But At Least There’s No Death Panels, Right?

Um, yeah.  Of course there are.

The provision [in the latest “Healthcare Bill”] allows Medicare to pay for voluntary counseling to help beneficiaries deal with the complex and painful decisions families face when a loved one is approaching death.

For years, federal laws and policies have encouraged Americans to think ahead about end-of-life decisions, and make their wishes known in advance through living wills and similar legal documents. But when House Democrats proposed this summer to pay doctors for end-of-life counseling, it touched off a wave of suspicion and anger. Prominent Republicans singled it out as a glaring example of government overreach.

Sen. Charles Grassley, R-Iowa, at the time a lead negotiator on health care legislation, told constituents at a town hall meeting they had good reason to question the proposal.

“I don’t have any problem with things like living wills, but they ought to be done within the family,” he said. “We should not have a government program that determines you’re going to pull the plug on grandma.”

Of course, the real problem – if you’re a Democrat who wants to socialize the healthcare system – isn’t that government will wield the power of life and death (via “case management”, which is indeed what HMOs do today – the difference being that HMOs can be left for competitors, or sued). 

No.  It’s that all us uppity peasants actually make them earn their pay, explaining the whole thing:

Thursday, the sponsor of the provision said the barrage of criticism may have actually helped.

“There is nothing more basic than giving someone the option of speaking with their doctor about how they want to be treated in the case of an emergency,” said Rep. Earl Blumenauer, D-Ore. “I think the outrageous and vindictive attacks may have backfired to help raise awareness about this problem, which is why it’s been kept in the bill.”

“And if you get out of line at any more town hall meetings, we’ll institute two death panels!  Hahahahaha!  Because we can!  That’s why!

25 thoughts on “But At Least There’s No Death Panels, Right?

  1. Ask your favorite lefty if they want Michelle Bachmann deciding what kind, if any, health care they get.

  2. I wouldn’t plan on the moonbats like Peevee and Doggy to actually comment on this.

    Peevee pees her pants at the thought of Bachmann. 😆

  3. “government will wield the power of life and death (via “case management”, which is indeed what HMOs do today – the difference being that HMOs can be left for competitors, or sued).”

    It’s reasurring to know that if [Big Insurance Company] decides to kill me because I’m too old that I will then have the freedom to take my business elsewhere.

    I think it’s a stretch to say that “end of life counseling” = “death panel.” Remember, these are Democrats we’re talking about. Their idea of a death panel would be politely asking the patient to pass away to keep premiums low for everyone else. [Of course in Minnesota, this could actually work.] Somehow I’m not worried.

  4. Hi KR. I am pretty confident that none of the people who post here that actually KNOW Pen personally would ever be silly enough to consider him a coward in any sense of the word. Quite the opposite. You’re just cranky because you got banned from Penigma for a pattern of using obscenities, along with other misconduct.

    There have never been any proposals that would equate to death panels. To assume that Democrats are in a hurry to kill grandma, and that Republicans are the only ones who aren’t is specious and kinda ugly thinking.

    When people make end of life arrangements, it reduces costs. Essentially similar provisions have been in legislation proposed by conservatives, Republicans, for years.

    As to the supposed superiority for life under our the status quo, I refer you to the studies done by the California Nurses Association among others, relating to the rejection rate, in some cases approaching 40%, instead of covering those who purchased health insurance.

    And good luck with changing HMOs, or any kind of insurance, for a competitor if you have a pre-existing condition, and do by all means take a look at some of the abuses of that concept, to the detriment of the health of those customers of their insurance.

    Here are a few links, as an example

    http://www.calnurses.org/…/first-of-its-kind-study
    http://www.calnurses.org/…/california-s-real-death-panels-insurers-deny-21-of-

  5. Peevish Peevee was too much of a coward to have a conversation over differing opinions with Bachmann.

    ….

    Hi DG. You seriously have lost your freaking mind. (oops, there is that obscene word “freaking” again! Lions Tigers and Bears, Oh my!!!)
    😆 😆 😆

    Let the record show that DG makes up new “obscene” words when taken to task.

    Bwwwwwwwaaaaaaaaaaaaaahahahahahahahahaha

    ….

    doggy, I think how you just said Mitch has “ugly thinking” was very tactfully done. Real nice!

  6. Speaking off topic for a moment, a few days ago Mitch wrote about guilt by association. Mitch himself has wisely advised me on occasion about interviewing people from both sides of a subject.

    I suggested Jeff Fecke be invited to comment, to explain his side, but never saw an indication that such an invitation had been issued.

    I don’t know Mr. Fecke, and he certainly doesn’t know me at all. However, inspired by Mitch’s advice to me, I dug up his email address, and suggested he should comment here – preferably before too many more topics became water under the bridge, and before everyone completely moved on to other subjects.

    I have not heard from Mr. Fecke, I’m not particularly expecting he will bother to respond to me, since as he doesn’t know me and I’m pretty insignificant on the horizon of blogging. But it will be interesting if he does reply, here or to me. If only to me, I will respond back here.

    I have to say that overcoming a natural shyness about contacting complete strangers has led to some interesting exchanges in the past, including exchanging emails with the author of the book on which the new George Clooney movie that just opened, Men Who Watch Goats, was based. There are a surprisingly large number of people who answer emails from complete strangers; it makes blogging something of a social adventure besides being a better source for factual information.

  7. To assume that Democrats are in a hurry to kill grandma, and that Republicans are the only ones who aren’t is specious and kinda ugly thinking

    Well, it would be, if that were what it were.

    But the fact remains that part of healthcare rationing involves calculating costs and benefits of procedures, based on the patient’s life expectancy. It’s called “Case Management”, and HMOs do it today. And it is, in fact, a death panel for some patients; if you’re 60 and have acute renal failure, you have a shot at a transplant; if you’re 80, forget about it.

    And yes, if your acute renal failure is a pre-existing condition, you don’t have the option of getting different insurance, obviously. But given that the supply of healthcare in any single-payer system is constricted from the word go, and gets worse and worse over time, the formulas for who gets treated will get more and more restrictive – and the waits for those who do qualify will get longer and longer, partly due to lack of supply, and partly – make no mistake about it – because the payer assumes that there’ll be some attrition on the waiting list, and indeed plans on it.

    Private systems increase the supply of care available, though. Socialized systems inevitably, inexorably, unavoidably decrease it.

    Don’t want to call it a “death panel”? Fine! But it’d be oh so refreshing if the Dems would get honest about the inevitable effects of single payer government run systems. Under whatever name – death panels, case management, or the Bouncing Unicorn Board – someone has to decide who gets the scarce-and-getting-scarcer supply of treatment.

  8. I suggested Jeff Fecke be invited to comment, to explain his side, but never saw an indication that such an invitation had been issued.

    I posted a comment in his blog noting that there’d be a response.

    In the past, I’ve asked him for comment, including two years ago when Michael Brodkorb and I caught him embellishing AP stories without attribution. He begged off. I think he’s more into making the charges than defending them.

    I have to say that overcoming a natural shyness about contacting complete strangers has led to some interesting exchanges in the past,

    That is actually a hobby of my dad’s. Not via email, of course, but via regular mail. Since I was a kid, he’s written to authors and writers of all kinds. And via that, he cultivated quite a few long-time penpals; Peter Mathison, author of The Snow Leopard, among others; sportswriter Frank DeFord (one of the deans of American sports journalism); the late Jean-Pierre Hallet, known as an activist for the Pygmies of the Ituri Forest (and author of five books on the tribe and his mission), which led to Hallet coming to my hometown twice on fund-raising missions; most famously, the late Jean Shepherd, author of A Christmas Story and the narrator of the movie based on the book.

    And I’d be remiss in pointing out that Chad the Elder, co-host emeritus of NARN Volume I, had a great example of same when he wrote, out of the clear blue sky, Mike Nelson, former host of Mystery Science Theatre 3000, kicking off one of the more interesting friendships the whole NARN crew ever cultivated.

  9. End of life decisions should be between the doctor and the patient (and, maybe, their lawyer). People should not be forced into meetings where their end-of-life decisions are made for them. Clearly that is what is going on in this bill, along with the establishment of single-payer health coverage.

  10. Those who think having a nice conversation with the doctor is different from a Death Panel don’t understand how old people think.

    An 80 year old woman, told by her doctor that she should not have this operation but instead should take pills to get by, and perhaps even consider forgoing the pills because of the the burden she has become to her children, who will be foreced to spend everything they own to pay for this very expensive and completely unnecessary luxury treatment, unless Grandma would agree to an alternative-to-life treatment that is painless and cheap . . . don’t think they won’t do it. Grandma will whisper “Well, if you think that’s best” and that’ll be the end of her.

    I sat in countless client conferences where the kids dragged Mom into the office because they were afraid the nursing home would get the home. No, the kids didn’t want to care for Mom themselves, they wanted her to go to the nursing home; they just didn’t want to sell her home to pay for it. They wanted fob Mom off on somebody else but keep their inheritance. Can we do that? Maybe with a life lease or a trust?

    All it would take is one small tweak to this health care bill – children must pay a portion of the cost of their parents’ care – and you’d see a mad rush of Baby Boomers carting Grandma off to the iceberg.

    .

  11. As a family practice physician since 1982, I’d like to express a few opinions.
    The wording of the “end of life counselling” in the first version of the bill (I haven’t wasted more time reading the others) was a typical all-thumbs government attempt to manage behavior by dangling a supposed carrot–a visit code through Medicare that would pay physicians for talking to their patients about end of life care. The simple fact is that we have been doing that forever. Maybe not to everyone’s satisfaction and often awkwardly and maybe not in the most timely manner, but let’s face it, when grandma has her stroke and the EMTs ignore the living will she had tucked away in her file cabinet by dropping an ET tube in her trachea, I, or somebody like me gets to hold hands with the family in the middle of the night and decide to leave the tube in or pull it out. Medicare can pay me every year to have “the talk” but the reality is that the default response of our health care system is to revive, resuscitate, whatever until the patient is transported. Having a living will means NOTHING unless you have enrolled in Hospice and have pre-registered with the medical examiner or unless you are cold by the time the first responders arrive. So to people who worry about death panels, I have the following advice: no governmental body ever arrives at a decision that doesn’t involve waiting around and picking a subcommittee to study the problem further, so don’t worry about it. There are too many other things wrong with the Obama/Baucus/Pelosi care bill to get sidetracked on death panels.

  12. KR, I think your attempt to make division between people is pretty pathetic. What you try to characterize as Pen being afraid to speak to Bachmann was about being courteous in not interrupting an existing conversation. You also conveniently leave out the other attempts by Pen to speak with Bachmann, including when she has been on Mitch’s radio show.

    Mitch can speak very articulately for himself without you trying to spin anything, and so can I; further our long friendship can certainly stand up to an honest difference of opinion. I have a perfectly adequate vocabulary without making up words. Can you say the same?

    I addressed a quoted comment made by Grassley that was clearly a misstatement of fact.

  13. “End of life decisions should be between the doctor and the patient (and, maybe, their lawyer). People should not be forced into meetings where their end-of-life decisions are made for them.”

    The article says that the option will compensate doctors who participate in end-of-life counseling. To say that these meetings will be mandatory or that the patient will not be involved in any decisions is completely baseless.

    K.Y.-Broad, you shouldn’t have a problem with death panels. After all, you have to break a few eggs to make an omelet, right?

  14. nate Says:

    October 30th, 2009 at 4:12 pm
    Those who think having a nice conversation with the doctor is different from a Death Panel don’t understand how old people think.

    An 80 year old woman, told by her doctor that she should not have this operation but instead should take pills to get by, and perhaps even consider forgoing the pills because of the the burden she has become to her children, who will be foreced to spend everything they own to pay for this very expensive and completely unnecessary luxury treatment, unless Grandma would agree to an alternative-to-life treatment that is painless and cheap . . . don’t think they won’t do it. Grandma will whisper “Well, if you think that’s best” and that’ll be the end of her.”

    and

    “you’d see a mad rush of Baby Boomers carting Grandma off to the iceberg.”

    Nate? I have sat in on consultations between doctors and elderly relatives.
    You make a pretty wild jump in a number of places in your argument, including 1. that doctors are not primarily concerned with their patient’s health and well being, but would casually for no particular gain to themselves, advise granny to do something bad for her, including misrepresenting treatment alternatives; 2. assuming that being concerned with end of life care costs equates to a willingness to off granny for profit; 3. assuming all old people will just go along with this without kicking up a fuss; 4. assuming Baby Boomers are all too selfish to care about or for Granny.

    Perhaps for assumption 4., you just assume that about Baby Boomers who are Democrats, but not about Baby Boomers who are Republican? Or, are you assuming the Republican party has simply become so small that there can’t be many Baby Boomers in it?

    Those are some pretty poor assumptions, Nate.

  15. “Grandma will whisper “Well, if you think that’s best” and that’ll be the end of her.”

    A big part of the conservative philosophy is individual responsibility. So Grandma needs to make her own choices, and no one else should be able to tell her otherwise. Freedom means freedom to make your own decisions, for better or for worse. If this is not a fair representation of the conservative perspective please let me know.

  16. DG :October 30th, 2009 at 2:40 pm
    “I suggested Jeff Fecke be invited to comment, to explain his side, but never saw an indication that such an invitation had been issued.”

    Mitch wrote:
    “I posted a comment in his blog noting that there’d be a response.

    In the past, I’ve asked him for comment, including two years ago when Michael Brodkorb and I caught him embellishing AP stories without attribution. He begged off. I think he’s more into making the charges than defending them. ”

    And I had no worries that you would be perfectly comfortable Mitch, if Mr. Fecke did respond to my request; otherwise I wouldn’t have made it.

    By way of disclaimer, I wrote the email using the Penigma email account, and made it clear that I considered both you Mitch, and Pen as friends. I also indicated that I was a co-blogger at Penigma. Fecke lists Penigma on his website as a moderate blog, however I have no idea how current he is with the changes and additions to it. I felt I should clarify that I was making a legitimate use of the blog name, since I have no idea if he’s ever read a word I’ve written before.

    It should be interesting to see what happens next, if anything.

  17. “If this is not a fair representation of the conservative perspective please let me know.”

    This is why conservatives are in favor of letting six year olds get drunk!
    Maybe you are stupid, Apathy Boy.

  18. Mitch wrote:
    “Private systems increase the supply of care available, though. Socialized systems inevitably, inexorably, unavoidably decrease it.”

    I would disagree with that on several counts, including that the numbers of people who actually have private system insurance / care is decreasing steadily.

    Mitch then wrote:
    “Don’t want to call it a “death panel”? Fine! But it’d be oh so refreshing if the Dems would get honest about the inevitable effects of single payer government run systems. Under whatever name – death panels, case management, or the Bouncing Unicorn Board – someone has to decide who gets the scarce-and-getting-scarcer supply of treatment.”

    Check out the links I provided about the refusal to provide care and the refusal to provide coverage for many needed procedures for privately insured people right now. Add to that our steadily declining ranking in international health statistics, while the rank of many countries that DO have some form of national medical care are pretty consistently higher AND not declining, and I would suggest those stats disproe your assertions about our status quo AND about national health care sysems.

    I don’t find the Conservatives OR the Republicans to be significantly more honest about health care issues than the other side. I do find some segments of them to be among the worst offenders in representations of health care proposal information.

    I try to read as much of the original proposals as I possibly can. I CAN suggest that it is so tedious, reading it all could be a new source of anesthetic. Because good lord, trying to read all of it – all of the various proposals – does tend to put one to sleep, possibly deeply enough for the removal of an appendix, if the surgeon were quick about it.

  19. Dog Gone, I think you are purposely being dishonest, or at the very least trying to ‘reframe’ Mitch’s point to meet the needs of your narrative.
    You should know that the measure of “the supply of care available” is not measured by “the numbers of people who actually have private system insurance”.

  20. I think it is worth pointing out that the number of people getting any kind of health care under the status quo is declining, rather precipitously.

    Having no private insurance means no health care for many people, which should be considered as one measure of ‘supply of care available’.

  21. This can’t be the best you can come up with, Dog Gone.
    “The number of people”? In absolute terms or percentages? Declining from what starting point? Surely not neolithic times.
    “Having no private insurance means no health care for many people, which should be considered as one measure of ’supply of care available’.
    “one measure”? What are the others? Should we kill children in the womb to drive our WHO measure up?
    Everyone wants to increase the availability of quality health care at a lower cost. The people who oppose Obamacare aren’t psychopaths. This is a very difficult problem. The really laughable thing is that some people think government “death panels” are better than corporate “death panels”.

  22. There are too many other things wrong with the Obama/Baucus/Pelosi care bill to get sidetracked on death panels.

    Right on cue from London, via Powerline:

    “In the United Kingdom, Parliament will take up a proposal to give National Health Service patients the right to seek private health care if they have been kept waiting for an appointment with a specialist for more than four months. Cancer patients, in particular, have evidently been removing themselves from the queue the hard way.

    But the problem isn’t only with specialized forms of treatment. The London Times quotes Jennifer Dixon of the Nuffield Trust:

    “It would not only give patients enforceable health care entitlements but it would also prevent managers and clinicians from controlling waiting times as a way of limiting demand and saving money,” she said. “In the past requirements to make financial savings often resulted in hospitals stopping routine surgery for a couple of months before the end of the financial year.”

    What a system! It beggars belief that Barack Obama and Democratic leaders in Congress want to reproduce the fiasco of socialized medicine here in the U.S.”

  23. Dear Dr. Dog Gone:

    We at the Panel on Wasteful Medical Expenditures note you’ve prescribed too many expensive end of life treatments. In the next Five Year Plan, your quota is limited to 10; more than that we won’t cover. If the families won’t pay then and you can’t cover it out of your earnings then we’ll pull your license and all your patients will suffer.

    We recommend you more vigorously triage patients and direct excess cases to assisted suicide, which we cover 110% in light of the savings generated in on-going exenses when your old patients die early. Sincerely yours . . .

    Here you go, DG, all your objections covered. No death panel. Doctor-patient counselling with family involvement. Treatment alternatives fairly discussed. Patient makes the final informed decision. Granny can ask her family to impoverish themselves or to let Granny go.

    I ask you, what’s Granny going to decide in those circumstances?

    This is the change you hope for? God save us.
    .

  24. dog-Nagit, I don’t give a rats @ss what your Kool-Aid addeled left wing moon bat “mind” thinks.
    You have repeatedly been taken to task and shown the error of your twisted thoughts.

    DG, Your blind adoration toward The Obama is pathetic.

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