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Lies, damn lies and health care reform

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August 11, 2009

Former Republican vice presidential candidate Sarah Palin says the health care overhaul bill would set up a "death panel." Federal bureaucrats would play God, ruling on whether ailing seniors are worth enough to society to deserve life-sustaining medical care. Palin and other critics are wrong.

Nothing in the legislation would carry out such a bleak vision. The provision that has caused the uproar would instead authorize Medicare to pay doctors for counseling patients about end-of-life care, if the patient wishes. Here are some questions and answers on the controversy:

Q: Does the health care legislation bill promote "mercy killing," or euthanasia?

A: No.

Q: Then what’s all the fuss about?

A: A provision in the House bill written by Rep. Earl Blumenauer, D-Ore., would allow Medicare to pay doctors for voluntary counseling sessions that address end-of-life issues. The conversations between doctor and patient would include living wills, making a close relative or a trusted friend your health care proxy, learning about hospice as an option for the terminally ill, and information about pain medications for people suffering chronic discomfort.

The sessions would be covered every five years, more frequently if someone is gravely ill.

Q: Is anything required?

Monsignor Charles Fahey, 76, a Catholic priest who is chairman of the board of the National Council on Aging, a nonprofit service and advocacy group, says no.

"We have to make decisions that are deliberative about our health care at every moment," Fahey said. "What I have said is that if I cannot say another prayer, if I cannot give or get another hug, and if I cannot have another martini — then let me go."

Q: Does the bill advocate assisted suicide?

A: No. It would block funds for counseling that presents suicide or assisted suicide as an option.

Q: Who supports the provision?

A: The American Medical Association, the National Hospice and Palliative Care Organization and Consumers Union are among the groups supporting the provision. AARP, the seniors’ lobby, is taking out print advertisements this week that label as false the claim that the legislation will empower the government to take over life-and-death decisions from individuals.

Q: Should the federal government be getting involved with living wills and end-of-life questions — decisions that are highly personal and really difficult?

A: It already is.

The government requires hospitals to ask adult patients if they have a living will, or "advance directive." If the patient doesn’t have one, and wants one, the hospital has to provide assistance. The mandate on hospitals was instituted during a Republican administration, in 1992, under President George H.W. Bush.

Q: How does a living will work, and how is it different from a health care proxy?

A: A living will — also called an advance directive — spells out a patient’s wishes if he or she becomes incapacitated. Often people say they don’t want to be kept alive on breathing machines if their condition is terminal and irreversible.

A health care proxy empowers another person to make medical decisions should the patient become incapacitated.

There’s also a power-of-attorney, which authorizes another person to make financial decisions for someone who is incapacitated.

Such legal documents have become standard estate-planning tools in the last twenty years.

Q: Would the health overhaul legislation change the way people now deal with making end-of-life decisions?

A: It very well could.

Supporters of the provision say the main consequence would be to formally bring doctors into a discussion that now takes place mainly among family members and lawyers.

"When you execute a legal document with your lawyer, it ends up in your files and in the lawyer’s files," said John Rother, a senior policy and strategy adviser for AARP. "Unless the doctor is part of this discussion, it’s unlikely that your wishes will be respected. The doctor will be the one involved in any decisions."

The American Medical Association says involving doctors is simple common sense.

"There has been a lot of misinformation about the advance care planning provisions in the bill," AMA President Dr. James Rohack said in a statement. "It’s plain, old-fashioned medical care."

Q: So why are some people upset?

Some social conservatives say stronger language is needed to protect seniors from being pressured into signing away their rights to medical treatment in a moment of depression or despair.

The National Right to Life Committee opposes the provision as written.

"I’m not aware of ‘death panels’ in the bill," said David O’Steen, executive director of the group. "I’m not aware of anything that says you will be hauled before a government bureaucrat. But we are concerned … it doesn’t take a lot to push a vulnerable person — perhaps unwittingly — to give up their right to life-sustaining treatment."

The White House says it is countering false claims with a "reality check" page on its Web site, http://www.whitehouse.gov.

___

On the Net:

White House site on health care claims: http://www.whitehouse.gov/realitycheck/

10 Responses to Lies, damn lies and health care reform

  1. bryan mcclellan

    August 11, 2009 at 11:00 am

    Take a good hard look at the underpinnings of our Nation folks. She is the one in dire need of life sustaining treatment. It is Her vulnerabilities and the sappers in the wire we should be focused upon.
    We do not exist if She is not standing tall against the tyrant and usurper.

    The death by a thousand cuts panel is alive and well and is staffed by politicians and corporate/insurance moguls whose boot heels are at Her neck.

    As evidenced by the corpse of the United States of America around which they so gleefully dance, the people are the secondary target.

    All they need do now is wait for Lady Liberty to lose consciousness while the masses slowly bleed their prosperity and freedom into the trough of greed and avarice from which these pigs so merrily slurp.

    The knives of innuendo and complacency are poised to sever meat from bone, and as they are impatiently waiting for the last dying breath, forked tongued adders who slither across our national psyche one sound bite at a time openly attempt to pit us one against the other.

    Will we let them succeed?

  2. Carl Nemo

    August 11, 2009 at 1:38 pm

    Thanks Bryan for a superbly written, moving piece concerning the very health of Lady Liberty herself.

    She’s been on life support for quite some time and the blips of her vitals on the monitor are getting ever more feeble and far between.

    These shadowy, corporatist usurpers with an agenda are going to push it to the envelope until there’s blood running in the streets… : |

    Carl Nemo **==

  3. Route101

    August 11, 2009 at 3:08 pm

    Well said and seconded Bryan and Carl.

  4. bryan mcclellan

    August 11, 2009 at 3:25 pm

    Good morning Carl, and thanks to you and the many here that we stand shoulder to shoulder with. We have been ganged by the few and affluent and now is the time to stand up for meaningful change sans the band-aid remedies.

    This is easy for me to say as I haven’t been able to afford health insurance or visited a doctor for many years now. I’m one that is fortunate to be reasonably in the pink and understand that this is not the case with many out there, but we do have a tool to fight with and that is stop paying your premiums, withhold and bank those funds, and form a nationwide Co-op to negotiate with the predators that are writing this legislation for their, not our benefit.

    If one considers the vast amount of funds the insurance industry rakes in quarterly the argument is moot that it will not bring these bloodsuckers to the table and force them to bargain in good faith.

    For example, on the average, a family plan for four costs 10,000 per year x 200,000,000. That is a nice piece of change, and this number excludes life, business/workmans comp, and auto premiums. I cannot find the numbers stating how much the insurance companies pay out annually, but the profit margins have to be excessive for them to pour all the funds they do into lobby and advertising coffers.

    That’s my solution for what it’s worth as I’m an old union guy, a Vet, and an American who refuses to view our plight in shades of gray.

  5. Carl Nemo

    August 11, 2009 at 5:09 pm

    Thanks Bryan for your feedback and thoughts concerning viable healthcare for all with minimal red tape and hopefully smooth access to such care.

    I’m providing a link to a bill that many people support in lieu of H.R.3200; ie., H.R. 676

    The United States National Health Insurance Act (“Expanded & Improved Medicare for ALL”) Sponsored by Rep. John Conyers (D-MI) and Rep. Dennis Kucinich (D-OH) The bill currently has 93 co-sponsors.

    http://www.hr676.org/

    One thing about his plan is that simply builds upon what is already in place; ie., Medicare except it would bring everyone under the umbrella of the program.

    H.R. 3200 is a new system cobbled together for the benefit of the powers that currently control both health insurance and the providers themselves. Why duplicate and create a new boondoggle that within a few years will have problems no differently than Medicare. By using the existing Medicare administrative infrastructure it will be a fairly seamless addition of the millions of folks that currently do not have any coverage. Of course this is an expansion of government sponsored socialism, but to me this will be the least damaging as opposed to the only one being shoved down our collective throats; ie, H.R. 3200. It will also allow for closer policing of the now in place Medicare and Medicaid programs too without agency duplication.

    Possibly site participants could make commentary concerning their sentiments about H.R.676. It’s not too late for a groundswell movement to force our Congressional leaders to chuck H.R. 3200 and to opt for this alternative.

    I’ve only perused the content of the bill, but the one thing I feel is that it will be administered in a far simpler fashion than the 1017 page H.R.3200.

    The system registration cards will have their own numbering system and not make use of SS #’s which are rife with fraud and abuse.

    Carl Nemo **==

  6. bryan mcclellan

    August 11, 2009 at 5:37 pm

    Carl I can’t see any way to argue with the present system of medicare/medicaid,I’m just not that learned pertaining to lawyer speak, but it may be that there are others that can shine a better light on it’s shortcomings so I will only say that if a system works, that means it can be tweaked into performing better.

    How human life and health became a commodity I will never understand. It goes against everything my parents ever taught me about getting along down the road.

  7. woody188

    August 11, 2009 at 9:38 pm

    FYI, only 59 million are now employed full-time in the United States. Some how that 20% is supposed to provide for the rest of the nation.

    Health insurance margins run 3-4%, but auto, home, and life run up to 40% or more. I have a friend at Nationwide and Safe Auto.

    I’d strongly consider joining a citizen run insurance plan if it was fair and actually kept costs down.

    *~*~*~*~*~*~*~*~*~*~*~*~*~*
    R U Main Core?

  8. gazelle1929

    August 12, 2009 at 9:34 am

    Speaking of lies, damned lies, and statistics, you might want to provide some backup for your assertion that only 59 million people are employed full time in the US.

    The BLS says that there were 140 million people employed in the US in July 2009.

    http://www.bls.gov/news.release/empsit.t01.htm

    And here:

    ftp://ftp.bls.gov/pub/special.requests/lf/aat12.txt

    You will find a breakdown (towards the bottom of the page) for 2008, which shows 120 million working full-time and 25 million working part time.

    I could not find the figures for 2009, but I’d have to really really doubt that the number of FT employees dropped by half in the past year.

  9. bryan mcclellan

    August 12, 2009 at 12:42 am

    Thanks Woody;
    I’ve seen various degrees of the downtrodden these past years and those numbers reflect a dangerous number of outsourced companies that have spiraled down the toilets of greed, but can no longer be virtually hidden by the floaters with control of the media blinders.
    Which leads me to wonder what the makeup of my classroom will look like this fall. When adult Ed starts averaging 30+ yrs. the jig is truly up.
    Take up a collection for gas anybody?

    The solution/enigma to the tune of the riddle would be,
    whom will we find,honest/credentialed and invulnerable enough to administer our insurance company?

    Griff is going to give us both hell now for Utopian thoughts, I hope.

  10. woody188

    August 12, 2009 at 5:08 pm

    You are right, I got my wires crossed. It’s 59% of the populace that is employed full-time and is providing for everyone else. Still not sustainable when the boomers retire in earnest, if they will be able to at all.

    I sometimes get my numbers confused when I’m not looking directly at them. Have to wonder how politicized the BLS data is anymore as well. Like reporting a 9.4% unemployment rate when we all know it’s closer to 20% if it were counted like they did during the Reagan Administration. Not counting people that have given up is a deceptive practice.

    Here’s one I know off hand, 1 in 10 are on food stamps.

    I also note you did not refute my insurance margin claims. At least I try to keep it honest and own up to my mistakes.