Death panels

Life, the universe, and everything.
Forum rules
- No personal attacks against players or staff members - please be civil!
- No posting of mature images/links, keep content SFW. If it's NSFW, don't post it on these forums.
kiryan
Sojourner
Posts: 7275
Joined: Sat Apr 14, 2001 5:01 am
Location: Los Angeles, CA and Flagstaff, AZ
Contact:

Death panels

Postby kiryan » Fri Aug 14, 2009 4:35 pm

I've been tossing around whether I really wanted to talk about "end of life" provisions. They are reportedly recently stripped out of the healthcare bill... but there were some quotes saying that 25% of healthcare is being spent in the last 1 year of a person's life.

So first question, is this a death panel as Sarah Palin charges? If she had private insurance, I'd bet she was covered.

"However, Barbara is a resident of Oregon and therefore, part of the state-run Oregon Health Plan. The state refused Barbara Wagner's request for the drug since it doesn't cover drugs that are meant to prolong the life of individuals with advanced cancer. After all, when the Oregon Health Plan was established in 1994 it 'was expressly intended to ration health care'" to save money. "But Oregon also has legalized assisted suicide, and in an unsigned letter from the state, Barbara was informed that the health plan would pay to cover the costs of a doctor to help her kill herself," but not give her the drug to prolong her life.

I think it is. Its the state, deciding whether or not they are going to pay for you to get the healthcare you need to continue living. I believe that they will essentially (eventually) take the health insurance premiums we are currently paying as tax, waste a shit ton of it, and pay more than they should which basically MUST reduce quality and quantity of care. Show me caess where the government spends money wisely and efficiently and I'll show you another road and bridge and dam that they overpaid for. Remember the $900 hammer?

Second question.

Do you support stripping out the death panel provisions?

I certainly do not. End of life care is ridiculously high. From full time nursing homes to expensive cancer treatments and transplants. This shit has to go away if we are going to reign in the cost of health insurance. I'm way way way more in favor of a bad bill that includes end of life provisions than more freedom and no death panels.
Ashiwi
Sojourner
Posts: 4161
Joined: Thu Jun 14, 2001 5:01 am

Re: Death panels

Postby Ashiwi » Fri Aug 14, 2009 6:49 pm

Before a bunch of rhetoric is posted, can we please clarify?

This "drug intended to prolong the life of individuals with advanced cancer," for example ... what kind of drug is this? I would almost bet that's just a vicious spin on how to say "This plan doesn't cover experimental and investigational treatments not approved by the FDA."

Somebody who wants an investigational procedure and either can't or won't pay for it, will say "so this plan will let me die before it will pay to save my life" but the reality of the situation is that if it's not FDA approved, in most instances, it's not happenin'.

Could you clarify your position on this and how it relates to the actual proposals?
Gormal tells you 'im a dwarven onion'
Gormal tells you 'always another beer-soaked layer'

Inama ASSOC:: 'though it may suit your fantasies to think so, i don't need oil for anything.'

Haley: Filthy lucre? I wash that lucre every day until it SHINES!
avak
Sojourner
Posts: 672
Joined: Thu Jan 02, 2003 6:01 am

Re: Death panels

Postby avak » Fri Aug 14, 2009 7:19 pm

So wtf is Palin arguing? That we spend at all costs to prolong life or that we manage costs at all levels of care? In almost every case, there is 'more' that can be done...another option for treatment..albiet with hugely diminishing returns on cost.

These neo-cons makin me crazy. Yo Palin...propose a solution or go eff a moose. Oh wait, she does...personal responsibility and open market. That seems to be working.
kiryan
Sojourner
Posts: 7275
Joined: Sat Apr 14, 2001 5:01 am
Location: Los Angeles, CA and Flagstaff, AZ
Contact:

Re: Death panels

Postby kiryan » Wed Aug 26, 2009 2:34 am

I've read quite a few articles referring to how Sarah Palin's "death panels" claim was debunked and is patently false. Yet the Democrats dropped the sections she attacked from the various healthcare bills like a hot potato.

What do you call it when government authorizes "advanced care planning" every 5 years when you get old and if your condition significantly detoriates. Who is going to determine what is "appropriate" recommendations for people? And when they recommend that you don't engage in highly expensive, low percentage outcome treatment... what would you call that? maybe not a death panel, but teetering on the edge certainly.

For those of you that will say it'll never happen... Government for the past few years has been talking about getting involved in how doctors operate... they are creating changes through medicare/medicaid to "cut out the waste" by "standardizing" the treatment of conditions as we speak. We've heard a lot about how one city will pay more per capita than another for the same % outcomes. Obviously waste... but what that really means is if your doctor orders more tests or the "wrong" procedures... IE not the ones the government determines are the standard treatment regimen... they will stop reimbursing you. They are already trying to "educate" doctors as to what this standard should be. I've seen it in the hospitals and insurance company I worked for.

I don't disagree with death panels if government is going to be responsible for healthcare. seriously... the government should stop paying for triple bypass surgery on 85 year olds and 10k a month nursing homes. When you are at the point of needing $300 a day care to stay alive with no realistic probability of being independent again, we need to let you die.

I just find it strange that people are denying that these are death panels.
Todrael
Sojourner
Posts: 1454
Joined: Fri Mar 16, 2001 6:01 am
Location: MI, USA
Contact:

Re: Death panels

Postby Todrael » Wed Aug 26, 2009 3:05 am

kiryan wrote:I just find it strange that people are denying that these are death panels.

I deny that they are death panels.

I deny that they are death panels with basically no understanding of what the argument is about, the bill in question, the politics around it, or the health care services it provides or does not provide.

I deny that they are death panels because it is a horribly charged phrase that will eliminate basically all attempts at rational thinking. It's aimed at the heart, at the gut, and bypasses the brain. It makes for an easy war cry, a talking point that can be spewed forth instead of requiring logical deduction. It's a phrase that's easy to use for manipulation, to induce fear, and to shape the discussion before the discussion has even begun.

You want to talk about death panels? Then I don't want to talk to you. Come back when you want to talk about something coherent.
-Todrael Azz'miala, Ravager
Get Toril Guides and Maps at Todrael's Lair
Get Item Stats at TorilEQ
Ragorn
Sojourner
Posts: 4732
Joined: Mon Jan 29, 2001 6:01 am

Re: Death panels

Postby Ragorn » Wed Aug 26, 2009 1:17 pm

I sorely wanted to post something about this around two weeks ago, but I decided to wait for the thread that Kiryan would inevitably start called "death panels." So here it is.

Todrael is exactly right. Your insurance company (your privately owned, for-profit, "best healthcare system in the world" insurance company) already has a panel of executives who decide whether to clear life-prolonging treatement to terminal and eldery patients. The system is already in place. And Kiryan, you're right too... it's a necessary failsafe in the insurance system. That decision NEEDS to be made, because insurance companies wouldn't be able to pay out for every experimental treatment that 85 year old Grandma seeks for her terminal cancer.

The debate isn't over the process.

The debate is that the Republicans are holding that process up and calling it a DEATH PANEL and claiming that BARACK OBAMA WANTS TO KILL GRANDMA. Do you see the problem here? Sarah Palin pointed out a necessary and reasonable part of the insurance process, slapped a horribly hyperbolic name on it, tried to use her retarded son to garner sympathy for her cause, and then used death panels as a weapon to try to mobilize gullible people against health care reform in general.

This would be like calling seat belts DECAPITATION STRAPS and then trying to get the Safety Act overturned.

Do you see the problem here?
- Ragorn
Shar: Leave the moaning to the people who have real issues to moan about like rangers or newbies.
Corth: Go ask out a chick that doesn't wiggle her poon in people's faces for a living.
kiryan
Sojourner
Posts: 7275
Joined: Sat Apr 14, 2001 5:01 am
Location: Los Angeles, CA and Flagstaff, AZ
Contact:

Re: Death panels

Postby kiryan » Wed Aug 26, 2009 9:56 pm

So its over using the charged words and the tactics. I can agree with that.

I will disagree with you on insurance companies doing the same thing. As far as I am aware, most insurance companies only limit treatment for "experiemental" procedures. There are no age or health based declinations to cover procedures. They are almost required to provide treatment if your doctor recommends it (even in the case of experimental if you have a lawyer). So your 85 year old with multiple problems can get chemo if his doctor recommends it.

The government is moving in the direction of denying treatment based on overall health... in Medicare/Medicaid... and these consultations, education, are the start of changing the medical and general culture to accept that some people just need to die.
Ragorn
Sojourner
Posts: 4732
Joined: Mon Jan 29, 2001 6:01 am

Re: Death panels

Postby Ragorn » Wed Aug 26, 2009 11:14 pm

kiryan wrote:So its over using the charged words and the tactics. I can agree with that.

I will disagree with you on insurance companies doing the same thing. As far as I am aware, most insurance companies only limit treatment for "experiemental" procedures. There are no age or health based declinations to cover procedures. They are almost required to provide treatment if your doctor recommends it (even in the case of experimental if you have a lawyer). So your 85 year old with multiple problems can get chemo if his doctor recommends it.

The government is moving in the direction of denying treatment based on overall health... in Medicare/Medicaid... and these consultations, education, are the start of changing the medical and general culture to accept that some people just need to die.

Can you quote where in the bill the provisions are laid out that identify age and overall health as criteria for withholding care?

So far, nobody has been able to that I know of.
- Ragorn
Shar: Leave the moaning to the people who have real issues to moan about like rangers or newbies.
Corth: Go ask out a chick that doesn't wiggle her poon in people's faces for a living.
kiryan
Sojourner
Posts: 7275
Joined: Sat Apr 14, 2001 5:01 am
Location: Los Angeles, CA and Flagstaff, AZ
Contact:

Re: Death panels

Postby kiryan » Thu Aug 27, 2009 2:03 pm

I agree its not there.

Do you believe these are not among the first steps towards that agenda? Do you think that its not in the back of their minds waiting for it to become publicly palatable? At least a couple of Obama's top advisers in healthcare are on record with some extreme views regarding population and healthcare control...
Ragorn
Sojourner
Posts: 4732
Joined: Mon Jan 29, 2001 6:01 am

Re: Death panels

Postby Ragorn » Thu Aug 27, 2009 3:16 pm

kiryan wrote:Do you believe these are not among the first steps towards that agenda?

No.

Do you think that its not in the back of their minds waiting for it to become publicly palatable?

No.

At least a couple of Obama's top advisers in healthcare are on record with some extreme views regarding population and healthcare control...

And at least a couple of Bush's top advisors were caught in gay sex scandals... does that mean Bush was secretly plotting to forward the gay agenda?
- Ragorn
Shar: Leave the moaning to the people who have real issues to moan about like rangers or newbies.
Corth: Go ask out a chick that doesn't wiggle her poon in people's faces for a living.
kiryan
Sojourner
Posts: 7275
Joined: Sat Apr 14, 2001 5:01 am
Location: Los Angeles, CA and Flagstaff, AZ
Contact:

Re: Death panels

Postby kiryan » Thu Aug 27, 2009 4:55 pm

when your a healthcare expert, and you get hired into a healthcare advisory job, and you are on record supporting population control and rationing. Its a little different than being a economist outed as a homo.

--

ok then. lets talk dollars and cents. Do you think we can give everyone the healthcare they are accusotmed to by cutting waste out of the current system? Do you believe our government in our country with our political system can actually make healthcare cheaper within the next 20 years? Do you think Americans are going to be ok with raising taxes necessary to pay for healthcare for all?

At the end of the day, the only way to cut the government's tab for healthcare is to ration it. So we are going to trade a system that rations based on your individual choices in terms of your economic prosperity for one run by the government. One way or another, it will be rationed.
Ragorn
Sojourner
Posts: 4732
Joined: Mon Jan 29, 2001 6:01 am

Re: Death panels

Postby Ragorn » Thu Aug 27, 2009 6:54 pm

kiryan wrote:ok then. lets talk dollars and cents. Do you think we can give everyone the healthcare they are accusotmed to by cutting waste out of the current system?

No. But then, I don't plan to be on government healthcare, I plan to continue my own plan with my private healthcare company. The government plan will be for people who can't afford, or whose jobs don't subsidize, private healthcare. This is like asking whether I think that government welfare will match my current salary... of course it won't, but why do I care? I won't be on it.

Do you believe our government in our country with our political system can actually make healthcare cheaper within the next 20 years?

No. But that's not the goal of this initiative, that's the goal of the tort reform initiative.

Do you think Americans are going to be ok with raising taxes necessary to pay for healthcare for all?

No, but I don't care. Americans aren't ok with raising taxes for any reason, ever, period. That's why we have a national debt... because Americans want wars and healthcare and free cars for everyone, but they're not willing to pay for any of it.

At the end of the day, the only way to cut the government's tab for healthcare is to ration it. So we are going to trade a system that rations based on your individual choices in terms of your economic prosperity for one run by the government. One way or another, it will be rationed.

Let me ask you a counter question:

Do you think that health care reform means that the government is going to tell you that you aren't allowed to use your own private health insurance provider? I ask, because you seem confused.
- Ragorn
Shar: Leave the moaning to the people who have real issues to moan about like rangers or newbies.
Corth: Go ask out a chick that doesn't wiggle her poon in people's faces for a living.
kiryan
Sojourner
Posts: 7275
Joined: Sat Apr 14, 2001 5:01 am
Location: Los Angeles, CA and Flagstaff, AZ
Contact:

Re: Death panels

Postby kiryan » Thu Aug 27, 2009 11:49 pm

I will not be able to keep my health insurance. I believe a public option will drive private insurers out of business in the short term and cost me more in the long term.

Additionally, I will be paying for everyone else's too through higher taxes or lower wages (because of higher taxes on my company payroll) a nd I won't be able to reduce my cost by making healthier and less expensive choices for me and my family. I will be locked into paying whatever government decides I must pay directly and indirectly.
kiryan
Sojourner
Posts: 7275
Joined: Sat Apr 14, 2001 5:01 am
Location: Los Angeles, CA and Flagstaff, AZ
Contact:

Re: Death panels

Postby kiryan » Fri Aug 28, 2009 12:14 am

http://online.wsj.com/article/SB1000142 ... 98676.html

Obama's Health Rationer-in-Chief

White House health-care adviser Ezekiel Emanuel blames the Hippocratic Oath for the 'overuse' of medical care.

Dr. Ezekiel Emanuel, health adviser to President Barack Obama, is under scrutiny. As a bioethicist, he has written extensively about who should get medical care, who should decide, and whose life is worth saving. Dr. Emanuel is part of a school of thought that redefines a physician’s duty, insisting that it includes working for the greater good of society instead of focusing only on a patient’s needs.


Suuuuuure, healthcare rationing is not part of the agenda.
Ragorn
Sojourner
Posts: 4732
Joined: Mon Jan 29, 2001 6:01 am

Re: Death panels

Postby Ragorn » Fri Aug 28, 2009 1:05 pm

kiryan wrote:I will not be able to keep my health insurance. I believe a public option will drive private insurers out of business in the short term and cost me more in the long term.

So wait... will the government's program be horribly inefficient and incapable of delivering quality care, or will it be SO AWESOME that it drives UHC and Anthem out of business?

Additionally, I will be paying for everyone else's too through higher taxes or lower wages (because of higher taxes on my company payroll) a nd I won't be able to reduce my cost by making healthier and less expensive choices for me and my family. I will be locked into paying whatever government decides I must pay directly and indirectly.

Yeah, you will. Just like I'm paying school taxes to put your five (six?) kids through school. That's part of living in our country.
- Ragorn
Shar: Leave the moaning to the people who have real issues to moan about like rangers or newbies.
Corth: Go ask out a chick that doesn't wiggle her poon in people's faces for a living.
kiryan
Sojourner
Posts: 7275
Joined: Sat Apr 14, 2001 5:01 am
Location: Los Angeles, CA and Flagstaff, AZ
Contact:

Re: Death panels

Postby kiryan » Fri Aug 28, 2009 3:02 pm

Public health will not be more efficient than private, it will just be subsidized ot the degree that it puts private health insurance as we know it out of business.

I'd be more than happy to take financial responsibility for the education of my children. but since you're going to give it to me for free, I will consume as much of it as possible to give my kids as much success as is possible. I'll be doing the same with healthcare if we go to a public option.
kiryan
Sojourner
Posts: 7275
Joined: Sat Apr 14, 2001 5:01 am
Location: Los Angeles, CA and Flagstaff, AZ
Contact:

Re: Death panels

Postby kiryan » Thu Dec 17, 2009 8:24 pm

http://online.wsj.com/article/SB1000142 ... ns_opinion

A doctor and republican senator explaining how the new health bill does ration care.

For instance, the Reid bill (in sections 3403 and 2021) explicitly empowers Medicare to deny treatment based on cost. An Independent Medicare Advisory Board created by the bill—composed of permanent, unelected and, therefore, unaccountable members—will greatly expand the rationing practices that already occur in the program.
..
Section 6301 of the Reid bill creates new comparative effectiveness research (CER) programs. CER panels have been used as rationing commissions in other countries such as the U.K
...
Additionally, the Reid bill depends on the recommendations of the U.S. Preventive Services Task Force in no fewer than 14 places. This task force was responsible for advising women under 50 to not undergo annual mammograms. The administration claims the task force recommendations do not carry the force of law, but the Reid bill itself contradicts them in section 2713. The bill explicitly states, on page 17, that health insurance plans "shall provide coverage for" services approved by the task force. This chilling provision represents the government stepping between doctors and patients. When the government asserts the power to provide care, it also asserts the power to deny care.
...
If the bill expands Medicaid eligibility to 133% of the poverty level, that too will lead to rationing. Because Washington bureaucrats have created a system that underpays doctors, 40% of doctors already restrict access to Medicaid patients, and therefore ration care.
...
Medicaid demonstrates, tragically in some cases, that access to a government program does not guarantee access to health care. In Maryland, 17,000 Medicaid patients are currently on a waiting list for medical services, and as many as 250 may have died while awaiting care, according to state auditors. Kansas, the home state of Health and Human Services Secretary Kathleen Sebelius, faces a Medicaid backlog of more than 15,000 applicants.
Sarvis
Sojourner
Posts: 6369
Joined: Fri Jan 26, 2001 6:01 am
Location: Buffalo, NY, USA
Contact:

Re: Death panels

Postby Sarvis » Thu Dec 17, 2009 8:41 pm

kiryan wrote:Public health will not be more efficient than private,


Despite all the evidence to the contrary. (That evidence being all the other countries with universal healthcare that actually pay less for better service.)
kiryan
Sojourner
Posts: 7275
Joined: Sat Apr 14, 2001 5:01 am
Location: Los Angeles, CA and Flagstaff, AZ
Contact:

Re: Death panels

Postby kiryan » Thu Dec 17, 2009 9:26 pm

Despite all the evidence that people in other countries are on massively long waiting lists?

I can't find the article now, but I saw a great rebuttal of your argument. Basically it said our healthcare is the best in the world despite the official reports. We find and save more lives than other systems because we spend more on testing. But we rank low basically because we have dramatically more fat people. Fat people die earlier and are prone to diabetes and other serious health issues that cost more. A side note is poverty and obesity are linked in the US and we have a relatively high level of income inequality compared to other nations.

Also specifically noted was the coverage for life extending drugs, particularly cancer drugs. There are few limits here in the US if your doctor decides they are necessary. In other nations, you simply don't get them and no law suit against is going to make them cover it.

It sounded very plausible to me, especially about the fat people.
Ashiwi
Sojourner
Posts: 4161
Joined: Thu Jun 14, 2001 5:01 am

Re: Death panels

Postby Ashiwi » Fri Dec 18, 2009 5:16 am

In response to insurers not utilizing services like this...

They already do, but you're certainly not going to see them presented quite like this yet. Most of the large name insurers are starting to move toward a format of diagnosis-based case management and utilization reviews. See how that sounds much more clinical than "death panels"? Because I'm diabetic I have my own assigned case manager who is there to help me choose my best healthcare options. At this time it is an optional service, but I really don't expect it to remain that way.

We also have a medical review board which reviews any medical care that is considered beyond standard care, and determines the medical necessity and treatment value of the services. Every year addendums to the policy are released stating which services have been determined to have little to no impact on the stabilization or recovery of a patient, and it's not unusual for those determinations to have a cost vs. effectiveness rationale.

So just how effective is radical cancer therapy for an 81 year old? Studies will probably show very little effectiveness due to a number of factors, including age.
Todrael
Sojourner
Posts: 1454
Joined: Fri Mar 16, 2001 6:01 am
Location: MI, USA
Contact:

Re: Death panels

Postby Todrael » Fri Dec 18, 2009 1:58 pm

According to this article, which uses CDC data (pdf), completely eliminating every form of cancer would only increase average life expectancy by 3.36 years. Similarly, for eliminating all forms of heart disease, you gain an average of 6.7 years.

That's why I support direct anti-aging research rather than high-profile disease research. Curing aging itself is the only solution.
Ragorn
Sojourner
Posts: 4732
Joined: Mon Jan 29, 2001 6:01 am

Re: Death panels

Postby Ragorn » Fri Dec 18, 2009 3:12 pm

I'm over this whole "death panel" thing. Yes, the government will likely institute diagnosis-based treatment. Yes, private insurance companies ALREADY do this. Republicans are still trying to provoke panic about the government adopting a system we ALREADY HAVE.
Sarvis
Sojourner
Posts: 6369
Joined: Fri Jan 26, 2001 6:01 am
Location: Buffalo, NY, USA
Contact:

Re: Death panels

Postby Sarvis » Fri Dec 18, 2009 3:13 pm

Yes, but the gub'mint is doing it! Things are only bad when the gub'mint does them...
kiryan
Sojourner
Posts: 7275
Joined: Sat Apr 14, 2001 5:01 am
Location: Los Angeles, CA and Flagstaff, AZ
Contact:

Re: Death panels

Postby kiryan » Fri Dec 18, 2009 6:54 pm

Good article Tod.
teflor the ranger
Sojourner
Posts: 3923
Joined: Fri Jul 26, 2002 5:01 am
Location: Waterdeep

Re: Death panels

Postby teflor the ranger » Sun Dec 20, 2009 6:58 am

Ragorn wrote:I'm over this whole "death panel" thing. Yes, the government will likely institute diagnosis-based treatment. Yes, private insurance companies ALREADY do this. Republicans are still trying to provoke panic about the government adopting a system we ALREADY HAVE.

Incorrect. Under a nationalized healthcare system, you wouldn't have a choice. For the moment, you have the option fo choosing your insurance company who will have differing policies, or choosing not to use an insurer at all, a choice not offered by the nationalized system. Lastly, you can sue a private insurer in many cases where you could not sue the Federal government.

Return to “T2 General Discussion Archive”

Who is online

Users browsing this forum: No registered users and 1 guest