospital. The contract is ringfenced and guaranteed, usually for 30 years. Predictably these public-private partnerships have turned out to be a boon for investors but not so good for the public. Shareholder returns in the range of 15-25 per cent and the need for profits increase the costs to local communities.

And the private sector's view of 'efficiency' has meant reduced services and job redundancies. Because the cost of PFI is met from the annual operating budgets of the hospital, less is available for direct patient care. The high costs of the first wave of PFI hospital schemes resulted in a 30-per-cent reduction in beds and a 25-per-cent reduction in budgets for clinical staff. More than 12,000 NHS beds have closed since 1997.

Low-paid, non-union jobs Britain has also been exporting this model abroad to Canada, Australia, Aotearoa/New Zealand and Europe - with similar results. In Abbotsford, British Columbia, a plan to rebuild the local hospital with private funding has run into stiff opposition from the Hospital Employees Union. A report on the scheme by PricewaterhouseCoopers assumed that collective bargaining rights would be destroyed and that cost-savings would be based on low-paid, non-union jobs.
Back in Britain in '2000 the Secretary of State signed a new 'concordat' with the private sector, describing it as 'a permanent feature of the new NHS landscape'. The agreement allows private clinics and hospitals to provide the public with up to 150,000 'procedures a year - things like cataract surgery, hip replacements or hernia operations. It also allows business to run NHS hospitals, form joint ventures with NHS organizations and to recruit overseas clinical teams for existing hospitals.

Alan Milburn has allowed eight private corporations to bid for public hospitals which don't meet the Government's draconian performance targets. These are BUPA and BMI (which together control 70 per cent of the British private health-insurance market), the Swedish-owned Capio, Interhealth Canada, Hospitalia Active Health from Germany and the British-owned Serco, Secta Group and Quo Health. Some of these outfits have never run hospitals before. The others have never run hospitals like those of the NHS which are at least 10 times the size of a typical private hospital.

The most controversial element is the creation of independent public-interest corporations with 'Foundation status'. These organizations will have NHS assets transferred to their ownership and be granted a licence to operate by an independent regulator. The proposals were drawn up in consultation with the private operators, including the chief executive of Kaiser Permanente, the giant Californian healthcare company.

The Foundation Trusts will be freed from NHS controls - they'll no longer be accountable to the Health Secretary but to a locally elected board. They are prohibited from selling their core assets. But they are allowed to raise funds for new building from capital markets and to set up joint ventures with the private sector. All public hospitals are now to be run along business lines - although there will be no shareholders initially.

Free from NHS control, hospitals will be able to break with national bargaining arrangements and negotiate or impose their own pay scales and conditions of service. The end result will be widening gaps in pay and working conditions.

Creeping commercialization
There will be increasing pressure to generate new sources of income. NHS hospitals already do this by opening private beds, leasing out parts of their land or allowing companies to run on-site services. For example, National Car Parks runs hospital car parking. Capita and Serco provide visitor and staff catering. McDonalds and WH Smith operate in hospital lobbies. Patient Line supplies telephones and televisions at astronomical rates. This will now be expanded.

New legislation allows hospitals to create companies which can exploit for research tissue samples taken during surgery. With ownership of human tissue unclear under British law, genetic data is a valuable commodity that many biotech companies would love to own.

At the same time the Government has introduced legislation to 'redefine' some NHS care. For example, an elderly or infirm patient may be fit for discharge but still have health and care needs - washing, dressing or feeding. This used to be called 'nursing' - but it can now be redefined as 'personal care' and is no longer covered by state funding.

If local authorities don't pick up the tab then patients can be billed. The costs and risks of continued care will pass to the individual, especially the elderly, who account for around 50 per cent of all hospital admissions. The fundamental principle of universal services, free at the point of delivery, will be undermined.
The Government has also established new regulatory bodies to smooth the way for privatization. The Independent Regulator has the power to determine the range of services and treatments to be provided by the NHS, which assets it can retain and which can be sold. The Commission for Healthcare Audit and Inspection (CHAI) polices performance standards. CHAI is the direct route to private sector control. It undertakes reports on quality in hospitals, success in which can lead to the 'earned autonomies' of a Foundation Trust - basically entrepreneurial freedoms which uncouple the hospital from the NHS. The next step is to be forcibly subjected to new management and franchised to the private sector. With this new regulatory regime the future of the NHS will no longer be a state responsibility.

The Government says its doesn't matter who provides healthcare services as long as they're state-funded. 'Reforms' are sold to the public as improving efficiency and choice and 'changing the delivery system'. The system will continue to be funded through taxation.

But a delivery system based on profits and returns to shareholders fragments the ability to pool the risks and costs of care from healthy to sick and from wealthy to poor. It introduces new inefficiencies and transaction costs making universal healthcare unsustainable.

The inherent but unstated logic of the NHS Plan is that the privatesector 'partners' will take over the running of hospitals in all but name. There will be a gradual reduction in free, tax-paid services at the point of use. Profits will compete with needs and, as the British experience with railway privatization and long-term care shows, access to services and quality is sacrificed.

There is no country in the world that delivers comprehensive, equitable healthcare through the market and on the back of for-profit providers. Yet governments across the world are rushing to follow the British path and are dismantling their healthcare systems. They and their citizens are in for a shock. When the market comes to health, access to care will be a lottery decided at the local level. The fear and uncertainty of the past are set to reappear.

Allyson Pollock is Head of the Public Health Policy Unit at University College London and Director of Research & Development at UCL Hospitals NHS Trust. She is also Chair of the Society for Social Medicine.

--------------------------------------------------------------------------------

posted August 12, 2009 02:56 PM              

BECAUSE WE ARE TRYING TOO HARD NOT TO BE CALLED SOCIALIST AND TO PLEASE EVERYONE. INCLUDING THE INSURANCE COMPANIES AND PROFITEERS WHO NOW RUN THE HEALTHCARE INDUSTRY. as i have been saying (over and over and over) the NHS in britain has been dismantled consistently and to terrible effect by those who think health should be for profit.

get this jwhop! since the railroads and post office were privatised in england people find them exorbitant in price and inefficient in the extreme. we are talking HERE about how the PO is inefficient and should be privatised. my in-laws never know when or IF their mail will get to them anymore. after decades of the most efficient, cost-effective, affordable mail system in the world.

the fact is that the "free market" is NOT the best solution in all cases. insurance would be a lot cheaper if the ceo's did not receive billions in salaries and bonuses.

posted August 12, 2009 03:43 PM              

say's you.

every email i get and check on is untrue.
jumping to conclusions is at an all time high with this new bill.

at this point i am not even sure i care anymore. what will be will be.

democrats hide stuff and republicans lie about it and both present a convuluted representation of the truth.

i am so sick of it. i had to tell my family and friends to quit emailing me things that are not true about it. take the time to check the facts prior to sending it to your top 100 friends.

this should have been hilary clinton's baby anyway.

palin is stupid as a fish it's true, but obama has his own agenda too.

And he is going to write a uncomplicated tax code? YEAH RIGHT!

congress can go get on thier first class jets and head thier drunk ashes to the moon for all i care anymore.

posted August 12, 2009 09:47 PM              

in the name of making it more to the taste of the naysayers, they will likely produce a half-arsed version that will fail and put us in a worse position than before.

and this topic has only been under discussion for the last 60 years or so.

posted August 13, 2009 10:49 AM            

Is it possible there are those too intellectually slow as to believe that just because the words..."tax payer funded abortions" don't appear in O'Bomber's O'BomberCare bill that provisions are not in there for "tax payer funded abortions"?

Is it possible there are those too intellectually slow to ferret out the facts for themselves rather than rely on the O'Bomber "Hallelujah Chorus" for their opinions.

As for Ezekiel Emanuel, his comments on making health care services available to certain age groups and not to others are contained in the follow statement by Sarah Palin. His comments and suggestions for allocating health care dollars by age group are also well documented on line...so, there's absolutely no excuse for not informing yourselves.

A chart produced by Ezekiel Emanuel can be found on the following web page. Notice how Emanuel would like to allocate health care dollars.
http://www.ncpa.org/pdfs/PIIS0140673609601379.pdf

You can also find out what the other clowns O'Bomber has surrounded himself have said and published and their well documented comments, papers and positions on health care....here:
http://rightsoup.com/rahms-brother-dr-ezekiel-emanuel-the-death-czar/

It always gives me a chuckle when one who is intellectually inferior to the one whom they are intellectually disparaging expose themselves...as in the title of this thread.
Those people would do well to stand on their right to remain silent on that subject.

For those who would like to know how Socialist health care works in the real world, let me point you in the direction of the state of Oregon..which has implemented that system.

In a recent case, the state of Oregon refused a woman treatment for her cancer and sent her a denial letter. In that letter, the state of Oregon refused her treatment...but offered to pay $50 if she would agree to be euthanized.

That's the real world of Socialist health care schemes and it differs greatly from the bloviating bullshiit coming out of Socialists lying mouths.

Sarah Palin: Concerning the "Death Panels"Sarah Palin's Notes
Concerning the "Death Panels"
Yesterday at 8:55pm

Yesterday President Obama responded to my statement that Democratic health care proposals would lead to rationed care; that the sick, the elderly, and the disabled would suffer the most under such rationing; and that under such a system these “unproductive” members of society could face the prospect of government bureaucrats determining whether they deserve health care.

The President made light of these concerns. He said:

“Let me just be specific about some things that I’ve been hearing lately that we just need to dispose of here. The rumor that’s been circulating a lot lately is this idea that somehow the House of Representatives voted for death panels that will basically pull the plug on grandma because we’ve decided that we don’t, it’s too expensive to let her live anymore....It turns out that I guess this arose out of a provision in one of the House bills that allowed Medicare to reimburse people for consultations about end-of-life care, setting up living wills, the availability of hospice, etc. So the intention of the members of Congress was to give people more information so that they could handle issues of end-of-life care when they’re ready on their own terms. It wasn’t forcing anybody to do anything.” [1]

The provision that President Obama refers to is Section 1233 of HR 3200, entitled “Advance Care Planning Consultation.” [2] With all due respect, it’s misleading for the President to describe this section as an entirely voluntary provision that simply increases the information offered to Medicare recipients. The issue is the context in which that information is provided and the coercive effect these consultations will have in that context.

Section 1233 authorizes advanced care planning consultations for senior citizens on Medicare every five years, and more often “if there is a significant change in the health condition of the individual ... or upon admission to a skilled nursing facility, a long-term care facility... or a hospice program." [3] During those consultations, practitioners must explain “the continuum of end-of-life services and supports available, including palliative care and hospice,” and the government benefits available to pay for such services. [4]

Now put this in context. These consultations are authorized whenever a Medicare recipient’s health changes significantly or when they enter a nursing home, and they are part of a bill whose stated purpose is “to reduce the growth in health care spending.” [5] Is it any wonder that senior citizens might view such consultations as attempts to convince them to help reduce health care costs by accepting minimal end-of-life care? As Charles Lane notes in the Washington Post, Section 1233 “addresses compassionate goals in disconcerting proximity to fiscal ones.... If it’s all about alleviating suffering, emotional or physical, what’s it doing in a measure to “bend the curve” on health-care costs?” [6]

As Lane also points out:

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. [7]

Even columnist Eugene Robinson, a self-described “true believer” who “will almost certainly support” “whatever reform package finally emerges”, agrees that “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.” [8]

So are these usually friendly pundits wrong? Is this all just a “rumor” to be “disposed of”, as President Obama says? Not according to Democratic New York State Senator Ruben Diaz, Chairman of the New York State Senate Aging Committee, who writes:

Section 1233 of House Resolution 3200 puts our senior citizens on a slippery slope and may diminish respect for the inherent dignity of each of their lives.... It is egregious to consider that any senior citizen ... should be placed in a situation where he or she would feel pressured to save the government money by dying a little sooner than he or she otherwise would, be required to be counseled about the supposed benefits of killing oneself, or be encouraged to sign any end of life directives that they would not otherwise sign. [9]

Of course, it’s not just this one provision that presents a problem. My original comments concerned statements made by Dr. Ezekiel Emanuel, a health policy advisor to President Obama and the brother of the President’s chief of staff. Dr. Emanuel has written that some medical services should not be guaranteed to those “who are irreversibly prevented from being or becoming participating citizens....An obvious example is not guaranteeing health services to patients with dementia.” [10] Dr. Emanuel has also advocated basing medical decisions on a system which “produces a priority curve on which individuals aged between roughly 15 and 40 years get the most chance, whereas the youngest and oldest people get chances that are attenuated.” [11]

President Obama can try to gloss over the effects of government authorized end-of-life consultations, but the views of one of his top health care advisors are clear enough. It’s all just more evidence that the Democratic legislative proposals will lead to health care rationing, and more evidence that the top-down plans of government bureaucrats will never result in real health care reform.

[1] See http://blogs.abcnews.com/politicalpunch/2009/08/president-obama-addresses-sarah-palin-death-panels-wild-representations.html.
[2] See http://edlabor.house.gov/documents/111/pdf/publications/AAHCA-BillText-071409.pdf
[3] See HR 3200 sec. 1233 (hhh)(1); Sec. 1233 (hhh)(3)(B)(1), above.
[4] See HR 3200 sec. 1233 (hhh)(1)(E), above.
[5] See http://edlabor.house.gov/documents/111/pdf/publications/AAHCA-BillText-071409.pdf
[6] See http://www.washingtonpost.com/wp-dyn/content/article/2009/08/07/AR2009080703043.html].
[7] Id.
[8] See http://www.washingtonpost.com/wp-dyn/content/article/2009/08/10/AR2009081002455.html].
[9] See http://www.nysenate.gov/press-release/letter-congressman-henry-waxman-re-section-1233-hr-3200.
[10] See http://www.ncpa.org/pdfs/Where_Civic_Republicanism_and_Deliberative_Democracy_Meet.pdf
[11] See http://www.scribd.com/doc/18280675/Principles-for-Allocation-of-Scarce-Medical-Interventions.

posted August 13, 2009 11:35 AM              

where do you get this stuff? show me! and did you know that oregon voters were the ones who put physician assisted euthanasia on the can-do list? federally it is still illegal, by the way...

posted August 13, 2009 04:42 PM            

Touching and self-serving defense? How so? I didn't find it touching at all, and if telling the truth is self-serving, what's wrong with it? Are you going to ferret through Emanuel's highly respected professional papers, and prove he was NOT taken out of context? No, of course you're not. You're just going to throw some token line out that you hope will be enough to cast doubt. You know it doesn't work that way. NOBODY here just takes your word on anything.

quote:

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Is it possible there are those too intellectually slow as to believe that just because the word "euthanasia" doesn't appear in O'Bomber's O'BomberCare bill...provisions are not in there for "euthanasia"?

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You're trying to make others out as intellectually slow? Really?

Let's do that thing where we pretend we're on opposite sides of the conversation. If this was Bush's bill, and someone like me was trying to imply that common sense would dictate that euthanasia actually is included in the bill, though it's not expressed directly anywhere within, what would you say to me? You would probably tell me that these bills are written in precise language in order that it might be interpretted precisely. Yeah, that's what ANYONE would say. It you can't make the goal, don't take the shot. It's a waste of everyone's time.

quote:

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Is it possible there are those too intellectually slow to ferret out the facts for themselves rather than rely on the O'Bomber "Hallelujah Chorus" for their opinions.

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This implies that you have ferreted out the facts. Last I checked, you'd done no such thing. Are you being intellectually slow? And how is it that on stuff like this your "ferretting out of facts" always involves opinion? Do you really think that some member of Congress coming to an uninformed decision on something is more truthful than the facts?

quote:

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A chart produced by Ezekiel Emanuel can be found on the following web page. Notice how Emanuel would like to allocate health care dollars. http://www.ncpa.org/pdfs/PIIS0140673609601379.pdf

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posted August 13, 2009 05:11 PM            

quote:

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ps - most of those links come up blank or barred...and quoting the entirety of the 1018 pages of the PROPOSED bill is less than useless.

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It's because of the bracket at the end of some of the links. I was curious about the Washington Post ones. Republicans love to try to throw the Washington Post into their source list as they consider it a credible leftist newspaper, and gives their opinion a more centrist appeal.

They are, OF COURSE, editorials (surprise, surprise ).

The writer of the first Washington Post article gets a couple things wrong in my opinion:

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. http://www.washingtonpost.com/wp-dyn/content/article/2009/08/07/AR2009080703043.html

"Purely voluntary" shouldn't mean to anyone that it's something available upon request. These are people that have NOT had any end of life counseling, people who do NOT have a living will, or durable power of attorney. Why would there be an assumption that these people would know to ask for such a thing? However, I can see the benefit of a doctor initiating that conversation in order that these people might manage the end of their lives better.

Rep. Earl Blumenauer (D-Ore.) is right. The elderly have no reason to believe for a moment that they are going to be pressured into signing end-of-life directives. Just because a doctor is discussing options with a patient, and offering a medical opinion does NOT mean or construe in any way that the patient will suddenly lose his or her will, and bend to whatever the doctor says. If there's any age group that is not likely to be swayed by the opinion of a stranger, it's the elderly. They know they're free. It's BS to suggest that doctor's are going to be selling people on euthanasia (it's illegal, for one).

________________________________

In the second article, get get this:

But I'll almost certainly support it, on the theory that something is better than nothing. I'll worry about the cost, but I'll reason that it's worth it to save children's lives and keep working-class families out of bankruptcy.

It's irresponsible for politicians, such as Sarah Palin, to claim -- outlandishly and falsely -- that there's going to be some kind of "death panel" to decide when to pull the plug on Aunt Sylvia.

posted August 13, 2009 06:36 PM            

katatonic, are you reduced to such laziness that you can't muster the energy to do a simple search for the Oregon woman refused treatment but offered euthanasia by the State of Oregon Socialist health care system instead?

Here katatonic. I wouldn't want you to extend yourself.

What becomes immediately apparent is that those eeeevil pharmaceutical companies have a hell of a lot more compassion and caring for people than those running the various Socialist health care systems here and abroad.

Of course katatonic I wouldn't really expect you to know anything about this incident. Given your association with only O'Bomber Kool-Aid drinkers and the various sites aligned with Socialist health care; I really wouldn't expect you or them to advertise the dirty little face of Socialist health care.

Letter noting assisted suicide raises questions
Barbara Wagner
Story Published: Jul 30, 2008 at 6:30 PM PDT

Story Updated: Nov 20, 2008 at 11:57 PM PDT
By Susan Harding and KATU Web Staff Video SPRINGFIELD, Ore.

Barbara Wagner has one wish - for more time.

"I'm not ready, I'm not ready to die," the Springfield woman said. "I've got things I'd still like to do."

Her doctor offered hope in the new chemotherapy drug Tarceva, but the Oregon Health Plan sent her a letter telling her the cancer treatment was not approved.

Instead, the letter said, the plan would pay for comfort care, including "physician aid in dying," better known as assisted suicide.

"I told them, I said, 'Who do you guys think you are?' You know, to say that you'll pay for my dying, but you won't pay to help me possibly live longer?' " Wagner said.

An unfortunate interpretation?

Dr. Som Saha, chairman of the commission that sets policy for the Oregon Health Plan, said Wagner is making an "unfortunate interpretation" of the letter and that no one is telling her the health plan will only pay for her to die.

But one critic of assisted suicide calls the message disturbing nonetheless.

"People deserve relief of their suffering, not giving them an overdose," said Dr. William Toffler.

He said the state has a financial incentive to offer death instead of life: Chemotherapy drugs such as Tarceva cost $4,000 a month while drugs for assisted suicide cost less than $100.

Saha said state health officials do not consider whether it is cheaper for someone in the health plan to die than live. But he admitted they must consider the state's limited dollars when dealing with a case such as Wagner's.

"If we invest thousands and thousands of dollars in one person's days to weeks, we are taking away those dollars from someone," Saha said.

But the medical director at the cancer center where Wagner gets her care said some people may have incredible responses to treatment.

Health plan hasn't evolved?

The Oregon Health Plan simply hasn't kept up with dramatic changes in chemotherapy, said Dr. David Fryefield of the Willamette Valley Cancer Center.

Even for those with advanced cancer, new chemotherapy drugs can extend life.

Yet the Oregon Health Plan only offers coverage for chemo that cures cancer - not if it can prolong a patient's life.

"We are looking at today's ... 2008 treatment, but we're using 1993 standards," Fryefield said. "When the Oregon Health Plan was created, it was 15 years ago, and there were not all the chemotherapy drugs that there are today."

Patients like Wagner can appeal a decision if they are denied coverage. Wagner appealed twice but lost both times.

However, her doctors contacted the pharmaceutical company, Genentech, which agreed to give her the medication without charging her. But doctors told us, that is unusual for a company to give away such an expensive medication.
http://www.katu.com/news/26119539.html

Letter noting assisted suicide raises questions
A Springfield woman's doctor hoped a new chemotherapy drug would help her but the Oregon Health Plan told her the treatment was not approved. Instead, the state would pay for assisted suicide. "I'm not ready, I'm not ready to die," the Springfield woman said.

posted August 13, 2009 06:55 PM            

quote:

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His own statements were self serving and a lie.

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I see a statement, but no proof...as usual.

Jwhop, one logical problem with your going on about Oregon is that if these patients had money, they'd be able to get better care. Another logical problem is that she is free to refuse any of these treatments. Trying to imply that this is "bad" socialized medical care is obscuring the fact that it's "some" medical care versus the "none" she might normally be entitled to.

quote:

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What becomes immediately apparent is that those eeeevil pharmaceutical companies have a hell of a lot more compassion and caring for people than those running the various Socialist health care systems here and abroad.

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Really? That's why your article ends with this line:

"But doctors told us, that is unusual for a company to give away such an expensive medication."

posted August 13, 2009 07:31 PM            

quote:

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Jwhop, one logical problem with your going on about Oregon is that if these patients had money, they'd be able to get better care...acoustic

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Those forced into O'BomberCare will be just about everyone as insurance carriers cannot compete with the federal government which will use taxpayer money to prop up the Socialist health care system O'Bomber and Socialist demoscats have planned.

O'Bomber has said...it may take some time but I'm in favor of a "single payer health care system"...a government run and managed Socialist health care system.

All O'Bomber needs to do to get that is run the insurance companies out of business.

posted August 13, 2009 08:02 PM            

quote:

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Thanks for admitting that those forced into Socialist health care will get inferior and rationed medical care.

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Who's forced? How do you make these ridiculous statements? Who isn't free to take their healthcare into their own hands? No one. Bogus, irrational thinking.

quote:

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O'Bomber has said...it may take some time but I'm in favor of a "single payer health care system"...a government run and managed Socialist health care system.

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So what? Anyone with a brain realizes that people change, and positions change. Just because he said something once, doesn't mean that he doesn't have the freedom to change that position.

quote:

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Thanks again for admitting that government run health care is inferior and rationed health care.

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My government healthcare while in the Navy was perfectly adequate.

And what I said was that SOMETHING is better than NOTHING, which is true. Your statement is a lie.

posted August 13, 2009 08:10 PM              

perhaps the reason is that it is not properly trialled (sic) yet? please do enlighten me some more. in the meantime perhaps she should look into the hydrogen peroxide thread in health and healing. could save her and her state a fortune!

and in the process tell me why i should LISTEN to someone who thinks guns=intellect and can't even spell the name of the president of his country? your attempts to sound highly educated are ludicrous. my 8th grade english teacher would have sent them back covered in red marks.

this bill is still in the drafting stages. your people, whoever they are, are still in a position to do something about it. so what are they doing? forming lynch mobs! that is SOOOO INTELLECTUAL.

once again, if you don't like me talking about "your people" don't make assumptions that you know anything about mine. i've been talking to you for some time now. does that mean YOU are a (closet) socialist?

posted August 14, 2009 04:47 PM              

For ‘Death Panels’ Before She Was Against Them? Palin Endorsed End Of Life Counseling As Governor
In recent weeks, right-wing groups have been pushing the myth that health care reform will somehow kill seniors. One of the most high profile voices pushing this lie has been Sarah Palin, who claimed President Obama will institute bureaucratic “death panels.” Today, again on her Facebook page, she continued the attack. Though some Republicans have rebuffed this absurd, inaccurate notion — like Johnny Isakson (R-GA), who called such talk “nuts” — others, like Newt Gingrich, have piled on to agree with Palin.

However, on April 16th 2008, then Gov. Sarah Palin endorsed some of the same end of life counseling she now decries as a form of euthanasia. In a proclamation announcing “Healthcare Decisions Day,” Palin urged public facilities to provide better information about advance directives, and made it clear that it is critical for seniors to be informed of such options:

WHEREAS, Healthcare Decisions Day is designed to raise public awareness of the need to plan ahead for healthcare decisions, related to end of life care and medical decision-making whenever patients are unable to speak for themselves and to encourage the specific use of advance directives to communicate these important healthcare decisions. [...]

WHEREAS, one of the principal goals of Healthcare Decisions Day is to encourage hospitals, nursing homes, assisted living facilities, continuing care retirement communities, and hospices to participate in a statewide effort to provide clear and consistent information to the public about advance directives, as well as to encourage medical professionals and lawyers to volunteer their time and efforts to improve public knowledge and increase the number of Alaska’s citizens with advance directives.

WHEREAS, the Foundation for End of Life Care in Juneau, Alaska, and other organizations throughout the United States have endorsed this event and are committed to educating the public about the importance of discussing healthcare choices and executing advance directives.

posted August 17, 2009 12:48 AM            

I'm sure you don't want to be labeled as a misogynist.

posted August 17, 2009 12:49 AM            

Finance Committee to drop end-of-life provision
By Michael O'Brien
Posted: 08/13/09 02:21 PM [ET]

The Senate Finance Committee will drop a controversial provision on consultations for end-of-life care from its proposed healthcare bill, its top Republican member said Thursday.

The committee, which has worked on putting together a bipartisan healthcare reform bill, will drop the controversial provision after it was derided by conservatives as "death panels" to encourage euthanasia.

"On the Finance Committee, we are working very hard to avoid unintended consequences by methodically working through the complexities of all of these issues and policy options," Sen. Chuck Grassley (R-Iowa) said in a statement. "We dropped end-of-life provisions from consideration entirely because of the way they could be misinterpreted and implemented incorrectly."

The Finance Committee is the only congressional committee not to report out a preliminary healthcare bill before the August congressional recess, but is expected to unveil its proposal shortly after Labor Day.

Grassley said that bill would hold up better compared to proposals crafted in the House, which he asserted were "poorly cobbled together."

"The bill passed by the House committees is so poorly cobbled together that it will have all kinds of unintended consequences, including making taxpayers fund healthcare subsidies for illegal immigrants," Grassley said. The veteran Iowa lawmaker said the end-of-life provision in those bills would pay physicians to "advise patients about end-of-life care and rate physician quality of care based on the creation of and adherence to orders for end-of-life care.