The Return Of The Death Panels…And The Democrats Want To Keep It Hush-Hush

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This is a topic that needs to be talked about. Needs to stay in the news. The Democrats want us to overlook it. So too add to DrJohn’s post yesterday about the return of the Death Panels check out this interview of Dr. Mark Seigel on Fox:

Partial transcript:

Dr. Mark Seigel – Think about it Greg, every year I’m gonna talk about that? [end of life care] The first problem is, as a practicing physician, I could tell you that that discussion is often unnecessary or overblown when you actually get into the trenches of being sick. When you get a so-called terminal illness you find that there is no such thing as a terminal illness. You may get better, there may be hope, and a lot of the patients who tell me “I wouldn’t want that doc,” when they’re sick they do want it. They want it and their family wants it. So the idea of having a yearly discussion…which an obvious goal here is to scale back on technology, scale back on end of life, get somebody in advance to tell you they don’t want something so you don’t have to pay for it. Let’s extend the insurance to 32 million more people who can come to see me with the common cold without anybody restricting it, with low co-pay, with no deductible, and then when they are really sick, when they really need my help and my care they already opted out of it, they’ve already told me they are not going to have this procedure done. It’s a very sneaky way to get end of life technology scaled back.

As the previous post stated, those death panels were removed from the final version of the ObamaCare bill but now Obama is moving us closer and closer to making those death panels a reality via the back door. His partner in crime, lover of all things Socialism, Dr. Donald Berwick has ensured that:

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.

~~~

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.

What could go wrong with that eh?

Just imagine how things will turn as the ObamaCare system becomes bankrupt (and it will) and the government looks for ways to shift costs. End of life care is expensive and mark my words they will look for ways to get rid of it.

A doctor interviewed for the NYT’s article was quoted with some examples of the questions you will be asked:

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 “treatable, life-threatening conditions” but lacked decision-making capacity in their final days. With the new Medicare coverage, doctors can learn a patient’s wishes before a crisis occurs.

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?”

John Hayward:

The government can get a lot of people to sign away critical care simply by asking their insidious questions of young and healthy patients, who are much more likely to insist they don’t want to lie in a hospital bed with a bunch of tubes stuck in them.

The Democrats remember the furor this issue caused so they want to keep it hush hush:

After learning of the administration’s decision, Mr. Blumenauer’s office celebrated “a quiet victory,” but urged supporters not to crow about it.

“While we are very happy with the result, we won’t be shouting it from the rooftops because we aren’t out of the woods yet,” Mr. Blumenauer’s office said in an e-mail in early November to people working with him on the issue. “This regulation could be modified or reversed, especially if Republican leaders try to use this small provision to perpetuate the ‘death panel’ myth.”

Moreover, the e-mail said: “We would ask that you not broadcast this accomplishment out to any of your lists, even if they are ‘supporters’ — e-mails can too easily be forwarded.”

The e-mail continued: “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.”

Hmmmm

If you have to hide what you’re doing then you KNOW you shouldn’t be doing it. Period.

This is just the beginning because while the bill itself is bad…the power the bill gives to the government to do things like this is worse.

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Over these next two years . . . devote a lot of attention to the Executive Branch of Government . . . disregard Obummer as much as you can . . . but watch the regulations and nugregs . . . a nureg is a proposed regulation . . . nuregs are where the visibility is at in the executive branch of government . . . a nureg is a new regulation that is proposed . . . they can be commented on by anyone via writing to your congressmen or senator. . . nuregs do not have to become regulations . . . if we stop the nureg . . . we stop the regulation . . . we stop the codes & standards that are writen to enforce the regulation. Keep in mind that a regulation is “enforced as if it is a law” . . . get it? A regulation is NOT a law . . . since it never has to pass the congressional vote . . . it is how the Executive Branch carries out the business of law . . . . to stop ObieCare . . . we must stop the regulations!!!!

I wonder how many Republican candidates in the upcoming election in 2012 are going to use half the issues out there or will they “Play Nice” like they have in the past and lose. Next year the RNC needs to start hitting the Dems hard with Facts such as these and make sure that all their upcoming candidates focus people on how much worse government has become under the Pretender in Chief.

Anyone can go to http://listserv.access.gpo.gov/ and sign up to receive the daily Federal Register Table of Contents via E-mail. I’ll tell you right now, though, you could spend your entire life reading all that crap…er…I mean “all those proposed regulations”.

I tried to get our local Tea Party to find some volunteers willing to read it every day and report any threats to liberty. They weren’t interested.

John;

Yep . . . there is an old saying. . .”You can impress them with your intellect or baffle them with your BS” . . . we have a government that is very baffling, lol

This is how we get all the things we get . . . transparency does not mean . . . understandable, rational . . . it is like looking through the window at the fires of hell.

There are no Death Panels.
Just get that thought completely out of your mind.
It is end-of-life care.
There is no Death involved.
Life ends, but there is no death.
What is the matter with you? Do you not understand newspeak?
Do you need to be re-educated again?
Dear Leader is GOOD.
Opponents of Dear Leader are BAD.
Costs will be cut by not providing treatment to the dying. See? It is really simple.
Hospice care for all, once your contributions to society diminish.
Euthanasia for all; this way to the egress.
Most regrettably, the senior citizens, taught from infancy to vote Democratic, will follow the lead cow into the slaughter house. And Democrats will continue to be elected by those who contribute nothing to the Federal Government, but receive payoffs in return for their votes.

What a disaster!

A few comments:

1) Back in 2007, Johnny Isakson (R. — Ga.) and Dick Lugar (R. -Ind.), two GOPer cons, were two of the original proponents of paying doctors for the time spent in end of life planning. Susan Collins was another sponsor. Here is the bill Isakson co-sponsored. So if this is a “death panel”, cons should start out by asking Isakson and Lugar why they proposed such an idea.

2) Are GOPer cons against doctors discussing with Medicare patients what their end of life care plan should be, or are you just against doctors getting paid for the time spent discussing it?

3) What is the philosophical opposition from the con side against discussing, as a 28 year old friend and her husband did earlier this year, do not resuscitate orders?

This is no more a “death panel” now than it was when it was proposed in 2007. As Isakson noted, anyone who calls it euthanasia is “nuts”. It is a dumb con meme that makes no sense at all . . . but are we surprised that it was resurrected anyway? I mean, seriously, I heard a con radio host discuss how she and her husband’s family discussed end of life care for her then-ill husband, who was on life support. But she somehow turns the same discussion SHE HAD a year ago into a “death panel” because OTHER people’s doctors will get paid a fee for having the very same discussion? Please . . . .

These people cannot live with the truth. We (who are over 50) know the truth. Just sayin’!

I’ve really disagreed with the characterization that end of life counseling is “the death panel”. How can you call something that when it’s been done for decades… for as long as hospice care has been around, and available via health insurance?

So yes, while I disagree with the Obama stealth regulations (for reasons I’ll go into below), I will say the hype on this is mislabeled, and misrepresented. That is not to say there are not “death panels” built into the non reforming “reform”.

The “death panels” are alive and well, and functioning under names – the MedPAC, and the IMAB. The latter is empowered with POTUS advisory capacity for budget cuts every six months, and Congress must have a joint resolution of rejection in order to stop any of their “advice” the POTUS chooses to send on from coming to fruition. These are appointees, fer heavens sake. And the onus is on both chambers of Congress to get their act together in 30 days in order to protest their findings.

May I remind everyone that even with a supermajority in the Senate, and a hefty majority in the House, it still took Congress a heckuva long time to pass their O’healthcare. And even that was done by abusing budget reconciliation rules.

Does anyone think Congress could possibly be organized enough to stop the IMAB from making the rules?

Now, INRE @Billy Bob’s comment above, and my objections to Medicare payments for end of life counseling. Specifically #2:

2) Are GOPer cons against doctors discussing with Medicare patients what their end of life care plan should be, or are you just against doctors getting paid for the time spent discussing it?

Yes, Billy Bob. I am against *paying* doctors for their consultations. First of all, they already recommend palliative alternatives, and have done so for years. In fact, you can’t qualify for Medicare coverage for hospice services without two doctors’ opinions that you have less than 6 months to live.

Why should we start *increasing” Medicare costs by paying doctors to do this once a year, whether palliative care is needed at that time, or not? What a scam.

Secondly, I find the entire idea that doctors have to be paid to discuss treatment options with patients entirely offensive. The patient already pays an arm and a leg for tests and sundry other hidden charges for diagnoses. They already have to go thru their primary doctors just to see specialists, so these doctors get plenty of unwarranted charges. i.e., when you have a skin problem, why can’t you go see a dermatologist direct? But noooooo…. we have to insert a middle man “primary” in there to increase the costs.

Now, the man who says he wants to bring the costs down (right….that’s a hoot) now says you have to pay for someone to tell you the results of those tests, and your options?

I’ll tell you what. You bring your BMW into my mechanic’s shop with a problem, we’ll diagnose it for you… but if you want to know the results, how about I tag on an additional charge… otherwise, I’m not gonna tell you? How do ya like that one?

Absurd.

Then you might want to add that they’re slashing hospice budget. So pay the doctors to recommend palliative care, then slash the benefits for what you recommend?

Idiotic. Bozos… all of them.

This regulations sneak is no surprise, mind you. It was in September when I pointed out that a GOP midterm win would only mean Obama would continue his agenda thru regulations instead of Congress.

It’s all for the good of the country.

Yes, Mata . . . Obingo has the regulator power to do pretty much anything . . . and that is where the attention of our congressional branch needs to be directed for the next two years . . . if they fail to watch Obozo that Tea we are so proud of will be so weak that it will taste a lot like pee!!!

Tea Party Time folks . . . it is time to boil the water and make the tea strong and with a bite!

Tallgrass, yes agreed good tea must be strong to bring some healthy behavior and change for the best of the people who will be still able to enjoy their BIGMAC AND FRYES.
BYE

When his view (along with the rest of his Party) is that the Constitution is “fundamentally flawed”, is any of this shit a surprise to anyone?

I won’t be holding my breath that any Republican’t will do what needs to be done to regain some semblance of Law to this federal government.

-This is only one of many…Cap N Tax, Net-takeover (after they just gave away control of ICCAN), drilling moratoriums, Cardcheck, etc, etc, etc.

Not even the Judicial branch has the knowledge/care to return us to the path of greatness, so in all honesty, I see nothing but dread.

The “Death Panel” moniker/misnomer has nothing to do with what’s really at stake here, as the entire CONCEPT of it is unconstitutional.

PATTVAN, BEST TO YOU ON THIS END OF YEAR AND FOR THE NEW YEAR COMING,
I say we cannot give up hope ,for this AMERICA HAD TO COPE WITH MANY CHALLENGES
DURING THOSES UNDREDS OF YEARS, AND SHE WILL FIX THIS ONE SO WELL IN TIME THAT THE CLEAN UP WILL BE TOTAL ON ALL FRONTS, AND WHAT WILL BE LEFT WILL BE THE TRUE AMERICANS THOSE WHO WILL HAVE WORK HARD FOR THEIR COUNTRY,
AND YOU WILL SEE THE OTHERS FLEE AS FAST AS THEY CAN, SO TO NOT FACE THE ANGER OF THE ones who have decided that their TOLERANCE HAD CHANGE AND FOUND IT’S LIMIT

BYE

Mata —

Your post above is so disjointed as to border on incoherent. Here is the problem: Medicare is on a glidepath to bankrupt the nation. A HUGE percentage of Medicare dollars are spent providing care to people who are in the last week of life. In the absence of an advance directive, hospitals extend a lot of care that the patient MIGHT not have wanted extended. With an advance directive, you tailor the care extended to the desires of the individual patient: those who want the earth moved get it, those who want less done get that, too.

On the one hand, you castigate ObamaCare and Obama for wanting to use “the MedPAC, and the IMAB” to call for “budget cuts every six months”. You wrote that Congress should step in to rein in these agencies that are, dastardly, seeking to cut Medicare expenditures.

Then, in the same breath, you say that it is a waste of money to pay doctors for engaging in the kinds of conversations that would address whether ill people will have the very costly end of life care that is bankrupting the system! In other words, you oppose cutting Medicare, but you also opposed spending a little bit more to help the system avoid needless expenditures.

But this is the other hilarious part: no doctor is going to get rich discussing end of life care with his/her patients once a year. You are not talking about a lot of money, but it is an effective dollar, both from the cost of care standpoint and the patient’s desires and needs. You are being penny wise and pound foolish on this, because it costs a lot less to pay doctors for discussing end of life care (like “Do you want to be resuscitated? Or put on like support?”) than it costs to actually extend that care to people who don’t want it! You are opposing, in other words, spending $200 discussing care options that could help the system avoid spending $50,000 to $100,000 providing unwanted and therefore unnecessary health care! And all this is because Obama is implementing this GOPer con supported plan, and because it will save Medicare dollars and LOWER the cost of that program . . . now you cons are against it?! This is simply incoherent!

The current con opposition to this GOPer con backed proposal reminds me of a union negotiation I did a number of years ago. We offered a one year contract, the union countered with a four year contract. Later, the union offered a three year contract and we accepted. So the union then OBJECTED! Why? They explained that they REALLY wanted a two year contract. They thought offering a three year contract would get our side to “split the difference” between our one year offer and their three year counter, and agree to a two year contract.

But that’s just it: when you offer something, you always run the risk that the other side will accept your offer!

Obama keeps doing this: cons come up with an idea, he signs on to it, then cons oppose their own idea. This may make good internal cons politics somehow (I am not sure how, but trust you cons think you know what you are doing), but it is pretty disheartening to see. But I guess GOPer cons are now so shell shocked that when Obama accepts their ideas, the cons then start to rethink the wisdom of their own con idea! Like cons consistently opposing the concept of tax cuts counting as increasing the projected deficit, then turning around and opposing Obama’s tax cut deal because it will “increase the deficit”! Or cons refusing to vote for their own deficit reduction commission proposal!

Like I said: it is pretty entertaining to watch cons rail against con idea, but I do wonder: “Where are you all going with this?” How does this make sense to you, to keep doing this?

The more I think about this, the more bizarre it becomes: the “smaller government” “less government spending” “no socialized medicine” cons are ACTIVELY OPPOSING Obama administration proposals to SPEND LESS MONEY on Medicare. They are OPPOSING concrete plans that will ACTUALLY result in fewer dollars spent and lower tax demands from the system. Cons are up in arms that Obama is actually DOING SOMETHING to rein in spending on one of the most costly, most socialistic programs in the federal government. He is now a “bad guy” because he is trying to spend less money on a Johnson Administration Great Society program. The ironies abound . . . .

Speaking of disjointed and incoherent, here comes @Billy Bob and his spin, right on cue.

So you advocate paying doctors for palliative “advanced directives” every year, even tho nothing in their condition warrants such advice, and purport this “saves” money.

In what universe, Billy Bob?

And what makes you assume that such advanced directives only originate thru doctor consultation, Billy Bob? Do you believe that information about DNRs and final arrangements are only available thru medical professionals? But then, you probably also believe that people only find out about wills and living wills if they pay an attorney beaucoup bucks per hour as well.

On the one hand, you castigate ObamaCare and Obama for wanting to use “the MedPAC, and the IMAB” to call for “budget cuts every six months”. You wrote that Congress should step in to rein in these agencies that are, dastardly, seeking to cut Medicare expenditures.

Then, in the same breath, you say that it is a waste of money to pay doctors for engaging in the kinds of conversations that would address whether ill people will have the very costly end of life care that is bankrupting the system! In other words, you oppose cutting Medicare, but you also opposed spending a little bit more to help the system avoid needless expenditures.

Medicare most certainly first needs to be reformed… i.e. the ponzi scheme must be slowly abandoned. But what you forget is that those who they are slashing services for are those who have paid in for over four decades. You will also need to face that once you are 65, you have no choice but to be forced into Medicare, and you cannot opt out unless you forfeit your Social Security.. which they also vested in for over four decades.

You cannot repair a ponzi scheme. And you most certainly cannot repair Medicare or Social Security. They were deplorable policy that would have been illegal in the private sector.

Apparently you have zilch experience in hospice/palliative care. In fact, right now, one can opt for hospice and change their mind midstream if they decide they wish to resume life extending treatments. I guess you’d like everyone to make a directive before they need palliative care, and then use that as a justification to deny them treatment when they actually face the real situation? Other than that, I have no idea why you think an advanced directive is going to save any cash whatsoever… unless you make that advanced directive irreversible.

But your reading disability again bubbles to the surface. What I pointed out was Obama’s admin regulations are advocating an increase in Medicare payments via these unnecessary consultations on an annual level, but then cutting back on the very services they are advocating to save expenses. For the dying to live out their lives at home with in home hospice care, or in the sundry hospice facilities, is considerably less expensive than doing so in the local hospital. And yet, this is where cuts are being made… twice. Both with the basic adjustment factor, and with budget cuts. Brilliant.

And predictable you are too dense to get the irony.

Then you justify it by saying no doctor will “get rich” with these added payments. I still say bring your car to my mechanics shop, Billy Bob. I’ll be happy to diagnose it for you, and then charge you extra to tell you what I found and what options you have for repair. You’re such a dunce, it’d be a pleasure to rob you blind.

One more thing, Billy Bob:

On the one hand, you castigate ObamaCare and Obama for wanting to use “the MedPAC, and the IMAB” to call for “budget cuts every six months”. You wrote that Congress should step in to rein in these agencies that are, dastardly, seeking to cut Medicare expenditures.

This is ceding away not only responsibility but Congressional authority to appointed officials on a panel. Congress and their actions are held accountable in how they handle the Medicare funds they have been absconding from every working individual since it’s mid 60s inception. Appointees are not.

This is just another “pass the buck” for responsibility trick for the elected ones. A five panel membership should not be deciding what and how much Medicare will pay out, for who and for what. Period. No oversight. No accountability. I don’t care how much glory you wish to attach to their task.

Another Billy Bob’ism: Obama keeps doing this: cons come up with an idea, he signs on to it, then cons oppose their own idea. This may make good internal cons politics somehow (I am not sure how, but trust you cons think you know what you are doing), but it is pretty disheartening to see.

Let me get this straight…. three GOP members, Collins, Lugar and Isakson (two of which are questionable as having any conservative in their political make up) sign on as co sponsors to a Dem introduced bill not once, but TWICE ( see S 465 introduced at the same time, and deals solely with advanced directives), and it’s “all cons” or a “con” idea to you? Rockefeller sponsored the bill you referenced. Bill Nelson sponsored S465. Both are Dems.

You’re a hoot… were you not so pathetic. It was, and remains a Dem idea that garnered the support of only three quasi GOP usual suspects.

Revelation for you. Neither of these got out of a Dem majority controlled committee to reach the Dem supermajority Senate floor. Does that tell you anything?

I see another of @Billy Bobs afterthoughts, and deplorable math, was retrieved from the garbage…

….the “smaller government” “less government spending” “no socialized medicine” cons are ACTIVELY OPPOSING Obama administration proposals to SPEND LESS MONEY on Medicare. They are OPPOSING concrete plans that will ACTUALLY result in fewer dollars spent and lower tax demands from the system. “

No, Billy Bob.

1: Paying doctors for consultations they are not being paid for now, and saying they can or should be done on an annual basis, is not “saving money”.

2: As of now an advance directive can be altered in the future, and the patient can opt for treatment to extend life. So unless you are saying that we have to do directives, today… pre palliative health status… for the future that are irrevisible, you’re just shooting off BS talking points that are utter jibberish. No, make that outright lies.

B-Rob, since when does a doctor have to charge more money for talking to his patient or patient’s family? this is incredible to even mentioned it,
you charge money for your words,because your a lawer but doctors are not lawer, they are healers so what a transgression of career will they want to do? to make more money,
this is pushing to far, and again on the back of the most VULNERABLES .
WHAT A SHAME FROM WHOEVER WILL IMPLEMENT THAT LAWS SO HORRIFIC,
ONE MORE OF THOSE MANY THAT WILL HAVE TO BE DELETED WHEN OUR CONSERVATIVES AND TEAPARTYERS GET THERE . THAT’S WHY YOU ALL ARE PUSHING THOSE LAWS BEFORE THEY COME, SHAME YOU ALL

New York City dwellers are among the most highly taxed in all the US of A.
But, for all their money to the city they got snowed in all over town.
Why?
Because ”big government” is not capable of moving quickly to deal with a sudden bad situation.
Men on the streets became local heros for clearing the way so people could get out.
People died because ambulances could not get to them in time.

The small town of Hamtramack, Michigan, is begging to be allowed to go bankrupt.
With only 22,000 people why is it’s city budget over $18 million a year?
Because Hamtramack took a ”big government” approach to local problems.

Since Hamtramack voted down a Civil Right’s proposal to guarantee lesbians, gays, bisexuals and transsexuals the right to Fair Housing they stick out like a sore thumb compared with places I’ve been.
They don’t fix the streets.
They won’t board up abandoned homes.
I forget all the other city services they’ve quit doing.
But their budget goes to 163 retired city workers before it goes for current needs done by the 100 current city workers.

Mata —

You simply make no sense. What difference does it make WHO cuts spending as long as the spending gets cut? And the argument that “bureaucrats”, especially a panel of medical professionals, should not cut spending, but Congress “should” cut spending . . . because they are elected? This borders on idiotic! Congress has NEVER cut Medicaid spending, but you think the Obama Administration should just wait on them to do what they have never done before? That proposal is a recipe for NOTHING to get done, just as nothing got done during the Hastert/Frist/Bush years . . . strike that: they actually made the problem WORSE by enacting Medicare Part D without paying for it! But you want more of the same and now criticize Obama for actually CUTTING SPENDING on Medicare? Yeah, that makes sense . . . .

By the way, Mata, you want to have the end of life planning done each year because PEOPLE’S CIRCUMSTANCES CHANGE! Duh! Such as: they get married and have another person to consider; they lose their spouse and now have a different plan; they are sick this year and weren’t last year; they had a friend die in a horrible painful way and don’t want that to happen to them; they were depressed last year and now have gotten treatment; there are treatments for illness this year that did not exist the year before. No, going over this on an annual basis makes all the sense in the world. You are simply nit-picking a reasonable plan because Obama supports it!

As for the cons who proposed this, you don’t really address why they were “wrong” to support this plan. And, yes, by any sane definition, Dick Lugar is a conservative, as is Isakson: the fact that Lugar works with Obama on important things does not make him “not a conservative”; it makes him an adult. This is an idea that the conservatives knowledgeable on the issues USED TO SUPPORT in 2007. But, thanks to the insanity that now possesses the cons, you FA cons oppose it. Why? Because Obama is for it. If Obama supports sunshine and puppies, y’all will be complaining about skin cancer and dog crap.

And did I say that end of life care is “initiated” through doctors? No, but that is a red herring anyway. Regardless as to who initiates it — the patient, their family, their lawyer — doctors should be involved, obviously. This proposal is about permitting more doctors to be involved in the planning by paying them for their time. How is it a BAD thing to pay doctors for time spent addressing patient care plans?

Your claim that this would not save money is ludicrous. People with no advance directive get the full blown resuscitation, intubation, “chi chi mumba” (Harvard Med term for tubes in every orifice) treatment. If they HAD an advance directive, their care would be catered to their choices. That means people who do not want the full treatment won’t get it and that will save money. As for the “costliness” argument . . . you are joking, right? It will cost about $200 per patient per year, if that. That is NOTHING in light of the costs of terminal care extended to people who may not want it. In fact, this is a rather hilarious argument: on the one hand you criticize Obama for cutting costs, then you claim he will add too much by paying doctors for planning, and you oppose that, too! What the hell do you guys want? Do you want a less expensive program, or not?

And that is the present day ignorance of cons coming in full view: you oppose a con plan that will save money because Obama is the one doing the saving. Talk about nonsense . . . .

Bees —

Let me ask you this: how long do you think it would take to do end of life discussions with the average Medicare recipient and their family? I would have to think it would take at least a half hour, assuming that all the kids agree with the parent. If not, it might take longer. That is time that the doctor would be seeing other patients, providing services to other people. You want them, instead, to do this for free? Why? How does that make any sense, to expect doctors to provide an hour out of their day, not get paid for it, and provide that to their Medicare patients and STILL make their numbers? Really, you think that makes sense and is fair to the doctors? Well, it isn’t and that would be a disincentive for the conversation to actually occur. And that is why the proposal was made in the first place: to incentivize doctors to sit with patients and plan out their care. Why is that a BAD thing?

@Billy Bob: You simply make no sense. What difference does it make WHO cuts spending as long as the spending gets cut? And the argument that “bureaucrats”, especially a panel of medical professionals, should not cut spending, but Congress “should” cut spending . . . because they are elected? This borders on idiotic! Congress has NEVER cut Medicaid spending, but you think the Obama Administration should just wait on them to do what they have never done before?

I’d like to say I can’t believe I’m hearing this from an attorney… but then, considering the particular attorney, it’s of little surprise that you don’t mind when Congress delegates away decisions in order to escape oversight, responsibility and accountability. How convenient that, in an election season, and the death panel of appointees has cut controversial coverage and lowered payments to the point doctors flee from Medicare/Medicaid patients, they can look at their constituents and say, “hey! it’s wasn’t me, babe”….

The question you ask yourself is all wrong… ala you whine to Skookum that he would get $198K worth of healthcare after being hit by a bus (no doubt, Obama’s bus, laden with cast off political bodies…). Yet the real problem lies with what you studiously avoid. Just why does it cost $198K to fix some broken bones? Why does it cost $200 to administer a simple tetanus shot?

But since you, and Congress, want to avoid the real problem and play the insurance premium and payment price fixing game instead, plus escape all repercussions of how the payments and coverage are slashed, I will tell you “what difference it makes”….what is cut and to whom is extremely important. After all, it was your Dem chums that got us into these ponzi schemes and screwed the nation into a spiral of deficit. If you hadn’t thrust the nation onto a system where the nanny state, via the taxpayer, is paying these costs instead of an individual having private insurance at their own expense, we wouldn’t be here now. So how the bozo statists that created this program decide back out of the same is no less complex.

And I… as a voter… want to be able to hold my elected officials reponsible for their bad decisions. I can’t touch a panel of empowered appointees, immune from accountability. But I’m sure this is probably beyond your comprehension.

And did I say that end of life care is “initiated” through doctors? No, but that is a red herring anyway. Regardless as to who initiates it — the patient, their family, their lawyer — doctors should be involved, obviously. This proposal is about permitting more doctors to be involved in the planning by paying them for their time. How is it a BAD thing to pay doctors for time spent addressing patient care plans?

Let’s see… we’re talking about wasteful spending. Try some math again, Billy Bob. Your shoes off? As of 2010, the Medicare enrollees numbered 46,589,141… that’s up two million from what it was just two years ago when the oldest of the boomers started hitting the 65 mandatory enrollment age.

You can see a pyramid graph here, but keep in mind it was as of 2000. So add 10 years onto every category there… and note each bar is in five year increments. By 2011, another 2.8 million will be added to the rolls. Suffice it to say that the 46.5 billion plus is the lowest number we’re going to see in the next 25-30 years.

Average doctor/consultation visit is $120 nationwide. Annual cost to pay doctors for their advanced directives for the 2011 anticipated Medicare enrollment of 49.389 million adds $5.925 billion annually to Medicare expenditures, and almost $29.6 billion in increased spending in the next five years alone… NOT including the boomers adding to the enrollment numbers each year.

What are they paying for, and can they get it elsewhere? But of course. You can download a free advanced directives form for your state, and have it processed for the maximum it would cost a notary. Some states don’t even require the notarization of the witness signatures. These forms are also available at doctors offices and other state facilities.

Additionally, the Patient Self Determination Act, implemented as part of the 1990 Omnibus Budget Reconciliation Act, is a federal mandate that health care providers that receive Medicare/Medicaid funds provide disclosure to patients of their rights to refuse treatment. The two bills that were proposed directly for this required disclosure were sponsored by GOP Sen. John Danforth in 1989, and House Dem Sander Levin in 1990. Both bills had some bipartisan co sponsors. Neither bill implemented increasing costs for physicians, who were on record as reluctant to have discussions with patients for both the delicate subject matter, and not wanting to do so without recompensation.

Why, pray tell, are you advocating more spending to do what is already readily available for very little expense? An advanced directive is flexible as physical health changes, and doesn’t require you go speak to your physician every year just because you changed your health representative. If you wish to alter your directive because of a health status change, that should be part of a physician’s consultation with you about your prognosis… when they give you your treatment options. In both cases, you simply download another form, or add an addendum to the existing with the proper witnesses. Both methods are adequate for holding up in a court of law.

As far as those involved… a physician can offer specifics on what life support treatments may be, but that’s all illness specific. His input is medical profession only. What most directives come down to are a personal moral or perhaps religious belief about medical treatment and life. None of these involve physicians, but include the individual, family and perhaps clergy.

Your claim that this would not save money is ludicrous. People with no advance directive get the full blown resuscitation, intubation, “chi chi mumba” (Harvard Med term for tubes in every orifice) treatment.

Why don’t you give us statistics of how many people are being kept alive – unconscious and/or incapable of making their own decisions – against their will, Billy Bob? The way you portray it, most the elderly prefer to die, and don’t (or didn’t) know they can request that via a directive.

I, instead, suggest it is the opposite. That the majority of people who are engaging in life prolonging treatments are doing so because that is their choice, or the choice of their family members speaking for them. And apparently, you resent that for the cost.

Additionally, with a few simple searches thru abstracts in the US Nat’l Library of Medicine, you will find that the amount of people that have been foregoing or accepting withdrawal of life extension treatments has been increasing in the past two decades. Most are not age related studies, and often conducted thru various ICUs in trauma centers. Because all providers (including hospitals) are required by federal law to disclose patients have the right to refuse treatment, many families who have not made up advanced directives gather with the doctors on rounds in the facilities, who advise them of the treatment options and prognoses.

Considering that advanced directives are not really a problem, and you’re making up some wild eyed, unsubstantiated talking point about how the system is being drained by the elderly who are being kept alive – against their will – the entire nonsense about paying doctors annually for consultations is nothing more than over priced compensation for what any family can get for (at most) the price of printing off a form and a notary. I suggest it’s a little incentive padding to keep the physicians happy and in the Dem pockets, as they’ve been for decades.

In fact, this is a rather hilarious argument: on the one hand you criticize Obama for cutting costs, then you claim he will add too much by paying doctors for planning, and you oppose that, too! What the hell do you guys want? Do you want a less expensive program, or not?

I do believe that, several times, I’ve already explained that paying doctors to do this annually is not going to “save money”, and only increase the costs unnecessarily. There is only one way that an advanced directive can “save money”… if it is a statement that you do not wish to have any life extension treatments under any circumstances, and that directive is irreversible. Other than that, patients and families generally make their calls as events demand…. just as they do now.

So, Billy Bob…. we’re waiting to hear from you any proof that the system is being burdened by those being kept alive against their will. Or are you just going to continue this line of BS?

Nice one Braindead Rob. Kill the elderly and unborn. Get them coming and going. Nice belief system you have there. Wonder if you’ll feel the same when it’s your turn on the chopping block?

Billy Bob rants: This is an idea that the conservatives knowledgeable on the issues USED TO SUPPORT in 2007. But, thanks to the insanity that now possesses the cons, you FA cons oppose it. Why? Because Obama is for it. If Obama supports sunshine and puppies, y’all will be complaining about skin cancer and dog crap.

No, Billy Bob. Three … count ’em… THREE quasi “cons” supported a Dem sponsored bill back in 2007. Three does not constitute a blanket majority of conservative or GOP beliefs…. except to those who love to desperately spin. I will also add that neither bill attempt made it out of a Dem majority committee to a Dem supermajority Senate floor. Appears there were quite a few lib/progs who also didn’t like it, eh?

And I’ve already explained why I don’t support it. It’s unnecessary added spending… and utterly absurd in the reality of Obama’s cutting the very programs he’s trying to get physicians to peddle.

I swear… a brick wall is more porous…

I swear… a brick wall is more porous…

And less dense, Mata.

Mata —

You used many words and piled up many insults . . . and you still made not a lick of sense. The reason is obvious, of course: you simply are not thinking this through. You are acting hysterical, about to explode with emotion without using what minimal gray matter God gave you. I can practically see the spittle flying off your maize and brown tobacco stained teeth.

On cutting Medicare — your argument continues to be nonsensical. It has nothing to do with me not understanding the Constitution and EVERYTHING to do with the fact that your argument is simply not very well thought out, or logical, or rooted or grounded in reality.

You are claiming, in essence, that it is Congress’ responsibility to cut government spending, and no one elses’. In your mind, the Executive Branch, which is what “the bureaucrats” are, has no say, or should have no say, on what money is spent. This, of course, is illogical, nonsensical, and nowhere supported in the Constitution, or any statute that I am aware of.

An example — supposed Congress, in an earmark, allocates $1.2 million to build an exit ramp. The Department of Transportation, however, figures out a way to build the intersection for $979,000. Under your idiotic argument, the Department of Transportation is “not allowed” to save money, because THAT IS Congress’ responsibility . . . really? Where in the Constitution does that document prohibit the Executive Branch from saving money?

And where in the Constitution is it written that an executive panel cannot cut spending? Give me an Article and Section cite!

Furthermore, the idea that a panel is “not accountable” is just dumb. Of course they are accountable! They are appointed by the executive branch and the executive branch can call for every members’ resignation if they get out of hand. If they get out of line, the executive branch has to answer for it, both during elections and during congressional oversight. And if the GOPer cons oppose something that a panel does, they can act by statute or use the power of the purse strings to cut all funding.

You make much of the fact that the 2007 bill never passed Congress. Well so what? It was never voted down, either. Furthermore, there is no rational argument that the Executive Branch, in the absence of an EXPRESS STATUTE, cannot expand the list of reimbursable services to include end of life care planning. And that is what the Obama administration did: expanded compensable services, the same way they could add a particular new medical test or device.

Again, I repeat the obvious — three GOPers co-sponsored this bill. The signed on to this plan. Why do YOU think they sponsored it?, signed their names on to it. Do you REALLY think they supported this because they want to euthanise old people? Do you? If you really believe that, then, as Johnny Isakson would say, you are “nuts.”

And another thing — if people do no have an advance care directive they may get care that they would not want. This happens all the time, obviously, because the default hospitals operate under is “do everything.” This is costly and USEFUL if that is what the patient and his or her family want; but if it is contrary to their reflective wishes, then it is a waste of money.

Again, the cost of the counseling will probably run about $200 per patient per year. Do you have any concept how expensive and wasteful it is to give terminal care services to someone who doesn’t want it? Have you given the slightest bit of thought to these issues? No, you haven’t. Because your arguments are incredibly poorly constructed and out right bizarre. Advance care directives are an essential part of responsible health care decision making. And WHY is it so important?

“You can boil it down to two words: ‘Who decides?’ ” says Bill Thomas, M.D. of Ithaca, N.Y., a nationally known geriatrician who developed the concept of “green house” nursing homes—facilities that are less institutional and help patients live richer lives in smaller settings.

“The entire point of doing this planning is thoughtful communication with a physician and creating some documents that can guide your care,” he says. “It’s so you decide.”

Got that? It is all about THE PATIENT deciding what care they will get, not the government or anyone else. Your incredibly short sighted and, frankly, DUMB position would deny many patients the ability to have this discussion with their doctor because, as you SURELY understand, they do not have the time or the money to take an hour out of their day to do end of life care planning for free.

Nope, you either are woefully ignorant about the importance of this planning, or you are being a kneejerk contrarian because you oppose anything Obama does, no matter how logical, reasonable or cost effective. Based on your previous post, I am not sure whether willful ignorance or mendacity is the explanation; could go either way.

Hard Right —

When Sen. Isakson noted that people who characterized his bill as euthanasia or a “death panel” were “nuts,” he was obviously referring to you. If you think that compensating doctors for talking to their patients about end of life care is “forced euthanasia,” then you are just bonkers. It is a VOLUNTARY PROGRAM, the same way that getting chemo is voluntary. NO one can force a Medicare patient to have this talk any more than they can be forced to have dialysis. Again, rather that dealing with reality, you cons venture off into nutty conspiracy theories (“Obama wants the kill babies and old people”) and utter b.s. Why do you cons always do that? I hope you don’t really believe what you write, since it is such nonsense . . . so why do you write it?

Honestly, cons, you need to do a better job picking your battles. If GOPer cons like Isakson support the proposal and the AARP (which SURELY is against euthanizing the elderly) both support the concept, you might need to rethink the rationale for opposing it.

Billy Bob… you’re such a pathetic apologist. Not to mention suffering from delusions of grandeur, assuming I am “acting hysterical” or you “can practically see the spittle flying off your maize and brown tobacco stained teeth.”. LOL Were that I gave you that much thought or consideration to raise such emotions. Truly, there’s crumbs on my kitchen counter that get more focus that your nonsense.

So Billy Bob… still waiting…. where are those stats that we are just drowing in wasted funds by keeping Medicare recipients alive when they actually prefer to die?

Braindead, I’m calling you on your beliefs as a leftist. Will you be so willing to euthanize yourself when it comes your time? I’m pretty sure the answer is no since your kind only wants others to sacrifice…for YOUR benefit.

No politician would be in office if they didn’t have our best interest at heart, would they?

Before relying on what someone says on FOX, consider this:

“World Public Opinion, a project managed by the Program on International Policy Attitudes at the University of Maryland, conducted a survey of American voters that shows that Fox News viewers are significantly more misinformed than consumers of news from other sources. What’s more, the study shows that greater exposure to Fox News increases misinformation.”

Now I know conservatives disagree with this conclusion, but opinions don’t negate scientific studies–only facts do.

@liberal1:

We know all about that, ahem, propaganda“scientific” study, AAMOF, we’ve already discussed it:

Fox News Viewers Are Misinformed Study, The Critique

Sometimes it really sucks to be late to a party, the grand entrance and all, winds up being….not so grand. 🙄

Ooo that must sting liberal 1. You tell us not to mindlessly listen to FOX, yet you mindlessly listen to a junk science study because it fit your stereotypical view of us. Liberal hypocrite…but I repeat myself.

Billy Bob sez: On cutting Medicare — your argument continues to be nonsensical. It has nothing to do with me not understanding the Constitution and EVERYTHING to do with the fact that your argument is simply not very well thought out, or logical, or rooted or grounded in reality.

…snip…

And where in the Constitution is it written that an executive panel cannot cut spending? Give me an Article and Section cite!

Nice attempt at a straw/red herring there, bubba. No one mentioned the Constitution, or questioned whether Congress has the authority to pass the buck of responsibility and accountability except for you.

However I will say this… attempts to debate any Constitutional issues with someone who believes all power and authority is fair game if it’s not an explicitly forbidden power stated in the Constitution is a waste of time. Those of us who were graduated before Bill Ayers instituted his “social justice” curriculum from your Chicago backyard learned that the Constitution states only that which the government is allowed to do. Anything outside of that, they are ripe for any unConstitutional challenge that the wealthy are able to mount. Because the challenge hasn’t been mounted doesn’t mean that any particular action isn’t unConstitutional. Just mean no one’s complained about it to the judicial branch.

i.e., if you break into my house for robbery, I know it’s you, but I don’t report it to the police, are you still a low life thief? Of course. You’re just an unpunished low life thief.

The Bill of Rights states pretty much what they are not allowed to do.

Therefore your comprehension of the Constitution, and assumptions that if it ain’t appearing in the B/W text, it’s a-OK is severely skewed in it’s foundation. Conversations about how blue the sky is tends to be a waste of time when you’re debating with a color blind human.

However your distorted “living Constitution” visions have nothing to do with the IMAB, now changed to the IPAB, and was originally the IMAC… ala it’s the final updated version of Obama’s proposed IMAC which I posted about in August of 2009.

Since you have this notion that if a “con”, or a few “cons” support a liberal idea, it must be correct, then you might have to take into consideration that even a multitude of House Dems find the the IMAB offensive. The letter sent to Pelosi, stating unequivocal opposition to the IMAB and the authority giveaway was unacceptable, contained 66 signatures… and a hefty amount of them Dems. MA Dem Rep Neal reissued the letter a second time.

Hence the reason the House version contained no provision for such a body to usurp MedPAC, as a MedPAC on steroids. But as we all know, this appropriations bill did not originate in the House, as the Constitution dictates, and Pelosi/Reid/Obama figured that budget reconciliation was the only way to get what they wanted … despite a House Dem majority.

Therefore, your comment…

Furthermore, the idea that a panel is “not accountable” is just dumb.

… indicates you may be the uninformed, blind partisan dunce here since Congressional House members of both parties happen to agree with me, and not you, INRE accountability and oversight being lacking.

Again, the cost of the counseling will probably run about $200 per patient per year.

Then you should be happy that I averaged the unnecessary increased spending at only $120 per consultation. So we’ll use your figures and that will add $9.960 billion additional annual spending for 2011 alone, and rising…. or over $50 billion in the next five years. It saves nothing if, when an event occurs, the patient or family decide they wish to live instead of conveniently die, of course. And since you have nothing to substantiate your claim that we’re paying out for Medicare victims who really want to die instead of have treatment to live, there’s very little savings for the output. Every event ends up with the family and patient deciding what to do in an imminent death moment… directive or not. Sometimes they don’t “pull the plug” immediately, and extend some hope. But the plug is indeed pulled often.. millions of times a year.. by either the family or patient’s choice.

So you may want to quit the BS line about how many Medicare victims that really are being kept alive against their will, draining the system.

Again, I repeat the obvious — three GOPers co-sponsored this bill. The signed on to this plan. Why do YOU think they sponsored it?, signed their names on to it. Do you REALLY think they supported this because they want to euthanise old people? Do you? If you really believe that, then, as Johnny Isakson would say, you are “nuts.”

Again, you tend to inflate, conflate, and insert strawmen/red herring accusations as an Alinsky diversionary tactic. I said nothing of euthanization. And in fact, I have pointed out that far more Dems in the House oppose the IMAB for the very same reasons I do – far more than the pathetic three GOPers you could dig up who support it. In fact, I can dig up an entire chamber of Congress who was led by your party, and still the majority opposed it for the same reasons I do.

Billy Bob=zero/zilch/nada
Mata=Grand Slam.
Crowd roars… 😆

Really inconvenient when you want to take a few and play the inflation/blanket assumption game, eh Billy Bob? Bested you at your own Alinsky tactic. We’re quick learners, we conservatives.

Honestly, cons, you need to do a better job picking your battles. If GOPer cons like Isakson support the proposal and the AARP (which SURELY is against euthanizing the elderly) both support the concept, you might need to rethink the rationale for opposing it.

You may want to have a chit chat with a huge number of your Dem House chums, Billy Bob. Seems your rationale is pretty damned thin, and based mostly on a bunch of trumped up numbers of Medicare victims who really want to die instead of live.

BTW, we’re still waiting for those stats of people (and their family members) who received, or are still receiving, treatment to prolong their lives, but really preferred to die.

why is it that. it is always the old people who have to suffer the most. and sacrifice the most. we worked all of out lives. and paid into social security and medicare. only to have it taken away from us. why are there never any mention of cuts to medicaid/food stamps.and free medical care and schooling for all the illegals in this country.and all the lazy asses in this country who would not work if they had a job.what about all the liars and cheaters who get ssi they are not entitled too?where do you suppose that money comes from. they steal it from social security. thats where. this is a travesty to all seniors. judgement day is coming.