During the stormy debate over his healthcare plan, President Barack Obama promised his program would not "pull the plug on grandma," and Congress dropped plans for death panels and "end of life" counseling that would encourage aged patients from partaking in costly medical procedures.
Opponents of Obama's plan, including former vice-presidential candidate Sarah Palin, dubbed such efforts as "death panels" that would encourage euthanasia.
But on Dec. 3, the Obama administration seemingly flouted the will of Congress by issuing a new Medicare regulation detailing "voluntary advance care planning" that is to be included during patients' annual checkups. The regulation aimed at the aged "may include advance directives to forgo aggressive life-sustaining treatment," The New York Times reported.
The new provision, which goes into effect Jan. 1, allows Medicare to pay for voluntary counseling to help beneficiaries deal with the complex decisions families face when a loved one is approaching death. Critics say it is another attempt to limit healthcare options for the elderly as they face serious illness.
Incoming House Speaker John Boehner said during the healthcare debate: “This provision may start us down a treacherous path toward government-encouraged euthanasia.”
Specifically, the measure was known as Section 1233 of the bill the House passed in November 2009. It was not included in the final legislation, however. It allowed Medicare to pay for consultations about advance care planning every five years. In contrast, the new rule allows annual discussions as part of wellness visits.
Elizabeth D. Wickham, executive director of LifeTree, a pro-life Christian educational ministry, told the Times that she is concerned that end-of-life counseling would encourage patients to forgo or curtail care, thus hastening death.
“The infamous Section 1233 is still alive and kicking,” Wickham said. “Patients will lose the ability to control treatments at the end of life.”
The rule was issued by Dr. Donald Berwick, administrator of the Centers for Medicare and Medicaid Services, according to the Times. He is a longtime advocate for rationing medical procedures for the elderly.
Before Obama tapped Berwick for the Medicare post, Berwick had long applauded Britain's National Health Service, which uses an algorithm to determine whether the aged are worthy of additional expenditures for medical care and advanced treatments.
Berwick has argued that rationing will have to be implemented eventually, stating, “The decision is not whether or not we will ration care. The decision is whether we will ration with our eyes open.”
Seniors appear to be a major target for precious resources under the Obama healthcare plan. According to the Congressional Budget Office, the Obama plan cuts nearly $500 billion in Medicare benefits to seniors as the federal government adds 30 million uninsured Americans to private and public healthcare systems.
The cost of caring for the elderly has not been lost on Berwick.
“The chronically ill and those towards the end of their lives are accounting for potentially 80 percent of the total health care bill out here . . . there is going to have to be a very difficult democratic conversation that takes place,” he said.
During the heated healthcare debate, supporters of the Obama plan vigorously denied that rationing for seniors would take place and scoffed at "death panel" critics such as Palin.
Last month, however, economist and New York Times columnist Paul Krugman told ABC News that rising Medicare costs could be dealt with only by "death panels and sales taxes."
He added: "Medicare is going to have to decide what it's going to pay for. And at least for starters, it's going to have to decide which medical procedures are not effective at all and should not be paid for at all. In other words, it should have endorsed the [death] panel that was part of the healthcare reform.’"
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"THE GREAT GOD AND MASTER OF THE CUT AND PASTE WORLD"
One more time: show of hands, those surprised. Anybody? Anybody? The history of government interference and/or control of a market is a history of shortage and inadequacy. Santayana was right.
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10:01 AM
partfiero Member
Posts: 6923 From: Tucson, Arizona Registered: Jan 2002
Obama Care will consist of givers and takers. As long as both vote, their a$$es WILL have to be kissed. But when grandma is too sick to make it to the next election, "KILL THE BEECH"!
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10:24 AM
avengador1 Member
Posts: 35468 From: Orlando, Florida Registered: Oct 2001
They won't call it a "Death Panel," so therefore it doesn't exist. It'll be a Happy Unicorn Life Transition Counseling Panel for the Children. Everyone will be in favor of that. You aren't against children are you?
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12:39 PM
partfiero Member
Posts: 6923 From: Tucson, Arizona Registered: Jan 2002
I for one am grateful you take the time to do this. Even though everything must be read with a bit of skepticism, still need to do the research. But that is my job if I want to be sure. Or one can choose to be completely uninformed like most of the population, Klapper included. Or one can choose to believe the 435 congressmen and the 101 senators we have, who just lie through their teeth.
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12:47 PM
rogergarrison Member
Posts: 49601 From: A Western Caribbean Island/ Columbus, Ohio Registered: Apr 99
But...what if it is on the internet AND in legislation or an executive order?
Wow, that would be something. But rather then be merely dazzled by the column length, I read the article posted. It is not in the legislation, and it was not an executive order. Furthermore, the article description of the new regulation from Medicare states that advance.directive counseling is voluntary. It does not state that g'pa is going to have to make a case for survival.
So. Awaiting snappy comeback. Please read the article first.
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12:49 PM
NEPTUNE Member
Posts: 10199 From: Ticlaw FL, and some other places. Registered: Aug 2001
Wow, that would be something. But rather then be merely dazzled by the column length, I read the article posted. It is not in the legislation, and it was not an executive order. Furthermore, the article description of the new regulation from Medicare states that advance.directive counseling is voluntary. It does not state that g'pa is going to have to make a case for survival.
So. Awaiting snappy comeback. Please read the article first.
Maybe you should have read up on the health care bill first. It was in there, they took it out when there was an uproar, and now they put it back as "voluntary". I find it disturbing that they keep pushing things like this. And the government would NEVER up the ante, would they? Buy hey, if you're OK with it, that's your choice.
BTW, read up on "the complete lives system", regarding the allocation of health care when resources are lacking, and get back to me. Evidence...no "snappy comeback" required.
So voluntary doesn't mean voluntary any more? Do you want to deny my parents counseling about advanced directives? Maybe my dad loves the Lord and is happy with what he accomplished in life and doesn't want to bankrupt my mom by staying on life support when the possibility of recovery is nil.
Interesting links though.
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01:12 PM
fierobear Member
Posts: 27116 From: Safe in the Carolinas Registered: Aug 2000
So voluntary doesn't mean voluntary any more? Do you want to deny my parents counseling about advanced directives? Maybe my dad loves the Lord and is happy with what he accomplished in life and doesn't want to bankrupt my mom by staying on life support when the possibility of recovery is nil.
Interesting links though.
I don't trust the government, especially this current government. When they try to make things mandatory, take them out, then put them back in as "voluntary", it raises red flags for me. But hey, that's just me. Your mileage may vary.
now these decisions are made by the INSURANCE CORPrats who ruthlessly class expensive new teck as experimental and refuse to pay in an effort to protect their profit
and in typical rightwing BIG LIE manor confuse getting a doctor to explain options and get paid for his time and efforts with some how being equal to killing people it is not the same and only a deluded rightwinger could think it is
------------------ Question wonder and be wierd are you kind?
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01:28 PM
fierobear Member
Posts: 27116 From: Safe in the Carolinas Registered: Aug 2000
now these decisions are made by the INSURANCE CORPrats who ruthlessly class expensive new teck as experimental and refuse to pay in an effort to protect their profit
Proof?
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01:30 PM
Scottzilla79 Member
Posts: 2573 From: Chicago, IL Registered: Oct 2009
now these decisions are made by the INSURANCE CORPrats who ruthlessly class expensive new teck as experimental and refuse to pay in an effort to protect their profit
Wouldn't this behavior by the insurance companies completely stifle innovation?
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01:55 PM
fierobear Member
Posts: 27116 From: Safe in the Carolinas Registered: Aug 2000
After public outcry over “death panels” forced Democrats to drop their proposed end-of-life planning from the health care overhaul legislation, the Obama administration is pressing forward to enact the same measures by bureaucratic regulations. The new regulations are set take effect starting Jan. 1, the New York Times reports.
Under the new policy, outlined in a Medicare regulation, the government will pay doctors who advise patients on options for end-of-life care, which may include advance directives to forgo aggressive life-sustaining treatment.
Congressional supporters of the new policy, though pleased, have kept quiet. They fear provoking another furor like the one in 2009 when Republicans seized on the idea of end-of-life counseling to argue that the Democrats’ bill would allow the government to cut off care for the critically ill. The final version of the health care legislation, signed into law by President Obama in March, authorized Medicare coverage of yearly physical examinations, or wellness visits. The new rule says Medicare will cover “voluntary advance care planning,” to discuss end-of-life treatment, as part of the annual visit.
Under the rule, doctors can provide information to patients on how to prepare an “advance directive,” stating how aggressively they wish to be treated if they are so sick that they cannot make health care decisions for themselves.
While the new law does not mention advance care planning, the Obama administration has been able to achieve its policy goal through the regulation-writing process, a strategy that could become more prevalent in the next two years as the president deals with a strengthened Republican opposition in Congress.
Despite the political firestorm of controversy surrounding such end-of-life planning, the Obama administration insists that research supports its decision to move forward with the controversial measure. “Advance care planning improves end-of-life care and patient and family satisfaction and reduces stress, anxiety and depression in surviving relatives,” the administration’s preamble to the Medicare regulation reads, quoting research from the British Medical Journal.
Several Democratic members of Congress, led by Representative Earl Blumenauer of Oregon and Senator John D. Rockefeller IV of West Virginia, had urged the administration to cover end-of-life planning as a service offered under the Medicare wellness benefit. A national organization of hospice care providers made the same recommendation.
Mr. Blumenauer, the author of the original end-of-life proposal, praised the rule as “a step in the right direction.” “It will give people more control over the care they receive,” Mr. Blumenauer said in an interview. “It means that doctors and patients can have these conversations in the normal course of business, as part of our health care routine, not as something put off until we are forced to do it.”
After learning of the administration’s decision, Mr. Blumenauer’s office celebrated “a quiet victory,” but urged supporters not to crow about it. Meanwhile, opponents of the measure, including Elizabeth D. Wickham, executive director of a pro-life Christian advocacy group told the Times she was concerned the so-called “end-of-life counseling” would actually encourage patients to forgo or curtail life-saving care.
“The infamous Section 1233 is still alive and kicking,” Wickham said. “Patients will lose the ability to control treatments at the end of life.”
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02:12 PM
avengador1 Member
Posts: 35468 From: Orlando, Florida Registered: Oct 2001
As I said, there are those who insist this won't happen or it doesn't exist. Right on cue:
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Just because it is on the internet doesn't make it so.
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You REALLY should loosen the tinfoil hat every once in a while and let your head breathe some clean, fresh air.
quote
and in typical rightwing BIG LIE manor confuse getting a doctor to explain options and get paid for his time and efforts with some how being equal to killing people it is not the same and only a deluded rightwinger could think it is
[This message has been edited by avengador1 (edited 12-27-2010).]
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02:31 PM
partfiero Member
Posts: 6923 From: Tucson, Arizona Registered: Jan 2002
now these decisions are made by the INSURANCE CORPrats who ruthlessly class expensive new teck as experimental and refuse to pay in an effort to protect their profit
and in typical rightwing BIG LIE manor confuse getting a doctor to explain options and get paid for his time and efforts with some how being equal to killing people it is not the same and only a deluded rightwinger could think it is
Only difference between the insurance companies and the government running it is, you will not be able to sue the government to allow the treatment, or for "F'"ng up and your poor old grandma dies. The government has about 10,000 ill run, and way over budget programs now, but this one will work really swell! I just know it!
The government has about 10,000 ill run, and way over budget programs now, but this one will work really swell! I just know it!
It amazes me how much people trust the government, even after government has f'ed everything up that it has touched to this point. And rayb calls US deluded?
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06:17 PM
partfiero Member
Posts: 6923 From: Tucson, Arizona Registered: Jan 2002
It amazes me how much people trust the government, even after government has f'ed everything up that it has touched to this point. And rayb calls US deluded?
Most know this is going to be a disaster. And for some, they could care less how much the government spends as long as they get their dollar from them. This kind of incurable personal greed is the sickness that keeps the 10,000 federal programs alive, and it will eventually bankrupt us.
Couldn't get many of the Dems to vote for it. They were too busy pulling cash out of the lobbyists pockets. Either that or they were worried about getting kicked out, which happened anyway.
I see the spin is still strong on this topic. Unjustified public fear created with the term "Death Panels" when the policy seems to be actually a Bush era one.
quote
The White House on Sunday said the new Medicare directive, reported Sunday by the New York Times, doesn't constitute a resurrection of the original health-care-bill language. It said the George W. Bush administration had already put in place guidelines allowing for Medicare to pay for end-of-life consultations.
A Medicare revamp in 2003 created a "welcome to Medicare" visit for seniors newly entering the program to get a checkup. Another law passed in 2008 specifies that the welcome visit can include a discussion of "end-of-life planning."
I see the spin is still strong on this topic. Unjustified public fear created with the term "Death Panels" when the policy seems to be actually a Bush era one.
But Ezekiel Emmanuel's "Complete Lives System" wasn't. Guess you missed that part.
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02:41 AM
Dec 29th, 2010
TiredGXP Member
Posts: 712 From: A cold, miserable place Registered: Jan 2008
End of life care counseling (and personal directives) have been around for some time - my elderly parents have created their directives. Probably a good thing since my Dad's dementia has progressed significantly in the past year. It's good that he was able to make his wishes known to us while he still had the ability to carry on a lucid conversation.
[This message has been edited by TiredGXP (edited 12-29-2010).]
