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१४८ टिप्पण्या:
Well this claim was overblown, however there are a lot of statist things in there. a zillion new Federal agencies, commissions and boards to determine:
- best practices
- fee payments
- acceptable insure
-
-
21 (I didnt count, but a lot, seriously) for womens health issues alone :)
In other words, this section of H.R. 3200 would require Medicare to pay doctors when they counsel their patients about such things as living wills, but no more frequently than once every five years, unless there’s a significant change in health status.
These people don't understand basic economics.
If doctors can get paid for it, they'll do more of it.
And how is the government going to know whether or not the patient initiated the discussion?
The doctor will just mark on her Medicare bill sheet that she gave the counsel, and the government will pay her, and the patient will never know that he “elected” to receive it.
End result: more end of life counseling given in a treatment environment that will indisputably be penurious, if Obama gets his way.
It doesn't push suicide, it just pushes the elderly to refuse "active treatments" in favor of hospice care. That is, no more investigation or therapy for new symptoms, cancer, or disease, just drugs to manage discomfort and pain.
For example, no dialysis after age 70, like in Canada and the UK. Renal failure is a good painless way to die, and quick. Plus it will save us a lot of dough.
No bypasses, hip replacements, or chemo for you, either, granny. But you can have all these yummy narcotics.
Not suicide, no; not even euthanasia. Those options will seem more attractive, however, to end the inevitable suffering.
I agree with you, at one level: the bill only encourages (?mandates?) periodic review about end of life care (Do you want full CPR? Food and water only? etc. etc.) This is not all bad, and I think many conservative sites opposed to the bill have gone way too far in concluding that it is a Trojan horse for euthanasia. Silly -- and it demeans the value of many of their other arguments against this horrendous piece of legislative crapola.
However, clearly the focus is on "wasted" resources (aka money) at the end of life, and the administration and Congress are listening to utilitarian bioethicists such as Ezekiel Emmanuel (brother of Rahm), whose philosophy about health resource allocation I find very chilling -- sacrifice the individual for the good of society, essentially. Scary stuff, which should be read by anyone interested in how these folks think. It comes dangerously close to eugenics, IMO.
When you combine this utilitarian philosophy with the burgeoning physician-assisted suicide movement (now legal in 3 states, soon in many more), you may well have something of a perfect storm. Oregon is already telling cancer patients it will not pay for palliative chemotherapy, but will cover PAS.
Two notes:
1) FactCheck is not a neutral 3rd party in this discussion. Just looking at the "FactCheck" which follows this one on "Boehner's Baseless Claim." Even they're forced to admit that his claim isn't "baseless" at all despite their own headline. They spend paragraph after paragraph adding "nuance" to the subject and even have to add "Obama's Response." All for a topic on which Boehner's claim is factually accurate. Neutral? Not in the least.
2) Maybe if Obama wasn't trying to jam this bill through at Warp 9 then people would have time to figure out what actually is and isn't, but when you have to try to decipher 1000 pages overnight because Democrats are threatening to hold votes on it every day, mistakes are bound to be made.
I can easily see how someone would read the definition page without understanding the greater context of that definition given that Democrats are purposely not giving people time to sit down and obtain that greater context because their poll support is melting down at exponentially faster rates every day.
National suicide, however, is part of the package.
Agree with Pogo--narcotics are much cheaper than life prolonging interventions esp when you reach your life expectancy--simply hand out morphine and withold surgeries. these old coots are going to die anyway.
If you follow the money, they in effect are saying the govt will pay for these services once every five years.
So you can expect to see "End of Life Counseling Stores Founded By Kirk Kevorkian" located very conveniently right next to "The Scooter Stores"!
Seems to me as Jim and Dr. Bob have pointed out, the "rahm it through approach" is leading to precisely these kind of bogus stories. On the bright side for opponents of this terrible legislation, this is fine by me, because it makes the administration have to try to explain what they want. And Obamas' numbers keep declining personally and on the health care issue overall.
Voting on this piece of garbage is now apparently deferred until October. For all the leaked bogus stories about "progress in the house," there isnt any. The honorable members will go home for the August recess and get hammered at home--Which, of course, is why the administration was hoping for a July bill.
At this point, Obama might want to go back and look at Hillary's attempt in 1993--the longer it took, the more it fizzled.
And I note that in the midst of the worst economic downturn since the great depression, Mr. Obama has sprung for a 20 million vacation get away on Martha's Vinyard. hmmmmmm
My own internal factchecker tells me that factcheck.org has a dog in this fight.
Pretty sad day for conservatives when fact checking is considered "liberal". It is odd there aren't any conservative counterparts to C&L and Thinkprogress that fact check liberals.
It may not say it explicitly, but does anyone doubt that most liberals would care one way or the other? I mean, it funds abortion so what's the diff?
"It may not say it explicitly, but does anyone doubt most liberals would care one way the other? I mean, it funds abortion, so what's the diff?"
None. One is a useless clump of cells getting in the way and the other's a useless husk hogging up precious resources.
Once you've convinced youself there's no such thing as life woth living BEFORE a certain age, you can very easily be convinced there's no such thing as life worth living BEYOND a certain age.
Stop treating Ted Kennedy now!!
I made a half hearted effort to read the relevant passage. Perhaps lawyers read it differently, but I found the prose to be obfuscatory and confusing. There seems to be room to hide just about anything behind those hedging clauses. And there are 1000 more pages of this. It's not that no one has read it, but that no one can read it.
The problem is when conservatives make outlandish claims like this, it besmirches the entire movement. Every time Rush Limbaugh opens his mouth, that's 1000 more votes for Democrats nationwide.
/hyperbole off
garage - there are plenty of conservatives who fact-check like Charles Johnson and Michelle Malkin. Both of them bash birthers regularly.
BTW, we should rename this "The Thanatos Bill".
I'm old enough to have seen this before, and I don't believe FactCheck's disclaimer. Affirmative action wasn't supposed to create quotas, either. But for a long time the reality was that it did.
Fred Thompson wakes up long enough to say "I'm not dead yet! I'm just sleeping!"
Big voting block:
Baby boomers
1946-1964
Estimate 76 million?
Begin retiring in 2011
Will be interested rationed cared and end of life issues.
Alex:
I've been wanting to rename it the "Omnibus Freedom Rollback Bill", but my view has obviously been too narrow.
However, clearly the focus is on "wasted" resources (aka money) at the end of life
Right. I don’t care about counseling, I care about denied treatment! That may not be euthanasia, but the results are going to be the same for some patients. You either get a potentially life saving treatment, or you die. That is not a decision I want anybody making but family.
When politician propose extreme legislation, people will respond in the extreme.
The health-care industry is estimated by 2016 to be 20% of the US GDP.
Between banks, auto industry and health-care Obama would have created the USSofA.
None of this will matter once I complete my time machine.
"It may not say it explicitly, but does anyone doubt that most liberals would care one way or the other? I mean, it funds abortion so what's the diff?"
Obviously I meant "wouldn't care one way of the other."
Any end of life provision for the news media?
Dan Rather Calls for White House to Save Journalism from Financial Hardship
knox -
"My own internal factchecker tells me that factcheck.org has a dog in this fight."
The answer is right in the header of the website "A Project Of the Annenberg Public Policy Center"
Annenberg...Annenberg...where have I heard that name before?
Oh yeah. Now it rings a bell.
But they don't have a dog in this fight. Nope. Not at all. Nothing to see here. Move along.
Annenberg never ever ever would be caught engaging in spin as they are here and have been found to do elsewhere as well. Even thinking that they would be as crazy as throwing millions of dollars at a domestic terrorist fronted by some uncredentialed, inexperienced nobody named Barack Obama. I mean who would believe something so utterly ridiculous?
You guys are funny. Ha Ha
Yeah, these claims really are outlandish and overblown.
I mean, it's not as if there has been a big physician-assisted suicide movement and euthanasia movement the last several years. And it's not as if many people have been killed by assisted "suicide" and euthanasia, including by starvation and dehydration.
It's not as if people have been pushing utilitarian and eugenic medicine for over a hundred years.
It's not as if bioethics "experts" at Ivy League universities are pushing ideas like denying care to old people and the disabled.
Yeah, all that culture of death talk is just crazy talk.
Reality check time. In professions the ethics are pointed to do the best for the client/patient who is the customer who pays the money for THAT PURPOSE. When the hiring customer is the Government, then a whole different set of purposes are a target aimed at and hit. As individuals we hire someone for our good. As a government, we get Jeremy Bentham's point of view that always calls for less for us and more for the "Greatest Good for the Greatest Number". Humanism turns out to be fierce and heartless destroying force to the one person, who is you and me. As an example, I changed insurance plans one time and had to pick a primary care doctor from a new primary care panel. In the bios of the doctors was a new Harvard Med school, black woman doctor, and I tried her. She was a trip. She was very efficiency oriented and never really saw me, but had a statistical approach to public health in which my vitals were not me but were my statistical grouping under age, sex, and race. All she wanted was fodder for her mill. I had to be treated for what I should be at risk for whether it was real or not. It was like Robert McNamara's way of running a war in Viet Nam. Hitting all the wrong targets out of an arrogance that they knew stuff that no one else did. If you want a real doctor who respects reality treating you, and not a statistician guessing at your needs, then steer clear of Harvard educated people. Ergo, steer clear of Obama's new world of health care where you will become the last important player in a scheme that is really all about money and power elites. That is my answer to whether Obama's plan is morbid...yes it definitely is for you and me.
Look I'm just not buying the idea that this plan will decrease quality. The only thing that really matters is the public option which would be a brand new entitlement program with a new tax hike to fund it. Even liberals agree on that.
Here's an idea, those that support these kind of "end of life" finacial balancing acts should go ahead and sign up now. Why wait until you are 70, Rahm and Barack? Chances are that at 48, if you have a serious life threaterning health issue, there be several more and that will add up to some big bucks.
Just do the country a favor and refuse treatment or better yet just don't even go to the doctor. Patriotism and concern for others begins at home.
All the bases covered with birthers and deathers.
Quayle: "If doctors can get paid for it, they'll do more of it."
Yes, most doctors go into the profession to maximize their incomes.
FactCheck.org is a statist joke, regardless of this particular issue.
Pogo said..."It doesn't push suicide, it just pushes the elderly to refuse "active treatments" in favor of hospice care."
It doesn' "PUSH" anything on anybody.
You're lying.
What part of this do many here not understand...Pogo?
Page 425 does deal with counseling sessions for seniors, but it is far from recommending a "Logan’s Run" approach to Medicare spending.
In fact, it requires Medicare to cover counseling sessions for seniors who want to consider their end-of-life choices – including whether they want to refuse or, conversely, require certain types of care.
The claim that the bill would "push suicide" is a falsehood.
FactCheck.org is a statist joke, regardless of this particular issue..
Oh rest assured by the time a particular claim has been thoroughly debunked there are 10 more waiting, so there is always a nice lag. But I can see why you guys hate fact checkers.
Nope, nothin' ahead but sunshine and roses in state-controlled medicine.
The new Medicare motto:
Dulce et decorum est pro patria mori.
Jeremy, by approving payment for a service, the govt in effect is endorsing & promoting it.
As I noted in a comment above, the "end of life counselors" will be advertising their govt-paid services on TV and radio ads just like The Scooter Store does now.
Ask yourself this- if health care costs are so high, why did they feel the need to include this in the bill??
AJ Lynch said..."Jeremy, by approving payment for a service, the govt in effect is endorsing & promoting it."
You mean things like testing for AIDS?
Inoculations for the flu?
Regular check-ups?
Deciding how and when one want to die is certainly none of the government's business, but it doesn't hurt to provide specific counseling so all the facts are at hand. My father spent the last 6 months of his life in constant pain because he was in a Catholic hospital that did not believe in pain medications (didn't want him "hooked" on drugs) or hospice (because it was considered a form of "giving up.")
It's pretty much changed at this point, but before their was open counseling it was purely up to the doctors and staff and whatever their religion- based policies were.
I just don't understand what the gripe is here, other that the usual whining and bitching about everything and anything.
New Medicare motto:
Got hospice?
New Medicare questionnaire:
Still paying income taxes greater than the sum of all government benefits received?
If yes, see doctor.
If no, see hospice.
Jeremy:
My point is end of life counseling or a govt paid scooter are "nice to have" but not necessities.
IF WE HAVE A HEALTH CARE SPENDING CRISIS, WHY ARE THEY ADDING MORE NON-ESSENTIAL STUFF?
Let the individual pay for this stuff. I have no objection to your examples btw.
@Jeremy:
Do you really contend that the Obama/Dem bills will not result in limitations to health care for the elderly that will bring about earlier deaths?
(BTW: I think the phrase you were looking for was: "empújela en el culo.")
I notice limited effectiveness posting on this subject from the utilitarian euthanasia-loving lefties. Witness garage's non sequiturs.
End-of-life counseling is the very mechanism by which the government plans to withhold care.
Do you remember the famous Doctor Zhivago's line, "I have always worked." when the marxist thugs ruling over his life tried to find reasons to kill him, and anyone else they could, for any reason, but really because he was a better man than them. The good Doctors who will to serve patients instead of serving the State will be the biggest losers in the Obamination.
Pogo said..."End-of-life counseling is the very mechanism by which the government plans to withhold care."
I've read absolutely nothing that relates to any plan to "withhold care."
When a doctor "counsels" a patient, and has to tell them that they have little chance of survival, it's the patient's choice as to what course the doctor should take. No doctor is going to "withhold care," based on what he or she feels is appropriate, without the patient's consent.
You're full of shit.
traditiona dolt - "The good Doctors who will to serve patients instead of serving the State will be the biggest losers in the Obamination."
"Serving the state?"
You get dumber by the minute.
elHombre said..."Jeremy: Do you really contend that the Obama/Dem bills will not result in limitations to health care for the elderly that will bring about earlier deaths?"
Yes.
Show me any evidence to the contrary.
You people are getting distracted on nonsense. The only thing that matters here is the public option. The rest of the stuff about quality of care is fluff. Even Jeremy would admit that.
elHombre - "euthanasia-loving lefties"
What does that even mean?
Are you saying only liberals feel they have the right to choose how and when they die?
Those on the right aren't interested in the right to die with dignity?
Who the fuck are YOU or is anybody for that matter, to tell others how or when they make that decision?
@Jeremy: No insensitivity toward your father's plight intended, but please cite the specific religious prohibition against prescribing pain killers or "giving up."
Your 1:09 post is just a gratuitous dump on religious hospitals. My 85-year-old mother was denied pain killers by doctors at a state university hospital who claimed to be worried about addiction.
Let me repeat my question: Do you really contend that the Obama/Dem bills will not result in limitations to health care for the elderly that will bring about earlier deaths?
The "gripe" underlying that question ought to be obvious, even to you.
We need a single-payer system.
Just like Medicaid.
We need a single-payer system.
Just like Medicaid.
No we don't. Ask the Britons how wonderful their single-payer system is.
BTW, I will pine for the day that RahmBo is frog-marched out of the White House on charges of bribery and extortion.
"We need a single-payer system.
Just like Medicaid."
I want to be kind because it is my nature, but insanity is the only way to describe this kind of thinking.
Barney Frank admits the public option is just a path to the single-payer plan Jeremy wants.
http://www.youtube.com/watch?v=f3BS4C9el98
Higher costs, lower quality, rationing . . . just what Doctor Obama ordered.
elHombre said..."Jeremy: No insensitivity toward your father's plight intended, but please cite the specific religious prohibition against prescribing pain killers or "giving up."
This was a Catholic hospital, and number of years ago, before many of these same hospitals began to loosen up.
They felt pain medication over and above the basic low level meds were overboard and would lead to "addiction." My father was already "addicted" to death, the doctors told him he had less than a year, and in fact died within months...so whatever pain meds would have only alleviated his pain and suffering. (Today it's common for patients to get morphine, etc.)
As to the hospice program, many of the more religious hospital didn't buy into providing counseling and comfort as the death was a given. They felt it was a form of "giving up" before God made that decision for them. (Today hospice is common, with many patients allowed to pass on in their own homes, surrounded by family and friends.)
Right now, one of the problems we have is over-testing, continued treatment when it's obvious survival is not possible, and not allowing patients to control their own destiny, as is their right.
Living wills are the best means of controlling one's destiny, and most people don't even have those. Had Terri Shivo had a living will she would have saved everybody a ton of grief.
Jeremy...Good doctors who will to serve the patient will be enslaved to the State aparatchiks who set all rules and set compensation as low as it can get. The good doctors will go elsewhere and you and me will not have a free country to go for quality care unless we are wealthy enough to pay for our care in Thailand by Israeli doctors
Jeremy wrote (1:35): Are you saying only liberals feel they have the right to choose how and when they die?
No I'm speaking of the lefties who think they have the right to choose how and when others die -- "with dignity," of course.
Jeremy wrote: Who the fuck are YOU or is anybody for that matter, to tell others how or when they make that decision?
Spare us the indignation, you jackass. You know perfectly well we are talking about the state bureaucracy making decisions determining who lives and who dies.
This is a paraphrase of liberal DEM Congressman Joe Sestak on the 1,000+ page healthcare bill which he supports:
1-The fewer govt regulations, the better the health care system.
2- Doctors should be paid based on the health of their patients. We should review the health of 100,000patients or so to determine if the doctor gets paid a lot or not so much.
Soylent Green is tonsils!
"No doctor is going to "withhold care," ...without the patient's consent."
1. Ha ha ha!! Yes indeedy, they will; see HMO capitation from the 1990s for the template.
2. But the care is withheld most often well before the patient gets in the door, by restricting available specialists, technology, and treatments. Delays, long queues, and cumbersome protocols serve to deny care as well.
TRO - Single-payer is the most logical way to go.
Medicare and Medicaid are both single-payer systems and you'll find very few who do not like what they get.
*When asked in a new Harris Poll 76% said they strongly support the treatment they receive through Medicare and 71% supported Medicaid.
The Veteran's Administration also is a single-payer system and other than a few of the recent hospital condition scandals, the treatment and service has been in place for a long, long time, treated millions of American vets, and given high marks.
*In 2003, when the prestigious New England Journal of Medicine published a study that compared veterans health facilities on 11 measures of quality , in all 11 measures, the quality of care in veterans facilities proved to be "significantly better."
Once we actually have a national health care system, Americans will wonder what took so long...and why we paid so much for so little...for so many years.
Pogo - You need to find yourself a new doctor.
I have friends who are doctors and nurses and if they read what you apparently think of them they'd be appalled.
VA hospitals have been shit-holes for years.
And your doctor and nurse friends are idiots.
elHombre said..."No I'm speaking of the lefties who think they have the right to choose how and when others die -- "with dignity," of course."
Again, I have absolutely no idea what the fuck you're talking about.
What "lefties" are making such decisions?
And who do YOU know who has ever had someone make that decision for them?
You're full of shit.
Pogo said..."VA hospitals have been shit-holes for years. And your doctor and nurse friends are idiots."
And once again, Pogo reveals himself to be an ignorant, uneducated boor.
Maybe if you were to actually read up on veteran's hospitals and the turnaround they've achieved over the past ten years you wouldn't sound like such an uninformed idiot.
As for my friends, they practice medicine, versus yourself, who practices being a fool.
Factcheck is liberal. Every thing is liberal....that I don't agree with.
I hate liberal things.
I hate...
therfore I am.
thank you.
Veterans Hospitals:
http://health.usnews.com/usnews/health/articles/050718/18va_2.htm
http://www.houston.va.gov/pressreleases/Fact_Sheet_20090717.asp
http://www.washingtonmonthly.com/features/2005/0501.longman.html
Keep government hands off my medicare!
I want my country back!
Obama is a racist, he hates white people!
That's all we need to keep saying until 2012 and the next election will be in the bag.
VA Hospital Warns Colonoscopy Patients of Exposure to HIV, Hepatitis
Tuesday March 24, 2009
"Worried military men and women flooded Miami Veterans' Hospital telephone hot lines Tuesday after Monday's announcement that improperly cleaned colonoscopy equipment might have exposed them to hepatitis and HIV."
"Medicare and Medicaid are both single-payer systems and you'll find very few who do not like what they get."
A couple problems there. First, a big part of the emphasis for health care reform is a result of the reality that Medicare is fast going bust.
Secondly, that is even without taking into consideration that more and more of the Medicare, Medicaid, etc. care is massively cross-subsidized by everyone else getting health care - primarily by those evil insurance companies. How is this done? By setting reimbursement levels below cost. And every time you hear about all the money that Medicare, etc. are saving by cutting costs, remember what they are doing is cutting reimbursement levels, which are already mostly below cost. That means that they aren't saving money, just forcing the public to subsidize them more.
One big problem with trying to expand these programs nationwide, or, indeed, impose either single payer, or public option, is that the only way that these programs work right now is due to the fact that there are a lot more people outside the programs cross-subsidizing them, than there are in the programs.
So, just imagine what would happen with a single payer system that tried this trick of driving down reimbursement rates in the face of rising costs. Many, if not most, doctors are already running extremely highly leverage operations. This would tilt them almost immediately into the loss territory, and if there isn't anyone left from which to recoup, then they are just going to quit.
But, at least it would be single payer.
Report: Poor Care at VA Hospital Caused 9 Deaths
by DAVID SCHAPER
NPR
January 28, 2008
"Investigators say the surgical unit at a southern Illinois veterans' hospital was in such disarray that doctors were allowed to perform operations they weren't qualified to perform and that hospital administrators were too slow to respond once problems surfaced, leading directly to the deaths of at least nine surgical patients and as many as 19.
Two internal Department of Veterans Affairs investigations also found that the medical mistakes seriously harmed more than a dozen additional veterans who were patients at the Marion, Ill., VA Medical Center."
V.A. Hospital in Philadelphia: Substandard prostate cancer care for our veterans
June 29
"This is a summary of events that occurred in a V.A. Facility in Philadelphia Pennsylvania 2002-2008:
When the Veterans hospital started their brachytherapy* program in 2002 it provided vets with an additional, less invasive therapy for prostate cancer that had not yet spread to other areas of the body. The new service was staffed via contract with staff and professional radiation oncologists from the University of Pennsylvania. The particular physician in question was trained at both Johns Hopkins and Penn.
Between 2002 and 2008 the implantation error ratio was 96:116 procedures.
Errors: Radiation seeds were implanted incorrectly, not sufficiently within the prostate and worse, implanted in adjacent organs and/or body tissue (i.e. bladder, rectum, and perineum).
Patients believed they were receiving the correct dosage needed to treat the cancer, however their prostates were undertreated and other organs were exposed to radiation they not only didn’t require but were damaged significantly."
I was so angry about Bush Derangement Syndrome.
But now I can totally understand Obama Derangement Syndrome.
I can barely enjoy the summer and wear cute tankys because I hate Obama, who is a racist.
Beaurugard Jefford Sessions III...from Alabama-2012.
Pogo - you can keep citing VA horror stories till your blue in the face, Jeremy will keep insisting that public health care is wondrous.
"
*When asked in a new Harris Poll 76% said they strongly support the treatment they receive through Medicare and 71% supported Medicaid."
Why shouldn't they? It is almost entirely paid for by everyone else, both through their Medicare taxes, income taxes (for Medicaid), and cross-subsidization by everyone else's health care payments.
Of course, they think it is a great deal. I would too, if I had a set up like that. The problem is that by its very nature, of being supported by everyone else, it cannot scale like you would like.
Tell those veterans to get their own health care! Now!
Details emerge about VA doctor's firing
The Associated Press
"FORT HARRISON, Mont. - A doctor at Fort Harrison's VA Medical Center who is accused of improperly conducting patient exams and altering records to reflect care that was never given was fired based on the findings of an investigation that began last year.
The hospital declined to release the name or specialty of the doctor, who was fired March 13. But a spokeswoman for the center said his patients were told of the findings and were assigned to another practitioner."
Wow, I'm shocked that seniors only give 70+ percent approval for their government run health care! Obviously 1/4 realize what a shit deal they're getting!
"Medicare and Medicaid are both single-payer systems and you'll find very few who do not like what they get."
I thought Barry promised his health care plan was going to lower costs. Medicare and Medicaid are about broke and have only resulted in higher costs.
"The Veteran's Administration also is a single-payer system and other than a few of the recent hospital condition scandals, the treatment and service has been in place for a long, long time, treated millions of American vets, and given high marks."
Been there, done that, it ain't all that you believe it is. And it is on a much smaller scale and dealing mostly with specific veteran's health care issues. Neither it nor the military health care system can be easily transferred to a total system for all Americans.
"Once we actually have a national health care system, Americans will wonder what took so long...and why we paid so much for so little...for so many years."
Yes, and unicorns exist.
Britain's cancer shame:
http://tinyurl.com/kkoxv3
http://tinyurl.com/kj6wxp
Justify that Jeremy.
I am fucking mad.
Fucking veterans getting free health care.
Fucking liberals.
Fucking government.
Fuck I am mad.
Canada's medical nightmare:
http://tinyurl.com/kuwct7
* High Costs, Low Quality
* Dying in Queues
* Bare-Bones Health Care
Had Terri Shivo (sic.) had a living will she would have saved everybody a ton of grief. (1:44)
Well, shame on her for causing all that grief. She should be killed. Oh ....
And who do YOU know who has ever had someone make that decision for them?
You're full of shit. (2:02)
I am really speaking prospectively, aren't I? But let's see, um, Terry Schiavo. That's it!
Also, decisions are made everyday in single payer, government run health care systems to deny treatment based on cost-effectiveness. For example, limiting an expensive drug treatment for breast cancer was a major issue in the last New Zealand election.
But we digress. Let's see, what was that pesky question you keep ducking?
Wasn't it: Do you really contend that the Obama/Dem bills will not result in limitations to health care for the elderly that will bring about earlier deaths?
" TitusLovesEveryoneBigHugs said..."Fucking veterans getting free health care."
What do the veterans you're fucking think about this?
Oh, Dr. Strangeloaf, your mask is slipping.
Go take a dump, willya?
We already got one Jeremy too many.
I really wish that Althouse was as trigger happy on the ban-stick as Charles Johnson sometimes.
elHombre - Terri Shivo represents the perfect example of someone who has literally no control over her own destiny, being taken advantage of by others.
She was brain dead, it's been proven beyond a shadow of doubt through doctor's reports and the autopsy, yet people like yourself still think the poor woman should have remained alive so the nutcases on the Christian right could use her as some kind of standard bearer.
You're a disgusting and selfish person and should be ashamed.
The Veteran's Administration also is a single-payer system
VA hospitals have been shit-holes for years.
You are both wrong. VA does a lot of things well (and has missteps like any other hospital), but people going to the VA have an option to go somewhere else if they aren’t happy. That is what we need to preserve.
Alex - Why can't you ever just accept the fact that some people don't agree with you?
What's the point of a discussion if every is saying the same thing?
If you're so upset over not having everybody on board with your opinions, here's a suggestion: Leave.
Pogo - Be sure to visit the sites I provided.
Educate yourself...for a change.
I read those all long ago.
Bullshit puff pieces.
VAH care is variable: average to to poor to good.
Not a template for the country, except by avoidance.
Shanna, some VA hospitals are in fact pretty poor, and although 'shit-holes' may be excessive, they're no reason to celebrate.
My older patients avoid them except to show up and get free medications. They do not trust them to diagnose jack shit.
They felt pain medication over and above the basic low level meds were overboard and would lead to "addiction." My father was already "addicted" to death, the doctors told him he had less than a year, and in fact died within months...so whatever pain meds would have only alleviated his pain and suffering. (Today it's common for patients to get morphine, etc.)
So instead of it being the Catholic Hospital, it will now be Sally Satchelbottom the government clerk who witholds treatment.
After all it was Obama who said that people will have to give up treatment that doesn't make them well. Since your father was going to die anyway, why waste money and time on him with pain killers that really aren't going to make him well. Same thing for those with AIDS, Parkenson, Diabetes and other illness from which you will never get 'well'.
What do we want to keep your father alive for anyway? He is old, using up resources and the sooner he goes the better for the State.
Brave new world. Welcome to it.
H.R. 3200, page 425: Subject to paragraphs (3) and (4), the term ‘advance care planning consultation’ means a consultation between the individual and a practitioner described in paragraph (2) regarding advance care planning...
What FactCheck left out was that the "practitioner described in paragraph(2)" of the bill has to be an employee of ACORN.
Kidding;)
Shanna, some VA hospitals are in fact pretty poor, and although 'shit-holes' may be excessive, they're no reason to celebrate.
VA hospitals are variable, like all other hospitals. Plenty of regular hospitals are poor too, it just doesn’t make the front page of the NY times every time anything happens. Lord knows I’m not trying to hold it up as an excuse for Obama Care because I really don’t want that. But, they are often unfairly maligned. I imagine some of your older patients remember the old days when things were very bad indeed, but they have improved quite a lot since then.
One thing with the VA is that they are dependent on congressional funds, and so they go though fat and lean times, wholly dependent on what is politically popular at any given moment. It would be a really bad idea to make that true of the entire government’s health care.
And as I mentioned, you can choose to go or not to go. That should be preserved.
Dust Bunny Queen said..."So instead of it being the Catholic Hospital, it will now be Sally Satchelbottom the government clerk who witholds treatment."
As usual, you're on the wrong page.
Things have changed dramatically as far as pain medications and hospice are concerned.
I described my father's situation, and as I mentioned, it was a number of years ago.
I suggest, when your time comes, instead of relying on the medical staff you refer to as "Sally Satchelbottom the government clerk who witholds treatment" (which makes absolutely NO sense whatsoever - other than being the standard wing nut insanity), you stay right there in your little trailer and let whatever God you believe in handle matters.
HR 3200 (America's Affordable Health Choices Act 2009) = THE DEPARTMENT OF HOMELAND HEALTHCARE.
Pogo, you don't know jack shit about anything.
Denigrating the veteran's hospitals is just plain stupid and it really reveals just how full of shit you are.
1. My mom was a veteran of WWII. In order to get her FREE! healthcare from the VA, she had to travel two and a half hours to the nearest VA hospital. Never saw the same doctor twice. When it became difficult for her to travel, she still had to make the trip because the VA wouldn't refill her meds without seeing her.
2. Husband of a friend had a seizure in Paris. Ambulance took him to the finest hospital in Paris (largest in the world, I'm told). An MRI would help them figure out the cause of his seizure; the soonest he could get the MRI was in a month. He flew home to the US and had the MRI the next day.
Pogo describes articles via U.S. News and World Report and The U.S. Department of Veterans Affairs as..."puff pieces."
Duh.
prairie wind - Anecdotal drivel.
There are good and bad experiences via any form of health care.
There are good doctors and bad doctors.
Get used to it...it's called "life."
Quayle: "If doctors can get paid for it, they'll do more of it."
Jeremy: "Yes, most doctors go into the profession to maximize their incomes."
Yes, Jeremy. Yes, they do.
Because becoming a Doctor is HARD. You know, like pull Barbie's string and she says, "Math is Hard." Really and truly HARD. Not only do you have to be really smart, but you have to spend the better part of your 20's busting your butt instead of having fun or having babies. The school just never ends.
So anyone who is SANE, Jeremy, who contemplates becoming a Doctor is going to be looking at what they will get out of it.
Because if they just want to feel good about themselves... they can volunteer at the local soup kitchen and get the exact same good feelings about helping their fellow human beings as if they spend a decade in an excessively difficult school first.
"I imagine some of your older patients remember the old days when things were very bad indeed, but they have improved quite a lot since then."
Actually, these guys have had recent bad experiences in Iowa, MN and WI VAs, and so will only go there for the free meds.
And your point needs to be put in bold, because it is so very very true:
"One thing with the VA is that they are dependent on congressional funds, and so they go though fat and lean times, wholly dependent on what is politically popular at any given moment. It would be a really bad idea to make that true of the entire government’s health care."
The 'fat and lean' times mean wide variations in quality, of course, responding only when there are scandals, such as the Walter Reed debacle last year:
'WRAMC's Building 18 is described in the article as rat- and cockroach-infested, with stained carpets, cheap mattresses, and black mold, with no heat and water reported by some soldiers at the facility.'
the Walter Reed debacle last year
I'm sorry, just have to say this real quick...
WALTER REED IS NOT A VA. It is Walter Reed ARMY hospital.
That is all.
When it became difficult for her to travel, she still had to make the trip because the VA wouldn't refill her meds without seeing her.
You can get them by mail now, I think.
Somehow that separation (military vs. VA) doesn't seem to help me.
'It Is Just Not Walter Reed'
Soldiers Share Troubling Stories Of Military Health Care Across U.S.
By Anne Hull and Dana Priest
Washington Post Staff Writers
Monday, March 5, 2007; Page A01
"His own VA hospital in Livermore was a mess. The gown he wore was torn. The wheelchairs were old and broken.
"It is just not Walter Reed," Oliva slowly tapped out on his keyboard at 4:23 in the afternoon on Friday. "The VA hospitals are not good either except for the staff who work so hard. It brings tears to my eyes when I see my brothers and sisters having to deal with these conditions. I am 70 years old..."
Look, I am not trying to bash them, but when people try to uphold VA hospitals as an example of the goal of national health care, it gives me the shivers, and their skeletons need to be shown.
Taxes. Socialism. Complicated. Great Britain. Rationing. Euthanasia. Bureaucrats.
Chew chew chew!
I'd say induce vomiting.
Most military hospitals are very good. (They also don't have to deal with the same patient demographic... to even get into the military you have to be healthy. Some dependents need care for various genetic conditions or diseases but for the most part military hospitals are dealing with healthy young men and women having babies. That and trauma and injuries, of course.)
The issue with Walter Reed, I'm convinced, was that it cared for soldiers separated from their units and then sent them on. People who need care are not able to deal with any more than their day to day crisis's, rehabilitation and even just staying alive. Civilian family members simply can't navigate the military system and even if they could, they are likely unable to deal with their loved one's condition, much less anything additional to that. Which is why being separated from your unit is such a big deal. Your whole support network might still be in Iraq or Afghanistan or else back home but in some other part of the country. The people whose job it is to watch out for their troops are not there. Your whole chain of command is elsewhere. You're a bit of an orphan.
So then you get well enough to do something about conditions but that means you're well enough to *leave* too. When the Walter Reed scandal hit the news there were people posting to Blackfive.net that they'd been there and were feeling guilty that after they left they didn't follow through to make sure that the soldiers who arrived after them didn't face the same conditions. But the thing is... they weren't *there* anymore and they were still dealing with their own recovery.
In a local military hospital the members of your unit will stop by to see you and even if you don't have energy for more than your own recovery, they *do*. You aren't an orphan. And when you are better, you're still *there*.
That said... like all things military, you can really get screwed over by the system and heaven help you if you have some sort of non-standard situation that must be resolved.
Also, in the end... you CAN go to a civilian hospital and civilian doctors.
When my husband had his herniated disks (three of them) and could get no MRI or exam or anything but muscle relaxants and pain meds, we knew several Airmen that were trying to decide if they could afford to go outside of the (free) military hospital system to get an MRI they could bring back to their military doctor.
We don't know if he'd have gotten better care at our next base because during our leave enroute we were technically far enough from any military hospital that the Air Force would pay for a visit to a civilian doctor, so we had the MRI in hand when we arrived at our next base... they had my husband in surgery with their neurosurgeon before he even in-processed. He was in the hospital for 14 days... and yet, his previous doctor wouldn't even order an MRI.
Yes... the idea of government "fixing" our health care system frightens me.
Yes, how dare anyone question a massive, vague, government takeover. Forget that Obama can't even give a coherent, convincing argument for it in his own press conference!
Those of you who make fun of people questioning this really come across as lapdogs. A lot of democrats are even backing away from this now, and quickly. More and more Americans are against it every day.
Are all these people ignorant? Reactionary? Paranoid? Greedy?
People have real, legitimate concerns. I should say, adults have real concerns. Fanboys just want Obama's plans to go through.
The pragmatic Obama has never run a lemonade stand.
Nancy Pelosi, a multi-millionaire, denigrates for-profit insurance companies today.
The Cash-for-clunkers programs is hitting all kinds of bureaucracy snags due to its complexity or inanity or both.
Ted Kennedy, Henry Waxman, Barbara Boxer, Joe Biden are all examples of longtime pols who have never run a private enterprise.
GovernmentCare’s Assault on Seniors
"The assault against seniors began with the stimulus package in February. Slipped into the bill was substantial funding for comparative effectiveness research, which is generally code for limiting care based on the patient’s age.
The harshest misconception underlying the legislation is that living longer burdens society. Medicare data prove this is untrue. A patient who dies at 67 spends three times as much on health care at the end of life as a patient who lives to 90, according to Dr. Herbert Pardes, CEO of New York Presbyterian Medical Center.
Nevertheless, Medicare is running out of money. The problem is the number of seniors compared with the smaller number of workers supporting the system with payroll taxes. To remedy the problem, the Congressional Budget Office has suggested inching up the eligibility age one month per year until it reaches age 70 in 2043, or asking wealthy seniors to pay more.
These are reasonable solutions—reducing access to treatments and counseling seniors about cutting life short are not. Medicare has made living to a ripe old age a good value. ObamaCare will undo that."
AJ Lynch said..."Nancy Pelosi, a multi-millionaire, denigrates for-profit insurance companies today."
God knows you wouldn't want to "denigrate" insurance companies. I mean, hey...just look at how wonder they are and how fair they are.
Probably why there have been multiple lawsuits won by the government over the past few years because they were screwing customers, canceling coverage or delaying coverage.
And don't even think about "denigrating" those wonderful oil companies.
By the way: While more people are losing their health insurance every day, and despite seeing a 10 percent drop in commercial enrollment to 1.4 million, UnitedHealthCare Profits Doubled Compared to Same Quarter Last Year.
Can you say...obscene?
Synova said..."Yes, Jeremy. Yes, they do."
You believe most doctors become doctors to maximize their incomes?
You sound like a very sad and cynical person indeed.
If whining and bitching was a tonic for health, this would be the healthiest group of people on the internet.
And yet, Jeremy... even knowing the evil present in human beings... you want to give more power to other people over your own life.
Because the SAME people, Jeremy... the exact same ones! Vile, grasping, venal human beings, will be in charge of the government programs. Money will be no less an issue, perhaps even more.
I only point this out to you to explain why what you *think* may be an argument against the private sector really is not at all.
In other words... I do not think this means what you think it means.
Synova said..."And yet, Jeremy... even knowing the evil present in human beings... you want to give more power to other people over your own life."
Between you, Pogo, Alex, and elHombre I don't know who makes less sense.
Exactly WHO would I be giving this "power" to?
Right now we're all dependent upon for profit insurance companies who's primarily goal is to pay as little as possible for out health care needs, you appear to believe by upsetting that wonderful situation, we're going to get fucked.
I have news for you: We're already getting fucked and have been getting fucked for years on end.
Americans pay MORE for their insurance and treatment than any other country on the planet, and rank quite a bit down the ladder as far as treatment, longevity, infant mortality, and other aspects of health care.
If you don't mind paying...keep on paying.
"You believe most doctors become doctors to maximize their incomes?"
Yes. Within certain parameters, certainly.
Sane people weigh the various elements of any life choice they make. They weigh probable income against the investment of time and effort and money. They weigh other elements as well, if they'll enjoy the job, have time for their family, do something worth while that is important.
Very very few people do not try to maximize their income.
The rather formidable investment necessary to become a doctor, time-money-sweat... all that is undertaken with the expectation of compensation adequate to make up for those years and financial debt.
This is not cynicism. Not at all.
Because I do not believe, at all, that the measure of virtue is some fuzzy-bunny utopic altruism or that human beings, in order to be "good", have to have it or that freaking public policy can depend on it.
I do understand that support for public healthcare for all, so we can show how much we care and are not *mean* people, does depend on the belief in this altruistic ideal, because if people don't really behave according to this self-less sacrificial version of human nature... many *many* people will decide that it's not worth the years of medical school, the debt, or the stress in their personal relationships.
And we will soon be short of doctors.
"And we will soon be short of doctors."
Already there, actually.
Synova said..."Yes. Within certain parameters, certainly."
Ohhhhhhhhhh, so suddenly we have "certain parameters."
Quit digging, fool.
You're already up to your chin in shit.
Mythbusting Canadian Health Care -- Part I
By Sara Robinson / February 4, 2008 - 5:23pm ET
http://www.ourfuture.org/blog-entry/mythbusting-canadian-health-care-part-i
UnitedHealthCare Profits Doubled Compared to Same Quarter Last Year.
I suppose the horse already left the barn as far as investment opportunity.
Mythbusting Canadian Health Care, Part II: Debunking the Free Marketeers
By Sara Robinson / February 11, 2008
http://www.ourfuture.org/blog-entry/mythbusting-canadian-healthcare-part-ii-debunking-free-marketeers
chickenlittle said..."I suppose the horse already left the barn as far as investment opportunity."
Not if we don't get some kind of national health care policy.
Their average stock price was right at $50 up until the current downtrend.
Right now you can buy in at about 30.
If they stay on top...there's no telling where it will go if a bill does not pass.
Jeremy wrote (2:23): [Terri Schiavo] was brain dead, ... yet people like yourself still think the poor woman should have remained alive so the nutcases on the Christian right could use her as some kind of standard bearer.
I don't believe I expressed an opinion about that. My point was that Schiavo did not die from an atrophied brain. She died as a result of an order issued by a government official, a judge, directing that she be denied any sustenance.
I would think that you, particularly as someone who is dangerously close to being brain dead, would be concerned about legislation that may expand the right of government officials to set priorities on matters of life and death.
So Jeremy, when are you gonna answer my question you chickenshit, euthanasia-loving putz?
Once again:
Do you really contend that the Obama/Dem bills will not result in limitations to health care for the elderly that will bring about earlier deaths?
Americans pay MORE for their insurance and treatment than any other country on the planet, and rank quite a bit down the ladder as far as treatment, longevity, infant mortality, and other aspects of health care.
Those figures have been repeatedly debunked, and I cannot believe that you don't know that.
For example, why does the U.S. rate lower on infant mortality? Because of the way that the statistics are kept, and what is considered a live birth. If you were to ignore premies and multiple births, as most of those countries do, we would look a lot better. And when comparing the U.S. to Canada, if you added all the difficult births sent down here from Canada to their statistics, instead of ours, things would shift a bit there too.
Exactly WHO would I be giving this "power" to?
Right now we're all dependent upon for profit insurance companies who's primarily goal is to pay as little as possible for out health care needs, you appear to believe by upsetting that wonderful situation, we're going to get fucked.
I can understand why you may prefer the nameless bureaucrat over the evil capitalist, but can you understand why we don't? Why we think of the DMV, IRS, etc., and aren't excited about nameless bureaucrats making those decisions for us.
And, you forget one big distinction. When the insurance company denies coverage, and under the terms of your policy, it should have been covered, then you can sue the insurance company, and if they lose, they will often get hit with bad faith and outrageous conduct punitive damages. This has the effect of significantly reducing the wrongful denials.
But, if that nameless bureaucrat denies coverage, you are typically SOL. You can't sue the government, because it is protected from suits like that through the doctrine of Sovereign Immunity. You can, of course, write a letter to your Congressman, your Senator, President Obama, the head of the agency, or even the tooth fairy. But unless you are on a first name basis with one of them, you are still going to be SOL.
Do you really contend that the Obama/Dem bills will not result in limitations to health care for the elderly that will bring about earlier deaths?
Given around 60% of patients at a typical hospital are funded by Medicare or Medicaid (most of whom are elderly and whose numbers are poised to expand) that seems inevitable under any plan; either that or just ramp up the printing presses until the last boomer dies off.
You believe most doctors become doctors to maximize their incomes?
Whether they do it to save the world, or just to make money, it doesn't really matter, when you are talking about destroying their livelihoods.
Most people who are seriously considering a career as a doctor are going to be scared away if they discover that they can't earn a living at it. It is just too much time and effort for no financial reward. We are talking school and training from age of 5 up through maybe the age of 30 or so. Add in a couple hundred thousand in educational debt, and the picture looks even worse. Add in the hours and the time on-call. No wonder physicians today are often counseling their kids to go into other lines of work.
And there is no reason to believe that ObamaCare, as it currently exists right now, would not make this significantly worse, through an attempt to impose Medicare type system of payments to the rest of us (without the rest of us being able to cross-subsidize those being covered by such a system).
Given around 60% of patients at a typical hospital are funded by Medicare or Medicaid (most of whom are elderly and whose numbers are poised to expand) that seems inevitable under any plan; either that or just ramp up the printing presses until the last boomer dies off.
But keep in mind that Medicare, Medicaid, etc. only work right now because they are massively cross-subsidized by all the rest of the paying patients.
Bruce - then answer is we need more government run medical schools.
If we do nationalize health care, I will do everything within my power to be on the committee that decides Jeremy's benefits and, for that matter, in every blue state.
They're gonna get national health care good and hard. My motto as a Natl. Medicare drone? Just Say No.
Pogo - no need to spout such nonsense. Jeremy is simply misinformed. Besides, 92% of Canadians love their health care.
The father of Canadian single-payer says to start privatizing:
http://www.manhattan-institute.org/html/miarticle.htm?id=2976
Castonguay advocates contracting out services to the private sector, going so far as suggesting that public hospitals rent space during off-hours to entrepreneurial doctors. He supports co-pays for patients who want to see physicians. Castonguay, the man who championed public health insurance in Canada, now urges for the legalization of private health insurance.
Sick with ovarian cancer, Sylvia de Vires, an Ontario woman afflicted with a 13-inch, fluid-filled tumor weighing 40 pounds, was unable to get timely care in Canada. She crossed the American border to Pontiac, Mich., where a surgeon removed the tumor, estimating she could not have lived longer than a few weeks more.
The Canadian government pays for U.S. medical care in some circumstances, but it declined to do so in de Vires' case for a bureaucratically perfect, but inhumane, reason: She hadn't properly filled out a form. At death's door, de Vires should have done her paperwork better.
I think Jeremy's world view just imploded.
Most Americans says "best days behind us" in Rasmussen poll:
http://tinyurl.com/24f5wf
48% say yes, 38% say no
I guess its human nature to be more pessimistic. It's in the human DNA. We are a species that no doubt deserves extinction.
I think Jeremy's world view just imploded.
I think Jeremy is busy trying to think up shit he can fling at you, Alex. Given the seriousness of your challenge, he may have to resort to that greatest of insults; charging (without evidence) that you listen to Rush Limbaugh.
Do you really contend that the Obama/Dem bills will not result in limitations to health care for the elderly that will bring about earlier deaths?
Given around 60% of patients at a typical hospital are funded by Medicare or Medicaid (most of whom are elderly and whose numbers are poised to expand) that seems inevitable under any plan; either that or just ramp up the printing presses until the last boomer dies off.
I suspect both will be necessary to keep a public system afloat, current or future. Extended suffering and/or early death due to rationing, while printing money as fast as possible to keep the rationing at "tolerable" levels to prevent a patient rebellion.
It is a balancing act that will ultimately fail.
chickenlittle wrote: "Given around 60% of patients at a typical hospital are funded by Medicare or Medicaid (most of whom are elderly and whose numbers are poised to expand)[limited health care leading to early death] seems inevitable under any plan...."
Maybe, but that is not currently proposed under existing Medicare, particularly for patients with "Medigap" insurance. It certainly seems inevitable under Obamacare.
My question to Jeremy, the euthanasia-loving putz, however, was whether he claimed it was not going to happen under Obamacare.
"Whether they do it to save the world, or just to make money, it doesn't really matter,..."
Because, in the end, there are all sorts of other ways to save the world that... cost less... give you more time with your family... are less constraining... and are less likely to result in people suing you for millions of dollars.
I am always thrilled to learn of those magnaminous altruistic doctors, the ones that did not go into medicine for money, who simply donate their services for breadcrumbs and a bite of cheese. Even room and board they shun, these secular saints, not to let filthy lucre stain their lily-white hands.
Bless them, these saints, these angels of mercy. But still, I want to see their 1040s please.
AJ Lynch said..."The Cash-for-clunkers programs is hitting all kinds of bureaucracy snags due to its complexity or inanity or both."
Yeah, it's REALLY hit a snag:
CNBC:
The Obama administration announced this morning that it won't be suspending its "cash for clunkers" program.
According to some rough math, the clunkers program could bring July car sales to an annual rate of more than 12 million, which would be a 27 percent increase and the highest sales since September.
Kurt Karl, chief economist at Swiss Re in New York, said he thinks the program could even turn third-quarter GDP positive.
"That's big enough with production and sales to give a solid punch to the third quarter," Karl explained. "That would take my slightly negative [projection] and take it to the definitely positive area."
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