Utopia Talk / Politics / End-of-Life Plan Back On Slippery Slope

Hot Rod Member	Sun Dec 26 12:08:49 Obama Returns to End-of-Life Plan That Caused Stir By ROBERT PEAR Published: December 25, 2010 WASHINGTON â?? When a proposal to encourage end-of-life planning touched off a political storm over â??death panels,â?? Democrats dropped it from legislation to overhaul the health care system. But the Obama administration will achieve the same goal by regulation, starting Jan. 1. 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 Democratsâ?? 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 â??voluntary advance care planning,â?? 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 â??advance directive,â?? 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. In this case, the administration said research had shown the value of end-of-life planning. â??Advance care planning improves end-of-life care and patient and family satisfaction and reduces stress, anxiety and depression in surviving relatives,â?? the administration said in the preamble to the Medicare regulation, quoting research published this year in the British Medical Journal. The administration also cited research by Dr. Stacy M. Fischer, an assistant professor at the University of Colorado School of Medicine, who found that â??end-of-life discussions between doctor and patient help ensure that one gets the care one wants.â?? In this sense, Dr. Fischer said, such consultations â??protect patient autonomy.â?? Opponents said the Obama administration was bringing back a procedure that could be used to justify the premature withdrawal of life-sustaining treatment from people with severe illnesses and disabilities. Section 1233 of the bill passed by the House in November 2009 â?? but not included in the final legislation â?? allowed Medicare to pay for consultations about advance care planning every five years. In contrast, the new rule allows annual discussions as part of the wellness visit. Elizabeth D. Wickham, executive director of LifeTree, which describes itself as â??a pro-life Christian educational ministry,â?? said she was concerned that end-of-life counseling would encourage patients to forgo or curtail care, thus hastening death. â??The infamous Section 1233 is still alive and kicking,â?? Ms. Wickham said. â??Patients will lose the ability to control treatments at the end of life.â?? 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 â??a step in the right direction.â?? â??It will give people more control over the care they receive,â?? Mr. Blumenauer said in an interview. â??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.â?? After learning of the administrationâ??s decision, Mr. Blumenauerâ??s office celebrated â??a quiet victory,â?? but urged supporters not to crow about it. â??While we are very happy with the result, we wonâ??t be shouting it from the rooftops because we arenâ??t out of the woods yet,â?? Mr. Blumenauerâ??s office said in an e-mail in early November to people working with him on the issue. â??This regulation could be modified or reversed, especially if Republican leaders try to use this small provision to perpetuate the â??death panelâ?? myth.â?? Moreover, the e-mail said: â??We would ask that you not broadcast this accomplishment out to any of your lists, even if they are â??supportersâ?? â?? e-mails can too easily be forwarded.â?? The e-mail continued: â??Thus far, it seems that no press or blogs have discovered it, but we will be keeping a close watch and may be calling on you if we need a rapid, targeted response. The longer this goes unnoticed, the better our chances of keeping it.â?? In the interview, Mr. Blumenauer said, â??Lies can go viral if people use them for political purposes.â?? The proposal for Medicare coverage of advance care planning was omitted from the final health care bill because of the uproar over unsubstantiated claims that it would encourage euthanasia. Sarah Palin, the 2008 Republican vice-presidential candidate, and Representative John A. Boehner of Ohio, the House Republican leader, led the criticism in the summer of 2009. Ms. Palin said â??Obamaâ??s death panelâ?? would decide who was worthy of health care. Mr. Boehner, who is in line to become speaker, said, â??This provision may start us down a treacherous path toward government-encouraged euthanasia.â?? Forced onto the defensive, Mr. Obama said that nothing in the bill would â??pull the plug on grandma.â?? A recent poll by the Kaiser Family Foundation suggests that the idea of death panels persists. In the September poll, 30 percent of Americans 65 and older said the new health care law allowed a government panel to make decisions about end-of-life care for people on Medicare. The law has no such provision. The new policy is included in a huge Medicare regulation setting payment rates for thousands of services including arthroscopy, mastectomy and X-rays. The rule was issued by Dr. Donald M. Berwick, administrator of the Centers for Medicare and Medicaid Services and a longtime advocate for better end-of-life care. â??Using unwanted procedures in terminal illness is a form of assault,â?? Dr. Berwick has said. â??In economic terms, it is waste. Several techniques, including advance directives and involvement of patients and families in decision-making, have been shown to reduce inappropriate care at the end of life, leading to both lower cost and more humane care.â?? Ellen B. Griffith, a spokeswoman for the Medicare agency, said, â??The final health care reform law has no provision for voluntary advance care planning.â?? But Ms. Griffith added, under the new rule, such planning â??may be included as an element in both the first and subsequent annual wellness visits, providing an opportunity to periodically review and update the beneficiaryâ??s wishes and preferences for his or her medical care.â?? Mr. Blumenauer and Mr. Rockefeller said that advance directives would help doctors and nurses provide care in keeping with patientsâ?? wishes. â??Early advance care planning is important because a personâ??s ability to make decisions may diminish over time, and he or she may suddenly lose the capability to participate in health care decisions,â?? the lawmakers said in a letter to Dr. Berwick in August. In a recent study of 3,700 people near the end of life, Dr. Maria J. Silveira of the University of Michigan found that many had â??treatable, life-threatening conditionsâ?? but lacked decision-making capacity in their final days. With the new Medicare coverage, doctors can learn a patientâ??s wishes before a crisis occurs. For example, Dr. Silveira said, she might ask a person with heart disease, â??If you have another heart attack and your heart stops beating, would you want us to try to restart it?â?? A patient dying of emphysema might be asked, â??Do you want to go on a breathing machine for the rest of your life?â?? And, she said, a patient with incurable cancer might be asked, â??When the time comes, do you want us to use technology to try and delay your death?â?? http://www.../politics/26death.html?_r=1&hp
CrownRoyal Member	Sun Dec 26 12:10:22 Death panels! The lie of the year is back?
CrownRoyal Member	Sun Dec 26 12:12:19 Btw Rod, do you have end-of-life plan?
Hot Rod Member	Sun Dec 26 12:17:36 CR, you should try reading sometime. I'm pretty sure you know how. Second paragraph, "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." This is a typical political ploy. If you don't get what you want try a different tack. Even if it is a baby step. My question at this point is if you follow your doctor's advice, does your life insurance still pay off?
Hot Stick Member	Sun Dec 26 12:19:37 I will if Hussein has his way. He will be in hospitals turning off life support machines to save money so he can fund more of his socialist programs. Look at the mess you liberals have gotten us into this time by voting for him. It will be worse than when you put carter in power.
ehcks Member	Sun Dec 26 12:20:39 'For example, Dr. Silveira said, she might ask a person with heart disease, "If you have another heart attack and your heart stops beating, would you want us to try to restart it"? A patient dying of emphysema might be asked, "Do you want to go on a breathing machine for the rest of your life?" And, she said, a patient with incurable cancer might be asked, "When the time comes, do you want us to use technology to try and delay your death?"' And I can not see why this is a bad thing.
The Politician Member	Sun Dec 26 12:22:16 It's a bad thing because OBama is president.
CrownRoyal Member	Sun Dec 26 12:23:31 My question at this point is if you follow your doctor's advice, does your life insurance still pay off? " Choice Rod, you always have a choice.
ehcks Member	Sun Dec 26 12:23:51 This topic in general is older than Obama, though. It's a bad thing because it involves giving people the ability to choose to do something to their own body that other people might disagree with, mostly on a religious basis.
Hot Rod Member	Sun Dec 26 12:24:11 CR - Btw Rod, do you have end-of-life plan? Yes, to continue my journey towards Nirvana.
The Politician Member	Sun Dec 26 12:24:34 That is exactly my point, this issue is older than Obama, however, he is president, it's his fault.
Aeros Member	Sun Dec 26 12:47:08 Right now, Medicare is getting bilked by big Pharma for billions of dollars for intensive cancer treatments that prolong life by only a few months at most. Its retarded.
Aeros Member	Sun Dec 26 12:47:28 *million
CrownRoyal Member	Sun Dec 26 12:49:40 Rod, you are very irresponsible and I think you hate America.
Hot Rod Member	Sun Dec 26 12:49:54 ehcks - And I can not see why this is a bad thing. As I said, this puts us back on the slippery slope IMHO. It is a baby step, but can you guarantee without doubt that it will not turn into a nightmare? Another question, if you survive the doctors advice will you be arrested and put into a mental institution? It is against the law to commit suicide in this country.
The Politician Member	Sun Dec 26 12:51:18 "As I said, this puts us back on the slippery slope IMHO. It is a baby step, but can you guarantee without doubt that it will not turn into a nightmare? " How so this concept has been around for decades... "It is against the law to commit suicide in this country. " No it isn't. Really dude?
Hot Rod Member	Sun Dec 26 12:57:00 Aeros - Right now, Medicare is getting bilked by big Pharma for billions of dollars for intensive cancer treatments that prolong life by only a few months at most. Its retarded. Congress has made it illegal for Medicare to negotiate prices with that pharmaceutical companies. Just as they have made it illegal for an individual to buy health insurance out of state.
CrownRoyal Member	Sun Dec 26 13:05:14 Just as they have made it illegal for an individual to buy health insurance out of state. " What a dumb lie. You can buy insurance from any state as long as you don't break that state's laws and regulations. Rod hates state rights.
The Politician Member	Sun Dec 26 13:06:43 It appears there are alot of misinformation being relayed by Roddy.
Hot Rod Member	Sun Dec 26 13:07:34 'HEALTH' insurance.
jergul Member	Sun Dec 26 13:07:42 Of course HR has an end of life plan. If he dies he would want to be revived time and time again.
Hot Stick Member	Sun Dec 26 13:08:55 My plan includes my brother informing you when I die. I will be creamated.
Hot Rod Member	Sun Dec 26 13:09:33 When I lived in Wyandotte County Kansas I could not buy heath insurance. PERIOD.
CrownRoyal Member	Sun Dec 26 13:10:14 Yes, health insurance, Rod, you dummy.
Hot Rod Member	Sun Dec 26 13:11:21 You don't know what you are talking about Canadian.
The Politician Member	Sun Dec 26 13:12:49 Just like it's illegal to commit suicide in this country right? Rod? Hmm?
The Politician Member	Sun Dec 26 13:13:26 Or how the whole concept of end of life care is something that just recently occured under Obama....hmm?
CrownRoyal Member	Sun Dec 26 13:13:40 Bring up the links then.
Hot Rod Member	Sun Dec 26 13:14:54 * OCTOBER 1, 2008 McCain Is Right On Interstate Health Insurance It's time to modernize our market. By MERRILL MATTHEWS Let's hope Democratic presidential candidate Barack Obama understands more about financial markets than he does about health-insurance markets. But the initial evidence isn't promising. A recent kerfuffle between Mr. Obama and Republican presidential candidate John McCain concerned the interstate purchase of health insurance. Mr. McCain wants to allow people to buy health insurance across state lines. Mr. Obama, on the other hand, opposes the idea and seems to believe it would create an unsafe, unregulated health-insurance market." MORE: http://online.wsj.com/article/SB122282743245193057.html
Hot Rod Member	Sun Dec 26 13:16:32 TP - Or how the whole concept of end of life care is something that just recently occured under Obama....hmm? I never said that moron. LOL, TP = Toilette Paper. How apropos.
The Politician Member	Sun Dec 26 13:18:16 Random fact, as long as insurers acquire the licenses from the states, you can acquire insurance across state lines. Carry on.
The Politician Member	Sun Dec 26 13:19:34 Rod missed out on the "?" mark. Also, how convenient he overlooks his lies about it being illegal in this country to commit suicide. Clearly his wardrobe of "facts" knows no bounds.
The Politician Member	Sun Dec 26 13:22:19 The real problem is that Rod wants states to lose money, that's why he wants this.
CrownRoyal Member	Sun Dec 26 13:24:23 Rod, did you even read the article? Just read it, I beg of you. You can buy any state insurance in US, you just have to adhere to that state's regulations.
The Politician Member	Sun Dec 26 13:25:03 Rod doesn't research topics...
Hot Stick Member	Sun Dec 26 13:27:38 LOL Toilet paper and Andy together. Why don't *YOU* research topics?
Hot Rod Member	Sun Dec 26 13:39:55 TP - Random fact, as long as insurers acquire the licenses from the states, you can acquire insurance across state lines. That is BS. If an insurance company has the license to sell in a particular state, then they have the legal right to sell in that state and you do not have to buy from their office in a different State. Who the hell are you anyway? BTW, you are correct about the suicides. It has been declassified as a crime in all states now, though some states still consider it a Common Law Crime that hinders your family from benefiting from your suicide.
Hot Rod Member	Sun Dec 26 13:44:41 CR - You can buy any state insurance in US, you just have to adhere to that state's regulations. "Mr. McCain wants to allow people to buy health insurance across state lines. Mr. Obama, on the other hand, opposes the idea and seems to believe it would create an unsafe, unregulated health-insurance market." I see nothing in the article concerning health insurance. please point it out to me.
The Politician Member	Sun Dec 26 13:48:51 http://new...0State%20Lines%20Explained.pdf This should take you a while...
CrownRoyal Member	Sun Dec 26 13:49:47 Many people in the employer-provided group market -- about 160 million Americans -- can already get health insurance across state lines. As a senator Mr. Obama, for example, lives in Illinois, but can get his health insurance through the Federal Employees Health Benefits Program, which is not located in Illinois. In addition, lots of small employers who offer health insurance through state-regulated insurers have employees who live in other states. And when my youngest daughter moved from Texas to New Jersey to go to graduate school, she remained on our family's Texas-regulated health insurance. In fact, people living in one state who buy health insurance in the individual market often move to other states, carrying their insurance policy across state lines." -------------------- But it's not the point. Any health insurance company in US can sell their policies in any state. What McCain and other retards want is for them not to adhere to state' s regulations.
The Politician Member	Sun Dec 26 13:54:38 "What McCain and other retards want is for them not to adhere to state' s regulations. " That's a BINGO, is that how you say it?
Hot Rod Member	Sun Dec 26 13:55:14 TP - it says in the first paragraph that selling across state lines is not the answer to our health costs problem. It may or may not, I don't know. All I said is it is illegal to buy health insurance across state lines. Your article clearly supports my statement.
The Politician Member	Sun Dec 26 13:56:18 You couldn't have possibly read that .pdf file in matter of...7 minutes. Try again.
CrownRoyal Member	Sun Dec 26 13:58:46 All I said is it is illegal to buy health insurance across state lines. Your article clearly supports my statement. " Yes, 160 millions Americans are criminals according to that article.
Hot Rod Member	Sun Dec 26 14:00:57 CR - Many people in the employer-provided group market -- about 160 million Americans -- can already get health insurance across state lines. That is true, but it illegal for an individual to shop across state lines for health insurance. You really did not think I meant employer supplied insurance did you? That would be stupid. obviously. TP - That's a BINGO, is that how you say it? Shit, both of you are foreigners and havge no idea what you are talking about.
The Politician Member	Sun Dec 26 14:02:58 It's a joke dipshipt, referencing the movie, "Inglorius Bastards". Do try and keep up.
CrownRoyal Member	Sun Dec 26 14:13:41 That is true, but it illegal for an individual to shop across state lines for health insurance. You really did not think I meant employer supplied insurance did you? That would be stupid. obviously. " No, Rod. You can buy health insurance from any company that is compliant with your state laws and regulations.
miltonfriedman Member	Sun Dec 26 14:24:37 "That is true, but it illegal for an individual to shop across state lines for health insurance." Wait. What? False. Are you really this ignorant or you didn't think your lie would be caught?
Cold Rod Member	Sun Dec 26 16:33:41 Nice how he runs away...
milton bradley Member	Sun Dec 26 16:45:11 well the board did vote him most dishonest poster at UP
Hot Rod Member	Sun Dec 26 16:46:51 I told you how it is, but as usual you refuse to admit the truth regardless of the evidence. I didn't run away, I am just smart enough to know you cannot convince a pile of shit of anything. I did not see "Inglourious Basterds".
Cold Rod Member	Sun Dec 26 16:48:57 You told whatever, but clearly you were wrong as you was just countered that you can buy insurance across state lines if that company abides by state regulations. Fucking retard.
Hot Rod Member	Sun Dec 26 16:51:41 Fucking pedo freaks.
Cold Rod Member	Sun Dec 26 16:52:38 Projection huh?
NeverWoods Member	Sun Dec 26 16:53:42 ^Molester of small children.
NeverWoods Member	Sun Dec 26 16:53:55 @HR.
miltonfriedman Member	Sun Dec 26 17:37:43 Summary of this thread: Pedo Rod makes a lie Pedo Rod got caught Pedo Rod then claims another poster to be a pedo freak despite being known to be one rinse and repeat.
milton bradley Member	Mon Dec 27 09:01:06 Funny how quiet adofl hitler has been since he logged on with the wrong tag...
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