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  • Jul 7, 2009, 07:12 AM
    tomder55
    Rationing health care
    It is now clear that the plans being forwarded to "reform " health care in the US involves rationing . How do I know this ? Because the people the President assigned to create a new plan make no bones about it .

    Ezekiel Emmanuel MD, Rahm Emmanuel’s brother,is Barack Obama’s “Special Advisor for Health Policy”.

    He recently penned an article in Lancet (registration required) co-authored with Govind Persad and Alan Wertheimer where they detail their thoughts on creating a model for health care rationing ;a system they call “The complete lives system” .

    Principles for allocation of scarce medical interventions : The Lancet

    Quote:

    This system incorporates five principles: youngest-first, prognosis, save the most lives, lottery, and instrumental value. … When implemented, the complete lives system produces a priority curve on which individuals aged between roughly 15 and 40 years get the most substantial chance, whereas the youngest and oldest people get chances that are attenuated … the complete lives system is least vulnerable to corruption. Age can be established quickly and accurately from identity documents. Prognosis allocation encourages physicians to improve patients’ health, unlike the perverse incentives to sicken patients or misrepresent health that the sickest-first allocation creates.
    They describe this as a better way for an unnamed bureaurocrat to determine who has the right to care in a rationed system than previous models ;that “the complete lives system is least vulnerable to corruption” .

    But the bottom line is that such a decision is being taken from the patient and the health care provider.

    On a scale from 1-10 I wonder what my instrumental value is ? Who's friend do I have to be to move my base number up ?
    Instrumental value allocation prioritises specific individuals to enable or encourage future usefulness.

    Yeah that's what I thought . This bureaurocrat will decide my fate on my usefulness...
    where a specific person is genuinely indispensable in promoting morally relevant principles, instrumental value allocation can be appropriate.
    So whatever you do ;make sure you are useful to the Obots.

    I don't know .Wouldn't it be simpler for Dr Emanuel to dress up in appropriate Nazi garb and just point his swager stick at those who are lebensunwertes ?
  • Jul 7, 2009, 07:36 AM
    450donn

    Boy, does this sound like gene selection? I thought this was tried and failed around 1935 in Germany!
  • Jul 7, 2009, 07:38 AM
    NeedKarma
    Quote:

    Originally Posted by 450donn View Post
    Boy, does this sound like gene selection?

    How does it sound like gene selection to you? And it what way do you find it reminiscent of jewish extermination?
  • Jul 7, 2009, 07:53 AM
    ETWolverine

    NK,

    It looks very much like the government deciding who lives and who dies based on age descrimination and nature of their ailment. That's pretty descriminatory in my book. And it is no different from Nazis saying "this one lives and that one dies" based on their ability to provide slave labor for the Reich (instrumental value allocation). The Reich determined who was strongest and most able to work, and those lived, while others went to the gas chambers. Age/health-based descrimination to determine who gets care and who doesn't is exactly what the Nazis did. How can you not see that?

    But whether you can see the connection or not, do you find this "instrumental value allocation" system to be a good idea?

    Do you think that it is a good idea that if you are over 40 you don't get the same level of care and the same medical options that you did between the ages of 18 and 40?

    Do you approve of this concept?

    Elliot
  • Jul 7, 2009, 07:55 AM
    tomder55

    Quote:

    Reporting from Washington — President Obama suggested at a town hall event Wednesday night that one way to shave medical costs is to stop expensive and ultimately futile procedures performed on people who are about to die and don't stand to gain from the extra care.

    In a nationally televised event at the White House, Obama said families need better information so they don't unthinkingly approve "additional tests or additional drugs that the evidence shows is not necessarily going to improve care."
    Quote:

    He added: "Maybe you're better off not having the surgery, but taking the painkiller."
    Obama discusses deathbed measures - Los Angeles Times
  • Jul 7, 2009, 08:09 AM
    450donn
    Quote:

    Originally Posted by NeedKarma View Post
    How does it sound like gene selection to you? And it what way do you find it reminiscent of jewish extermination?


    OK, here is an example that you might comprehend.
    Say you are a 25 year old female, not married yet and no children. You get cancer, and because it will cost 50,000 dollars to treat you it is decided that you are not worth the cost, because that 50K could be spread to 50 other people with lesser illnesses. Because of the cancer you ultimately die, thereby eliminating your genes from the gene pool and also stopping the possible spread of your defective gene that allowed you to get the cancer in the first place. Think it's not possible?
    THINK AGAIN!
    Any system that allows for rationing of health care is gene selection by it's very nature. Those that are "deemed" worthy get and those that are not don't.
  • Jul 7, 2009, 09:37 AM
    speechlesstx
    That may explain why it was so easy for Obama to fire Gerald Walpin, he's an old, off his rocker guy that's outlived his usefulness.

    Such an Orwellian name, the "complete lives" system, where only the youngest, most "morally relevant" people with high "instrumental value" get to live their 'complete' life. Ain't it ironic that the guy who's name represents the plan is an old, sick senator that may have outlived his usefulness?
  • Jul 7, 2009, 09:42 AM
    excon
    Quote:

    Originally Posted by ETWolverine View Post
    Do you think that it is a good idea that if you are over 40 you don't get the same level of care and the same medical options that you did between the ages of 18 and 40?

    Do you approve of this concept?

    Hello Elliot:

    You didn't ask me, but I didn't think you'd mind if I answered. Health care is already rationed. The wealthy get it, and the poor don't. But, if it's going to BE rationed, I'd rather the criteria be HEALTH and not PROFITS.

    Can you imagine suffering from a disease that just not many people suffer from?? There IS a drug, though, that will SAVE YOUR LIFE, but because the drug companies are looking for PROFITS instead of HEALTH, they're not going to make that life saving drug for you because there's no PROFIT in it.

    I'm sure you'd sacrifice your own life in the name of blind conservatism, but what if this was your child? Isn't SHE entitled to live?

    excon
  • Jul 7, 2009, 09:50 AM
    tomder55
    Ex

    The insurance company is not the final arbiter in that case . It is difficult I know... but one can get medicine outside the approved covered plan . Yes it costs more but so long as the drug is legal or the care and procedure the doctor recommends is available there are ways around the insurance company's decision .

    Who do you appeal to when the government tells you no .

    I'm sure you are aware of the case in Oregon where the drug for treatment was no approved by their politburo ,but they instead recommeded assisted suicide ? Is that what you want ?
    http://abcnews.go.com/Health/story?id=5517492&page=1
  • Jul 7, 2009, 09:54 AM
    excon
    Quote:

    Originally Posted by tomder55 View Post
    Who do you appeal to when the government tells you no

    Hello tom:

    An activist judge, perhaps?

    excon
  • Jul 7, 2009, 10:09 AM
    NeedKarma
    Quote:

    Originally Posted by 450donn View Post
    You get cancer, and because it will cost 50,000 dollars to treat you it is decided that you are not worth the cost, because that 50K could be spread to 50 other people with lesser illnesses.

    That's not all how it works. Where did you get that idea? If that was a feasible option then the for-profit insurance companies would have done that decades ago.
  • Jul 7, 2009, 10:24 AM
    450donn

    AHHH but that is exactly how rationing works. Those that "someone" decides is deserving will get, those that they decide are not worthy will not get. Just look to the UK for an understanding of how a bankrupt/failed system works. Rationing is rationing no matter how you slice it. Just because you might be younger you get cancer treatment and my wife does not? What is fair about that sort of thing?
  • Jul 7, 2009, 10:26 AM
    ETWolverine
    Quote:

    Originally Posted by excon View Post
    Hello Elliot:

    You didn't ask me, but I didn't think you'd mind if I answered. Health care is already rationed. The wealthy get it, and the poor don't. But, if it's going to BE rationed, I'd rather the criteria be HEALTH and not PROFITS.

    Can you imagine suffering from a disease that just not many people suffer from??? There IS a drug, though, that will SAVE YOUR LIFE, but because the drug companies are looking for PROFITS instead of HEALTH, they're not going to make that life saving drug for you because there's no PROFIT in it.

    I'm sure you'd sacrifice your own life in the name of blind conservatism, but what if this was your child? Isn't SHE entitled to live?

    excon

    There are several problems with your argument, Excon.

    1) Pharma companies already give away drugs to poor people. We don't need nationalized health care to make drugs available to people who can't afford them. I have already posted links to the pharmaceutical companys' websites for their affordable drug programs. I'm not going to do it again. Look at other threads, I'm sure you'll find it.

    2) In the scenario you pose, I can go outside the insurance system to buy whatever I want out of my own pocket. In a Government-run system there is no going out of the program to get your drugs. You can ONLY get them from the government. And if the government has decided that you don't get them, you don't get them. Period. There is no going out of pocket to get them. Private systems leave choices. Government-run systems do not.

    A profit based system means that something is ALWAYS available for the right price. A government-run system means that if the government doesn't approve it, you're dead. I'd rather have the choice to get the drugs myself if my insurance doesn't cover it even if it's expensive... even if it bankrupts me... than be stuck without it because the government says so.

    Elliot
  • Jul 7, 2009, 10:37 AM
    NeedKarma
    Quote:

    Originally Posted by 450donn View Post
    AHHH but that is exactly how rationing works. Those that "someone" decides is deserving will get, those that they decide are not worthy will not get. Just look to the UK for an understanding of how a bankrupt/failed system works. Rationing is rationing no matter how you slice it. Just because you might be younger you get cancer treatment and my wife does not? What is fair about that sort of thing??

    The article is dated Jan. 31, Obama took office on Jan. 20. I doubt that paper was written in 10 days. In fact the article evaluates systems already in existence at the time Bush was president. So how is this an Obama thing? Oh right... because it isn't. Also it a paper, not policy. Geez, you scaremongers work 24/7.
  • Jul 7, 2009, 11:00 AM
    speechlesstx
    Quote:

    Originally Posted by NeedKarma View Post
    The article is dated Jan. 31, Obama took office on Jan. 20. I doubt that paper was written in 10 days. In fact the article evaluates systems already in existence at the time Bush was president. So how is this an Obama thing? Oh right...because it isn't. Also it a paper, not policy. Geez, you scaremongers work 24/7.

    Gee, I remember how apoplectic the left was over the PNAC document even though that was just a paper and not policy. Talk about "scaremongers."

    What you're missing is that the Obama plan is already establishing such things, namely the Federal Coordinating Council for Comparative Effectiveness Research.
  • Jul 7, 2009, 11:07 AM
    NeedKarma
    Quote:

    Originally Posted by speechlesstx View Post
    What you're missing is that the Obama plan is already establishing such things, namely the Federal Coordinating Council for Comparative Effectiveness Research.

    From the article:

    "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. The council will consider the needs of populations served by federal programs and opportunities to build and expand on current investments and priorities. It will also provide input on priorities for the $400 million fund in the Recovery Act that the Secretary will allocate to advance this type of research."

    Where's the scary part here?
  • Jul 7, 2009, 11:17 AM
    ETWolverine
    Quote:

    Originally Posted by NeedKarma View Post
    From the article:

    "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. The council will consider the needs of populations served by federal programs and opportunities to build and expand on current investments and priorities. It will also provide input on priorities for the $400 million fund in the Recovery Act that the Secretary will allocate to advance this type of research."

    Where's the scary part here?

    The scary part is that in order to "improve the performance of the US health care system" the decision of what medical care people get is going to be made not by doctors and patients based on what's best for the specific patient, but by bureaucrats in offices in Washington DC, based on a chart that says this person is too old for this procedure, that person is young enough for the procedure. The scary part is that instead of the needs of the specific patients, the government is going to make medical decisions based on "the needs of populations served by federal programs and opportunities to build and expand on current investments and priorities." If your death is better for the population at large than your survival, in the opinion of some bureaucrat, you don't get the care you need. THAT is what is scary.

    What bothers me is why YOU are not scared of that.

    Elliot
  • Jul 7, 2009, 11:24 AM
    tomder55
    Notice how the chart in the Emanuel article peaks at the same age demographics as Obama's biggest voting block. (btw don't be a child under 8 and ill according to this chart)

    http://pajamasmedia.com/richardferna...09/07/rahm.jpg
  • Jul 7, 2009, 11:26 AM
    NeedKarma
    Quote:

    Originally Posted by ETWolverine View Post
    The scary part is that in order to "improve the performance of the US health care system" the decision of what medical care people get is going to be made not by doctors and patients based on what's best for the specific patient, but by bureaucrats in offices in Washington DC, based on a chart that says this person is too old for this procedure, that person is young enough for the procedure.

    It says none of that. Point me where it says that.
  • Jul 7, 2009, 11:28 AM
    NeedKarma
    Quote:

    Originally Posted by tomder55 View Post
    notice ....

    What a nasty little site you get your information from: Pajamas Media Propaganda central.

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