Can anyone explain this Bloomberg article to me?

http://www.bloomberg.com/apps/news?pid=20601070&sid=apv3pcTOWVjk

Because based on my understanding, this plan by Obama would indicate rationing of Medicare.

But that can't be... Obama said there wouldn't be any rationing. And we should all believe Obama.

Right?



Cardiologists Crying Foul Over Obama Medicare Cuts (Update1)



By Alex Nussbaum and Lisa Rapaport

Aug. 28 (Bloomberg) -- An Obama administration plan to cut Medicare payments to heart and cancer doctors by $1.4 billion next year is generating a backlash that's undermining the president's health-care overhaul.

While President Barack Obama and members of Congress have spent August debating health insurance and medical costs at public forums, specialists are waging what one advocate calls a “tooth and nail” fight against a separate initiative to boost the pay of family doctors, and cut fees for cardiologists and oncologists. The specialists, in newspaper columns and meetings with lawmakers, say patients will lose access to life-saving care, from pacemakers to chemotherapy.

The proposal by Medicare, the government insurer for the elderly and disabled, is an effort by Obama to focus U.S. medicine on preventive care. The fight by physicians who work with the most expensive patients is weakening support for Obama's broader goal, legislation to remake the health system, said Mark B. McClellan, 46, a former Medicare chief.
“If you can make the health-care debate all about moving slices of the pie around, it's very easy to generate opposition and very easy to get derailed,” said McClellan, a physician and analyst at the Brookings Institution, a policy research center in Washington, in an interview.
Obama and his allies in Congress are pushing to extend coverage to the 46 million Americans without health insurance, at a potential cost of $1 trillion over a decade. The separate Medicare proposal, announced July 1, slashes projected spending for care by cardiologists and oncologists by more than 10 percent each, while paying family doctors 8 percent more and nurses an additional 7 percent.

'Tooth and Nail'

“Our 37,000 members are fighting tooth and nail on these other issues rather than fighting thoughtfully for expanding access,” said Jack Lewin, 63, chief executive officer of the Washington-based American College of Cardiology.

The cuts could have the unintended consequence of rationing care, especially in rural regions with a large number of Medicare patients, doctors said. In other areas, specialists may decide to pull out of Medicare, or ask patients to make up the difference with higher out-of-pocket payments, said Alfred Bove, president of the American College of Cardiology.

“A fair number of cardiologists are looking at the accounting and saying 'we can't afford it,'” Bove said in a telephone interview.

Some oncologists in rural areas may stop offering chemotherapy in the office, forcing patients to travel to more- distant hospitals, said Allen S. Lichter, 63, CEO of the 27,000- member American Society of Clinical Oncology in Alexandria, Virginia.

Cuts 'Impossible'

The cuts would be “impossible” for some small-town cardiologists who rely on Medicare patients, said Zia Roshandel, a heart doctor in Culpeper, Virginia. The town of 10,000 people is about 60 miles southwest of Washington.

Roshandel and two partners see perhaps 50 patients a day at his practice, the local hospital and a community clinic for the indigent, the 40-year-old said in a telephone interview. Medicare accounts for two-thirds of their clientele, he said.

Already squeezed by government and private insurers, Roshandel said he has cut office hours, forgone paychecks and shifted his 12 workers to a high-deductible insurance plan over the past two years. The latest proposal would push him out of private practice altogether, most likely to a hospital in a larger community less reliant on Medicare, he said.

'Close the Office'

If the proposal stands, “the bottom line is I'm going to close the office,” he said. “This is impossible for me to survive. If my partners and I don't get a salary and run it for free, maybe then we can survive.”
Medicare would reduce reimbursements for some of Roshandel's most common procedures, raising the amount patients will need to pay up front, he said. The government would cut the $251 it pays for an echocardiogram, a sonogram of the heart, by 40 percent, he said. The rate for a cardiac catheterization, another test, would drop by a third to $249.

Those reductions include an additional across-the-board cut of 22 percent for all physicians mandated by federal budget rules. Legislation passed by three committees in the House last month would eliminate that cut, at a cost of $200 billion to U.S. taxpayers. Even so, if Medicare goes ahead with its tilt toward primary care, cardiologists will suffer, Roshandel said.

The Obama administration's plan to raise payment for primary care doctors is intended to encourage more doctors to enter the field. Some 65 million people already live in areas considered by the U.S. Health and Human Services Department to have too few primary care doctors, with less than one practitioner for every 2,000 people, according to department figures as of March 31.

Outnumbered by Specialists

The U.S. has 250,000 primary-care doctors and nurses and about three times as many specialists, said Atul Grover, 39, chief advocacy officer for the Association of American Medical Colleges, a Washington group. The number of medical school graduates in the U.S. entering family medicine fell more than a quarter from 2002 to 2007, according to a study last year by the group and the American Medical Association.

With the number of Americans older than 65 soaring, specialists will be in short supply, Grover said. The Census Bureau projects 81.2 million people in the U.S. will be 65 or older in 2040, from 40.2 million in 2010.

'Silver Tsunami'

“That silver tsunami that represents the baby boomers hitting Medicare age is coming,” Grover said in a telephone interview, referring to the U.S. generation born from 1946 through 1964. “In the next 20 years, we are going to face a physician shortage really across the board.”

Medicare, which covers 45 million people, is expected to spend $503.1 billion this year, accounting for one of every five dollars spent on U.S. health care, the Centers for Medicare and Medicaid Services estimated in February. Spending will reach $931.9 billion in 2018, the agency said.
Without changes, the system is guaranteed “to basically break the federal budget,” Obama said at a White House news conference July 22.

The reimbursements, though, are still a proposal, and may change before a final schedule is adopted Nov. 1, said Ellen Griffith, a spokeswoman for the Centers for Medicare and Medicaid Services, in an e-mail. “All comments that are submitted during the comment period will be given careful consideration,” she said.

Reid Cherlin, an assistant White House press secretary, said the proposal “reflects an effort to pay primary care doctors more appropriately for services to Medicare patients. We have a deep appreciation for the lifesaving work that cardiologists and oncologists do every day, and as part of the rulemaking process CMS has met with groups representing both fields.”

Focus on Results

McClellan, who ran Medicare while George W. Bush was president, said the ultimate solution requires changing how doctors are paid to focus more on results rather than on the number of patient visits.

“My hope is that they'll resolve it in a way that doesn't just move the deck chairs around in a Medicare payment system that's clearly sinking,” he said. “This gets resolved by changing the way that Medicare pays so that both the specialists and the generalists get paid more when they work together and deliver better care.”

McClellan cited Medicare pilot programs in which doctors have formed “accountable care organizations” allowing them to better coordinate patient care. The ACC, the cardiologist group, has pitched another alternative that would use lower co-pays to steer patients to better-performing doctors and give bonuses to physicians and hospitals that cut wasteful spending.

Tensions Rising

Tensions are rising among doctors, said Ted Epperly, 55, president of the American Academy of Family Physicians in Leawood, Kansas, in a telephone interview. Epperly runs a family practice in Boise, Idaho, and teaches at the University of Washington School of Medicine in Seattle.
Specialist colleagues have implied his support for the Medicare changes may cost his students, he said.

While family-care students typically spend parts of their three-year residencies training with specialists, “What I've heard is 'maybe we just won't have time any longer to teach your residents,'” Epperly said.
The ACC is offering a sample letter to patients, asking them to write Congress. “I am concerned that my physician may no longer be able to treat me or other Medicare patients,” the letter says. The campaign has extended to fliers, posters and even the on-hold message the group plays for callers to its Washington office, which asks the public to fight “drastic pay cuts for cardiology.”

The arguments have a familiar ring, McClellan said.

“The usual way that you try to scuttle a health-care reform proposal is by saying whatever it is going to reduce your access to the care that you need,” he said.

Three Years Earlier

Cancer specialists made similar warnings three years ago when reimbursement was cut for the drugs they used, said Nancy M. Kane, a professor at the Harvard School of Public Health in Boston and member of the Medicare Payment Advisory Commission, a panel of outside advisers to Congress.

“As far as I know we have not seen a drop in the number of oncologists since then,” Kane said. “People are not screaming that they don't have access to oncologists.”

The pay shift would help right a financial imbalance that keeps young physicians out of family care, said Epperly, of the family doctors' group.
Average total compensation for family doctors ranged from $150,763 to $204,370 a year, according to a 2008 survey by Modern Healthcare magazine. Cardiologists fetched from $332,900 to $561,875. Radiation oncologists, cancer doctors who specialize in radiation therapy, earned $357,000 to $463,293.

“If we don't invest more in primary care, we won't have the resources to offer more access,” Epperly said. “Our system is very good at getting people to do what they're paid to do. That's why specialists are doing all the things they do, because they're paid gobs of money.”

To contact the reporters on this story: Alex Nussbaum in New York; Lisa Rapaport in New York.

Last Updated: August 28, 2009 09:22 EDT


Am I reading this article correctly?

Is Obama proposing the idea of taking money out of the hands of specialists and putting it into the hands of PCPs and GPs?

Isn't that rationing? Didn't Obama and those on the left promise us that we wouldn't see rationing in Obamacare? That we could increase the number of insured without losing services and without increasing costs?

And none of the people interviewed in this article seem to be denying that rationing is what would be happening. Some try to justify the rationing, some argue against it. But nobody seems to deny that that is what the proposal is. And yet, that seems to be the exact opposite of the promisses coming from the left about how there will be no rationing.

And what of those who NEED specialty care? Are they supposed to make due with PCPs and general medicine practitioners instead? Are we to make due with bandaids and aspirin where the required treatment is heart surgery? Are we to take the "blue pill" when what we really need is an organ transplant? Are we to make due with a GP when what we need is an oncologist? That seems to be what this article is saying will happen under Obama's proposal.

But perhaps those on the left have a better explanation for what this proposal means. Perhaps I'm misinterpreting it.

After all, I'm just a conservative member of the mob and a fear monger. The Libs are SOOOO much smarter than I am. Perhaps they can spin... er... explain this in a way that makes sense.

Elliot

After all, I'm just a conservative member of the mob and a fear monger. The Libs are SOOOO much smarter than I am. Perhaps they can spin... er... explain this in a way that makes sense.Hello El:

I don't know if you're misinterpreting it or not. However, if it were me, and a guy is going to TURN ME DOWN for services, it don't make much difference WHO the guy works for, whether it be the government or a private insurer.

To me, it would be LESS obscene if they did it in the name of insuring EVERYBODY, than if they did it in the name of profit.

However, neither is necessary, and it's only speculation that Obama is going to do it. There's NO speculation, however, about the insurance companies denying service, though. They are, this very day, going to RATION health care to lots of people, some of whom are going to die as a result.

That's an obscenity you're unwilling to cop to.. No matter. WE know it - even if YOU don't.

excon

This is kind of off the topic but I have a question. ET you argue that with private insurance if you get denied for care you can simply go find a different insurance company. But if you get denied for care from one insurance company what makes you think another insurance company is going to insure you with a preexisting condition?

Can anyone explain this Bloomberg article to me?

Cardiologists Crying Foul Over Obama Medicare Cuts (Update1) - Bloomberg.com (http://www.bloomberg.com/apps/news?pid=20601070&sid=apv3pcTOWVjk)

Because based on my understanding, this plan by Obama would indicate rationing of Medicare.

But that can't be... Obama said there wouldn't be any rationing. And we should all believe Obama.

Right?



Am I reading this article correctly?

Is Obama proposing the idea of taking money out of the hands of specialists and putting it into the hands of PCPs and GPs?

Isn't that rationing? Didn't Obama and those on the left promise us that we wouldn't see rationing in Obamacare? That we could increase the number of insured without losing services and without increasing costs?

And none of the people interviewed in this article seem to be denying that rationing is what would be happening. Some try to justify the rationing, some argue against it. But nobody seems to deny that that is what the proposal is. And yet, that seems to be the exact opposite of the promisses coming from the left about how there will be no rationing.

And what of those who NEED specialty care? Are they supposed to make due with PCPs and general medicine practitioners instead? Are we to make due with bandaids and aspirin where the required treatment is heart surgery? Are we to take the "blue pill" when what we really need is an organ transplant? Are we to make due with a GP when what we need is an oncologist? That seems to be what this article is saying will happen under Obama's proposal.

But perhaps those on the left have a better explanation for what this proposal means. Perhaps I'm misinterpreting it.

After all, I'm just a conservative member of the mob and a fear monger. The Libs are SOOOO much smarter than I am. Perhaps they can spin... er... explain this in a way that makes sense.

Elliot


There is going to be rationing of healthcare by third party payors [ government and private insurance ] by cost and availability. I think Americans have to acknowledge this fact first. Limited resources just are not going to be "free" or widely available overnight.


The problem is that Obama denies this very fact and has a lot of people drinking the koolaide that healthcare can be free and universal. Obama is not the one taking care of sick people; doctors, nurses, hospitals, physical therapists, receptionists etc... These folks don't work for free, 24 / 7 .


How about tort reform?

How about increasing competition among health insurers, at no cost to the taxpayor?

Oh and another point, even if reimbursement goes up a few percent to primary care, where are all the primary care doctors going to come from? Are future medical students and residents going to be FORCED into a particular field of medicine BY THE GOVERNMENT?
Just because you build a baseball field does not mean there will be enough baseball players.




G&P

Hello El:

I don't know if you're misinterpreting it or not. However, if it were me, and a guy is going to TURN ME DOWN for services, it don't make much difference WHO the guy works for, whether it be the government or a private insurer.

Can you tell me of a single insurance company that has decided to pay GPS more by taking that money away from specialists? Until you can, there's no comparison.


To me, it would be LESS obscene if they did it in the name of insuring EVERYBODY, than if they did it in the name of profit.

That's kind of like saying that it's less obscene if Hitler killed 6 million Jews in the name of making Germany stronger than if he did it in the name of racism and bigotry. I really don't see the difference.

However, like I said, I don't see rationing in private insurance companies. I have never heard of an insurance company telling their service providers that they are going to pay the GPs more by taking money from the specialists.

So your comparison between the insurance companies and the government is somewhat flawed.


However, neither is necessary, and it's only speculation that Obama is going to do it. There's NO speculation, however, about the insurance companies denying service, though. They are, this very day, going to RATION health care to lots of people, some of whom are going to die as a result.

Please prove that. You have SAID it many times, but you have NEVER been able to prove it.

As I have said before, NOBODY in this country has to go without medical care. EVEN if they are denied by an insurance company, there are other options. THAT HAS been proven over and over again.


That's an obscenity you're unwilling to cop to.. No matter. WE know it - even if YOU don't.

Excon

It's a statement you haven't been able to prove. I can't cop to something that isn't true.

But you haven't explained to me how Obama can promise not to ration health care, and yet put forward a plan to ration health care. That's one that you ain't copping to.

So you are not answering the question I posted, AND making statements of "fact" not in evidence.

Elliot

This is kind of off the topic but I have a question. ET you argue that with private insurance if you get denied for care you can simply go find a different insurance company. But if you get denied for care from one insurance company what makes you think another insurance company is going to insure you with a preexisting condition?

Actually, what I argue is that if you get denied, you have MULTIPLE other options.

These include:

1) Finding another insurance company.
2) Paying out of pocket.
3) Free clinics.
4) Obtaining care from charitable organizations.
5) Setting up a long-term payment plan with your provider.
6) PAYING MORE for insurance that does cover you.
7) Purchasing supplemental insurance in addition to your regular insurance to cover what the main policy won't cover.
8) Finding doctors nice enough to donate their time to the indigent.

And others.

My entire point is that there are OPTIONS in a non-government system. If one option doesn't work for you, there are other options that can.

Yes, it is possible that if one insurance company denies you, you might be denied by others. But even if that happens, there are STILL other options.

Not so in a single-payer government-run system. There are no other options if you are denied services under a single-payer system.

My point isn't that some other insurance company will take you. My point is that there are OPTIONS... whatever those options may be for you.

Elliot

Please read:
Twenty-six Lies About H.R. 3200

Twenty-six Lies About H.R. 3200 | FactCheck.org (http://factcheck.org/2009/08/twenty-six-lies-about-hr-3200/)

NK,

This thread has nothing to do with HR 3200. This is about a plan by Obama to make changes within the structure of Medicare.

Would you care to make a RELEVANT post? Or should we just continue to ignore you?

Elliot

You're an angry man aren't you? :)

How nice to have your people under Medicare have to beg for medical procedures, that seems to suit you just fine.

You're an angry man aren't you? :)

Not really. I'm just wondering when you're going to post something both relevant and correct. I haven't seen it happen yet.


How nice to have your people under Medicare have to beg for medical procedures, that seems to suit you just fine.

I'm AGAINST people having to beg the government for medical procedures... remember? That's what being AGAINST government-run health care is all about. I'm in favor of free-market health care that has lots of nice options so that people don't have to beg to the government for their medical care. YOU'RE the one in favor of people having to go to the government for health care.

You seem to be confused about what people's positions are. But no more confused than usual for you.

Elliot

I'm AGAINST people having to beg the government for medical procedures... remember?
Let's look at what you posted earlier when spitvenom asked "But if you get denied for care from one insurance company what makes you think another insurance company is going to insure you with a preexisting condition?"


Actually, what I argue is that if you get denied, you have MULTIPLE other options.

1) Finding another insurance company.
2) Paying out of pocket.
3) Free clinics.
4) Obtaining care from charitable organizations. Begging
5) Setting up a long-term payment plan with your provider. You've been refused!
6) PAYING MORE for insurance that does cover you. Too late, You've been refused!
7) Purchasing supplemental insurance in addition to your regular insurance to cover what the main policy won't cover. After you've been refused???
8) Finding doctors nice enough to donate their time to the indigent. Begging

http://media.patriotpost.us/img/edition/2009/35h-shovel.jpg

Let's look at what you posted earlier when spitvenom asked "But if you get denied for care from one insurance company what makes you think another insurance company is going to insure you with a preexisting condition?"
[/b]

It is obvious that you have no idea how private insurance works. Not surprising, since you live in a country where you have to beg your government for your care.

In this country, paying for MORE insurance means that you get it... even if you were refused for it before. That's why you are paying MORE. The more you pay, the more coverage you get. It's a free-market concept that I wouldn't expect you to understand.

Ditto for buying supplemental insurance. The more you are willing to pay for, the more coverage you are able to get.

Neither of those constitute begging, and neither of them are dependent on whether you have been denied before.

However, in a single payer system, if you are denied, you don't get the option of paying more for more coverage. If you are denied, there is no other solution.

Not to mention that there's a huge difference between begging to the government and begging in the private sector. Governments don't care how much you beg... they're government bureaucrats. But in the private sector, you can usually find someone willing to help you out. I'd rather beg in the free market than beg the government. It's more likely that I'll succeed in getting what I need that way.

But of course, it's likely that I wouldn't have to beg. There are, as I mentioned, other options. Costly, perhaps... but still available.

With the government, if you are denied, all you've got left is begging.

Elliot

That's all you got eh tom? Standard "too long to understand so I'll use the talking point or funny picture that's going around". That seems to be what the far right is doing these days - not engaging in back and forth discussions but putting out "fear and smear" short palatable bursts hoping no one will research the truth behind it.

INot surprising, since you live in a country where you have to beg your government for your care.Explain that to me please as I've never experienced it.

Explain that to me please as I've never experienced it.

Sure you have... every time you have gone to your government for health coverage. You've just been luckly that you haven't had to beg too hard.

So instead of begging you will hope and pray the insurance company who carries you made a big enough profit so your claim won't get denied. Sounds reasonable.

Sure you have... every time you have gone to your government for health coverage. You've just been luckly that you haven't had to beg too hard.
You have absolutely no idea of how it works here do you? So you just spout off crap all the time without a clue.

Tom,

Good photo.

Rush actually had a comment last week about government-run health care.

He said that in the end there would be only two insurance companies left: All-Statist and Statist Farm. And Statist Farm is also going to be the place they put you out to pasture when you're too old to be elligible for health care procedures.

Elliot

That's all you got eh tom? Standard "too long to understand so I'll use the talking point or funny picture that's going around".

I guess you've never seen an editorial cartoon or gag image from a liberal. If you liked that one you'll love this one...

http://iowntheworld.com/blog/wp-content/uploads/2009/09/unknown1.jpeg


That seems to be what the far right is doing these days - not engaging in back and forth discussions but putting out "fear and smear" short palatable bursts hoping no one will research the truth behind it.

Hasn't that talking point gotten more than a little stale?

In this country, paying for MORE insurance means that you get it... even if you were refused for it before. That's why you are paying MORE. The more you pay, the more coverage you get. It's a free-market concept that I wouldn't expect you to understand.

Ditto for buying supplemental insurance. The more you are willing to pay for, the more coverage you are able to get. Hello again, El:

You're a slippery guy, all right, but that's why I'm here...

Let me ask you this... You don't have insurance. You HAVE a preexisting condition requiring expensive surgery. Considering the free market concept of profit, what insurance company is going to sell you insurance no matter what the cost??

The fact is, none will. THAT'S the free market at work.

If they intend to make a profit, they're going to have to charge you MORE for the insurance than the surgery will cost, and what dinglebonk is going to do that?? THAT'S the free market at work.

excon

Hello again, El:

You're a slippery guy, alright, but that's why I'm here....

Lemme ask you this.... You don't have insurance. You HAVE a preexisting condition requiring expensive surgery. Considering the free market concept of profit, what insurance company is going to sell you insurance no matter what the cost???

The fact is, none will. THAT'S the free market at work.

If they intend to make a profit, they're going to have to charge you MORE for the insurance than the surgery will cost, and what dinglebonk is going to do that??? THAT'S the free market at work.

excon

So... you are saying that no insurance company will sell someone with a pre-existing condition any insurance at any price?

Bull$h!t.

It may cost like a mother... but you could buy insurance, even if you have a pre-existing condition.

OR you could pay your medical bills out of pocket, especially if the cost of insurance premiums is too high.

The point is that in a free market system there are other options, from out of pocket, to supplemental insurance, to paying more for insurance, to charities. With a single-payer system, there is no other option.

That's a point you can't get past. Our system has options. A single payer system doesn't. You are trying to prove that those other options "aren't real options", but you can't. Because you know that in a free-market system, there's always someone willing to sell you something for the right price... even insurance to a person with a pre-existing condition... or medical care for out-of-pocket payment. That's the nature of free-markets. You can't change that little fact no mater how hard you argue against it, and it kills your whole socialist medicine model.

Free markets bring options. Government control brings none. End of story.

Elliot

All I have to say is this...

Obama doesn't have to worry about any pesky health insurance. He and his family have the best money can buy and he doesn't have to pay a dime for it for the rest of his life. Isn't that nice? While the rest of the peasants will happily have to die as they can't get any health treatment regardless as they don't rate.

They don't want to address all the illegal alien free health care that is literally ruining our country and making hospitals close their doors. No, why solve the problem when they can just make more problems? That's our wonderful government for you. Why should everyone get a nice heart surgery when only the "worthy" politicians or wealthy folks can get this type of care? Well, because they're better than we (the peasants that is) are, that's why. Haven't you figured this out yet? The politicians in Washington don't pay into Social Security. Never have and never will. Why should they when they will get their annual salary each year after they are no longer in Washington! Why should they have to live on a SSR check of $1,000 or $2,000 or whatever? They won't and will not do that. No, they collect $100,000+ each year, every year for the rest of their lives. And as far as paying any health care premium. Forget that. They don't and they won't. They get that free as well forever. Why doesn't the American public wake up to the fact that we have all these little "kings and queens" getting rich off the labor of our backs for the rest of their life and stop the overly generous "pensions" that they get and the free health care that they get? No, we're too timid to say anything or pipe up that what they're doing is wrong, wrong, wrong. Take away their "pensions". Take away their free best money can buy health care and see how loudly they protest.

That's all you got eh tom?

Nahhh there's plenty more where that came from

http://www.colleenhammond.com/blog/wp-content/uploads/2009/07/Obama-Care-Bring-out-Your-Dead.jpg

Keep 'em coming, it reflect your views nicely! (and those of republicans who can handle things is short soundbites or simple pictures)

Or links to Jon Stewart comedy bits ?

Did you watch it? It was less comedy than investigative journalism. Whereas your cartoons are more sad fear mongering with no back up.

Maybe I'm wrong.. maybe the death commissions will not be as bad as the British NHS they are modeled after
Sentenced to death on the NHS - Telegraph (http://www.telegraph.co.uk/health/healthnews/6127514/Sentenced-to-death-on-the-NHS.html)

See, you blew right past what I said. Stewart asked the "death panel" lady to show him where in the bill is her evidence to back up her claim... that's where the comedy began. You're doing the same thing as her.

Betsy McCaughey is former Lt. Governor of NY State and a long time patient advocate.

Jon Stewart gets laughs from a liberal audience repeating what his staff of writers pen.

Hello:

The right wing isn't, and never has been a partner in health care reform. The idea from the beginning was to kill it. Therefore, arguing with them about their points being wrong, won't penetrate. They KNOW they're wrong, but they're succeeding with them, so why change?

Do they have any integrity? Nahhh. They like the INSURANCE INDUSTRY DEATH PANELS that are already set up.

excon

Betsy McCaughey is former Lt. Governor of NY State and a long time patient advocate.

Jon Stewart gets laughs from a liberal audience repeating what his staff of writers pen.
Wow, even after that interview you support her. That's fanaticism.

Actually NK, since it has been pointed out in public about a thousand times where the references to the Death Panels are in the various bills, and since we can point to the actual death panels in Brittain and Canada (whether you care to admit it or not), there's no reason for McCaughey to repeat something she has pointed out so many times before. If Stewart can't keep up, that says much more about his lack of ability than it does about her.

He's a comedian, and not a particularly good one. That's all he's got going for him.

Which means he'll probably run for Congress eventually.

Elliot

See? All you have are personal attacks.

It's also been proven that there is no reference to death panels in the bill - just your vivid imagination fueled by hatred of universal health care.

And no, there are no death panels in Canada <sigh>. You don't even know how the system works here, that much has been very obvious by your posting.

Hello:

The right wing isn't, and never has been a partner in health care reform. The idea from the beginning was to kill it. Therefore, arguing with them about their points being wrong, won't penetrate. They KNOW they're wrong, but they're succeeding with them, so why change?

Do they have any integrity? Nahhh. They like the INSURANCE INDUSTRY DEATH PANELS that are already set up.

excon

As opposed to those on the Left were willing to reach across the aisle and work with the Republicans?

Bwaahahahahahahaha

Then why did the lefties try to ram this piece of cr@p down our throats without giving anyone a chance to read it? What was the emergency?

Why have they rejected EVERY SINGLE AMENDMENT proposed by Republicans without debating the amendments? Republicans have been trying to amend the bills in Congress and have tried to work out several different compromises, and have been rejected EVERY TIME. Tom has posted several of those amendments that were rejected without debate. If the Dems are being bi-partisan, why won't they work with the Reps on these amendments?

Why have the congressional libs KILLED EVERY BILL ASSOCIATED WITH MAKING THEM SUBJECT TO THE SAME PLAN THAT THEY ARE TRYING TO SADDLE US WITH? Why is health care reform good enough for us, but not good enough for them?

C'mon, excon. Do you really think that the libs have attempted to be bi-partisan on health care reform?

Republicans are in favor of health care reform. They're just not in favor of communism. There are other forms of health care reform. I've listed about a dozen items that could be reformed to fix health care. So have others here. Republicans have been pushing THOSE health care reforms for years and gotten nowhere. So to say that Republicans are against health care reform is a fallacy and you know it.

So in essence your post was demonstrably just a pile of BS.

Elliot

See? All you have are personal attacks.

It's also been proven that there is no reference to death panels in the bill - just your vivid imagination fueled by hatred of universal health care.

And no, there are no death panels in Canada <sigh>. You don't even know how the system works here, that much has been very obvious by your posting.

HR3200, section 1233, subsection 5(b).

DEATH PANELS.

Checkmate.

Elliot

She read the bill and the writings of Emanuel ;Daschelle and Holder. Stewart can barely read the script he's given .

They are slated to be administrators of the 'Complete Lives Systems' commissions (does that sound better than death panels ?) .

All she has done is read the legalese in the bill and cross referenced it to what Emanuel and Daschele have written.


But since no one likes the message she gets smeared like Palin .

HR3200, section 1233, subsection 5(b).

DEATH PANELS.

Checkmate.

Elliot

‘(B) The level of treatment indicated under subparagraph (A)(ii) may range from an indication for full treatment to an indication to limit some or all or specified interventions. Such indicated levels of treatment may include indications respecting, among other items--CommentsClose CommentsPermalink

‘(i) the intensity of medical intervention if the patient is pulse less, apneic, or has serious cardiac or pulmonary problems;CommentsClose CommentsPermalink

‘(ii) the individual’s desire regarding transfer to a hospital or remaining at the current care setting;CommentsClose CommentsPermalink

‘(iii) the use of antibiotics; andCommentsClose CommentsPermalink

‘(iv) the use of artificially administered nutrition and hydration.’.CommentsClose CommentsPermalink

(2) PAYMENT- Section 1848(j)(3) of such Act (42 U.S.C. 1395w-4(j)(3)) is amended by inserting ‘(2)(FF),’ after ‘(2)(EE),’.CommentsClose CommentsPermalink

(3) FREQUENCY LIMITATION- Section 1862(a) of such Act (42 U.S.C. 1395y(a)) is amended--CommentsClose CommentsPermalink

(A) in paragraph (1)--CommentsClose CommentsPermalink

(i) in subparagraph (N), by striking ‘and’ at the end;CommentsClose CommentsPermalink

(ii) in subparagraph (O) by striking the semicolon at the end and inserting ‘, and’; andCommentsClose CommentsPermalink

(iii) by adding at the end the following new subparagraph:CommentsClose CommentsPermalink

‘(P) in the case of advance care planning consultations (as defined in section 1861(hhh)(1)), which are performed more frequently than is covered under such section;’; andCommentsClose CommentsPermalink

(B) in paragraph (7), by striking ‘or (K)’ and inserting ‘(K), or (P)’.CommentsClose CommentsPermalink

(4) EFFECTIVE DATE- The amendments made by this subsection shall apply to consultations furnished on or after January 1, 2011.CommentsClose CommentsPermalink

(b) Expansion of Physician Quality Reporting Initiative for End of Life Care-CommentsClose CommentsPermalink

(1) Physician’S QUALITY REPORTING INITIATIVE- Section 1848(k)(2) of the Social Security Act (42 U.S.C. 1395w-4(k)(2)) is amended by adding at the end the following new paragraphs:CommentsClose CommentsPermalink

‘(3) Physician’S QUALITY REPORTING INITIATIVE-CommentsClose CommentsPermalink

10
‘(A) IN GENERAL- For purposes of reporting data on quality measures for covered professional services furnished during 2011 and any subsequent year, to the extent that measures are available, the Secretary shall include quality measures on end of life care and advanced care planning that have been adopted or endorsed by a consensus-based organization, if appropriate. Such measures shall measure both the creation of and adherence to orders for life-sustaining treatment.CommentsClose CommentsPermalink

1
‘(B) PROPOSED SET OF MEASURES- The Secretary shall publish in the Federal Register proposed quality measures on end of life care and advanced care planning that the Secretary determines are described in subparagraph (A) and would be appropriate for eligible professionals to use to submit data to the Secretary. The Secretary shall provide for a period of public comment on such set of measures before finalizing such proposed measures.’


That's it? That's been debated by your side and lost. Where are the references to death panels?

That's it? That's been debated by your side and lost. Where are the references to death panels?

The references are in what treatments they will have the power to withhold.

Stuff like FOOD, WATER, Antibiotics, medical treatments.

But of course, withholding that stuff doesn't constitute "death panels" in your book, because it doesn't actually say the words "death panels".

What the bill DOES do in sections 142 and 143 is establish two separate 'commissions' that determine who gets what care based on their remaining useful lives as determined by those panels.

So you're right. There are no death panels. There are death commissions.

So... you have two commissions that determin who gets care based on their remaining useful lives. And you have legislation that forces older people to be "counseled" to allow themselves to die rather than be takne care of. And you have legislation about what forms of health care can be withheld for old people.

That translates as DEATH PANELS, no matter how you slice it.

Try as hard as you like, NK, you can't run away from what the bill says. Those words will come back to haunt you every time you try to deny it and make you look even more foolish the more times you try.

Elliot

Hello NK;

I had a conversation with my dinning room table last night... It said Elliot was right...

excon

Try as hard as you like, NK, you can't run away from what the bill says.
But you are! You don't quote the text that supports your argument, you had your personal interpretation.

Hello NK;

I had a conversation with my dinning room table last night.... It said Elliot was right...

excon

That would mean your dining room table has more brains than you do.

As I have previously posted;H.R. 1 (the Stimulus Bill ) contains $1.1 billion to fund the Federal Coordinating Council for Comparative Effectiveness Research. Zeke Dr Death Emanuel in on the council .

Federal Coordinating Council for Comparative Effectiveness Research Membership (http://www.hhs.gov/recovery/programs/os/cerbios.html)


Obama's Regulatory Czar Cass Sunstein will play a role in deciding the government's role in controlling medical care. He says that human life should be measured in "quality-adjusted life years" .

www.aei-brookings.org/admin/authorpdfs/redirect-safely.php (http://www.aei-brookings.org/admin/authorpdfs/redirect-safely.php)?

As you see .The death panel has already been established and will be managed by people who have definite opinions on who should live and die.

Federal Coordinating Council for Comparative Effectiveness Research Membership (http://www.hhs.gov/recovery/programs/os/cerbios.html)


Comparative effectiveness research provides information on the relative strengths and weakness of various medical interventions. Such research will give clinicians and patients valid information to make decisions that will improve the performance of the U.S. health care system.
...
The Council will not recommend clinical guidelines for payment, coverage or treatment.
Yea, that sounds like a crazy death panel!

But you are! You don't quote the text that supports your argument, you had your personal interpretation.

Not my personal interpretations... all I did was quote the text of the bill. It says what it says... no way around that...

But if you want personal interpretations, you can look to the people who created the bills... people like Zeke Emanuel, Obama, Carol Shea-Porter. They make it very clear what THEIR interpretations and their intent with these bills are.

Elliot

Yea, that sounds like a crazy death panel!

When the stated purpose of the panel is to determine how much "effective" life you've left and base your level of care on that, yeah, it's a death panel. They decide what you get and if you're too old you don't get it. That is the very definition of a death panel... no matter what fancy name they give it.

Elliot

Not my personal interpretations... all I did was quote the text of the bill. It says what it says... no way around that...At no point in your post (https://www.askmehelpdesk.com/1960404-post39.html) did you quote the text of the bill.

When the stated purpose of the panel is to determine how much "effective" life you've left and base your level of care on that, yeah, its a death panel. They decide what you get and if you're too old you don't get it. It says none of that on that website. None.

When the stated purpose of the panel is to determine how much "effective" life you've left and base your level of care on that, yeah, its a death panel.
Hello again:

Yeah, my dinning room table read it and told me the same thing.

Look. There's no reasoning, here. The words say one thing... The right wingers say the words mean something else...

Is it because they can't read?? Is it because their ideology BLINDS them from the words? Is it because they DON'T believe what their lying eyes tell them, but they DO believe Rush Limprod? Or, could it be that they're willing to defeat ANYTHING Obama wants, and they're willing to lie about it to get their way. Or maybe they're dinning room tables.

It's got to be ONE of the above.

excon

Well if you guys don't like that Obamacare is going down in flames then join MoveOn's virtual vigil (http://pol.moveon.org/vv/?rc=homepage).

Well if you guys don't like that Obamacare is going down in flames then join MoveOn's virtual vigil (http://pol.moveon.org/vv/?rc=homepage).Hello again, Steve:

Oh, it's going down... The Dems, who have ALL three branches of government, and one of the largest majority's in congress in history, have defeated themselves.

excon

Yea, that sounds like a crazy death panel!


Yes that text is how it is sold to the public . But , the real purpose is to establish official criteria for denying care to less favored patients based on their sick formula about a patient's worth. . Like I said ;read the words of the advocates that the President has as his top advisors on this . They make no bones they would ration critical care to patients based on their worth... just like the English system I linked to earlier.

http://localcrank.files.wordpress.com/2008/10/tinfoil-hat1.jpg

yes that text is how it is sold to the public . But , the real purpose is to establish official criteria for denying care to less favored patients based on their sick formula about a patient's worth.
Hello again, tom:

So, if I would have said that the text of the Patriot Act said ONE thing, but the REAL purpose of it was to destroy the Fourth, Fifth and Sixth Amendments to the Constitution, you'da told me to put on my tin hat...

At least you ADMIT the words don't say what the Wolverine says they do... You're concern is the leftist, socialist, communist plot that's underway for a government take over of everything, and knocking off granny too... I got it.

excon

I read the text and the writing of the people who authored it. But that stuff should be ignored evidenty. Sort of like reading the Constitution without reading the Federalist papers if you ask me. But intent it would seem to me would be important when deciding if you support legislation .

Political Evidence: Obama's Ration Man: Ezekiel Emanuel (http://www.politicalevidence.com/2009/08/obamas-ration-man-ezekiel-emanuel.html)






In Dr. Emanuel's writings, he overtly advocates the rationing of healthcare based on age. In January 2009, just one month prior to taking his new position at the White House, Dr. Emanuel co-wrote an article entitled, “Principles for allocation of scarce medical interventions”, in the British medical journal The Lancet. In this article he advocates a particular healthcare allocation system which he calls the “complete lives system.” He declared in The Lancet article that in healthcare, “scarcity is the mother of allocation." He explains, “This system (complete lives system) incorporates five principles: youngest-first, prognosis, save the most lives, lottery, and instrumental value. As such, it prioritizes younger people who have not yet lived a complete life and will be unlikely to do so without aid.”




Is this the influence that Obama's chief of staff's brother has?


Say you are 65 and have been paying into Medicare for close to 40 years, when you get sick and expect the system that you have been paying into for 40 years to help you in your time of need, some government panel made a decision that your life is "not worth as much" as some 20 year old who has barely paid anything into the Medicare PONZI SYSTEM.

With the baby boomers getting to this age, and less workers to pay into this PONZI SYSTEM, RATIONING IS GOING TO HAPPEN.







G&P

Excon,

From 1233 5(b):


The level of treatment indicated under subparagraph (A)(ii) may range from an indication for full treatment to an indication to limit some or all or specified interventions.

What do the words "limit some or all specified interventions" mean to you? To me it means "limit some or all specified interventions". To you, it must mean something OTHER than what it says.

Which of those words are NOT in the bill?

Why do you insist on saying that the bill DOESN'T REALLY say that when it clearly does.

The bill LIMITS TREATMENT. It does so through a panel... excuse me, a commission... established in sections 142 and 143, who's job it is to do just that... limit care based on life expectancy.

That commission is a "death panel", whether you choose to call it that or not. Call it a "commission" if you want. Call it the Rotary Club if it makes you more comfortable. But it is a group of people that makes decisions, based on the age of the patient, on what care will be provided. That is a "death panel".

It's there in plain English. You choose to ignore it. Fine. But you're not going to convince anyone else that it ain't there when we can give them a copy of the bill and point to the specific wording and allow them to read it for themselves.

Elliot

I read the text and the writing of the people who authored it. But that stuff should be ignored evidenty. Sorta like reading the Constitution without reading the Federalist papers if you ask me. But intent it would seem to me would be important when deciding if you support legislation .Hello again, tom:

I didn't read the papers you refer us too... Maybe I should. However, your reaction to them has biased me already. I can't believe that any papers published by anyone, other than Dr. Kevorkian, would state the writers INTENTION to kill people... It's ludicrous on its face.

Your side continuously said that the bill contained such language, but I couldn't find it. Am I going to have to read 100's of pages to come up with the same conclusion?? Maybe you could give us the Readers Digest version. But, could you use THEIR words?? I don't know if I'd trust you to interpret them.

Now, if you're suggesting that there's going to be some end of life decisions made by some people, that's true. But, it's no different today. You wouldn't be suggesting that your insurance carrier will cover EVERYTHING an aged person might want, are you?? No, you wouldn't. Because there is some insurance company adjuster who's going to have his own "death panel", isn't he?

excon

Why thanks Elliot, took you long enough. :)

Here's the text immediately before that paragraph:

'(5)(A) For purposes of this section, the term 'order regarding life sustaining treatment' means, with respect to an individual, an actionable medical order relating to the treatment of that individual that--Comments (http://www.opencongress.org/bill/111-h3200/text#)Close Comments (http://www.opencongress.org/bill/111-h3200/text#)Permalink (http://www.opencongress.org/bill/111-h3200/text?version=ih&nid=t0:ih:2858)


20 (http://www.opencongress.org/bill/111-h3200/text#)
'(I) is signed and dated by a physician (as defined in subsection (r)(1)) or another health care professional (as specified by the Secretary and who is acting within the scope of the professional's authority under State law in signing such an order, including a nurse practitioner or physician assistant) and is in a form that permits it to stay with the individual and be followed by health care professionals and providers across the continuum of care;Comments (http://www.opencongress.org/bill/111-h3200/text#)Close Comments (http://www.opencongress.org/bill/111-h3200/text#)Permalink (http://www.opencongress.org/bill/111-h3200/text?version=ih&nid=t0:ih:2859)

6 (http://www.opencongress.org/bill/111-h3200/text#)
'(ii) effectively communicates the individual's preferences regarding life sustaining treatment, including an indication of the treatment and care desired by the individual;Comments (http://www.opencongress.org/bill/111-h3200/text#)Close Comments (http://www.opencongress.org/bill/111-h3200/text#)Permalink (http://www.opencongress.org/bill/111-h3200/text?version=ih&nid=t0:ih:2860)

'(iii) is uniquely identifiable and standardized within a given locality, region, or State (as identified by the Secretary); andComments (http://www.opencongress.org/bill/111-h3200/text#)Close Comments (http://www.opencongress.org/bill/111-h3200/text#)Permalink (http://www.opencongress.org/bill/111-h3200/text?version=ih&nid=t0:ih:2861)


1 (http://www.opencongress.org/bill/111-h3200/text#)
'(iv) may incorporate any advance directive (as defined in section 1866(f)(3)) if executed by the individual.It's the individual's preference, not anyone else's decision.

Why thanks Elliot, took you long enough. :)

Here's the text immediately before that paragraph:
It's the individual's preference, not anyone else's decision.

Did you read the part about a counselor telling people they SHOULD make choices to limit their care by filling our DNRs, DNIs, living wills, etc.

So what we have are commissions that determine levels of care based on age, send out counselors to convince people to allow themselves to die rather than obtain care, and have specific rules to limit care.

Thanks, NK. You're just proving my point.

Death panels AND death counselors.

All run by the same people who brought you the postal system, the IRS and Social Security.

'nuff said.

Elliot

Did you read the part about a counselor telling people they SHOULD make choices to limit their care by filling our DNRs, DNIs, living wills, etc.No I didn't see that part because it's not in there. I did see where the individual has the power to make choices as they always have.

Did you read the part about a counselor telling people they SHOULD make choices to limit their care by filling our DNRs, DNIs, living wills, etc.Hello again, El:

No, I couldn't find it. If it's there, why didn't you post THAT - the SMOKING GUN??

excon

Hello again, El:

No, I couldn't find it. If it's there, why didn't you post THAT - the SMOKING GUN??????

excon

That would be in 1233 sections 1-4.

And the reason I haven't posted here is because I posted it BEFORE and you already ignored it.

Elliot

Hello again, El:

If you can't prove what you say, what you say is bunk. If I ignored it before, it's because it doesn't say what you say it says...

Look, even the well read and respected tomder said it's not there... What's up with that?

excon

It's the individual's preference, not anyone else's decision.

Apparently that's no longer the case in the UK.

Sentenced to death on the NHS
(http://www.telegraph.co.uk/health/healthnews/6127514/Sentenced-to-death-on-the-NHS.html)

In a letter to The Daily Telegraph, a group of experts who care for the terminally ill claim that some patients are being wrongly judged as close to death.

Under NHS guidance introduced across England to help doctors and medical staff deal with dying patients, they can then have fluid and drugs withdrawn and many are put on continuous sedation until they pass away.

But this approach can also mask the signs that their condition is improving, the experts warn.

As a result the scheme is causing a “national crisis” in patient care, the letter states. It has been signed palliative care experts including Professor Peter Millard, Emeritus Professor of Geriatrics, University of London, Dr Peter Hargreaves, a consultant in Palliative Medicine at St Luke’s cancer centre in Guildford, and four others.

“Forecasting death is an inexact science,”they say. Patients are being diagnosed as being close to death “without regard to the fact that the diagnosis could be wrong.

“As a result a national wave of discontent is building up, as family and friends witness the denial of fluids and food to patients."

The warning comes just a week after a report by the Patients Association estimated that up to one million patients had received poor or cruel care on the NHS.

The scheme, called the Liverpool Care Pathway (LCP), was designed to reduce patient suffering in their final hours...

In 2007-08 16.5 per cent of deaths in Britain came about after continuous deep sedation, according to researchers at the Barts and the London School of Medicine and Dentistry, twice as many as in Belgium and the Netherlands.

No death panels, just a "death pathway." Maybe that will give the Dems a new angle to work this in. What could we call it, Obamanasia? Barackin' down the highway of death?

Hello again, El:

If you can't prove what you say, what you say is bunk. If I ignored it before, it's because it doesn't say what you say it says....

Look, even the well read and respected tomder said it's not there.... What's up with that?

excon

Ah... but I did prove it. And you ignored it.

But the rest of the American population ISN'T ignoring it. They HAVE read it and they've seen it. Which is why Obamacare is going to die a stillborn death. Obama can claim it doesn't say what is says all he wants... it's too late. People have already read it.

Stick a fork in it... it's done. One way or another.

If he still manages to pass it (he does have 60 votes in the Senate), it'll get overturned in 2010 when Congress goes back to the Republicans... even if they can't pass a bill to reverse it, they can just defund it.

If he DOESN'T pass it, he will become the first Preident in American history to become a lame duck after only 9 months in office. And Congress will STILL go to the Reps in 2010. And so will the Oval Office in 2012.

He created this situation. He made his bed. Now he can lay in it.

Elliot

Hey NK, is this what we can expect, too?


Health cuts likely deep (http://www.canada.com/Health+cuts+likely+deep/1953960/story.html)

By Derek Spalding, Daily NewsSeptember 2, 2009

The latest B.C. budget maintains a commitment to increase health-care spending, but not enough to avoid service reductions in many communities.

Ministry of Health funding will increase nearly 18% in the next three years, reaching $15.7 billion by 2011-12. Medical Services Plan premiums will jump 6% on January 2010, the first hike since 2002.

The increase will equate to a maximum of $3 a month for single people or $6 per family.

The Hospital Employees' Union was quick to criticize, saying that health authorities will have to absorb the cost of MSP premium hikes. And, as demand on health services is expected to grow faster than funding, the province's health authorities are slashing spending to balance their books.

Repeated requests to speak with Vancouver Island Health Authority CEO Howard Waldner or any management staff were rejected on Tuesday. Communication staff members said details of the authority's budget will not be released for two more weeks, despite an earlier projection for the end of August.

Other health authorities have already revealed their plans. The Fraser Health Authority expects to cut surgeries, seniors' programs and services for the mentally ill to make up a budget shortfall of up to $160 million. This shortfall comes, despite a $96-million increase in base funding from the provincial government.

The head of Health Sciences Association of B.C. attacked the government's budget. President Reid Johnson said "British Columbians, who rely on our health care system, will pay more for less."

Health authority budget cuts will reduce access to services, Johnson explained. "In July, Health Minister Kevin Falcon delivered an edict to health authorities to slash their budgets. Those cuts will result in dramatic service reductions - including diagnostic services like lab, X-ray, MRI, ultrasound and nuclear medicine," Johnson said.

Not enough money? Let's cut surgeries... and services to seniors and the mentally ill. They must not be high enough on the Canadian comparative effectiveness scale.