Death panel fears force Obama, health reformers to hide

[trc123]

12.27.10 | Merrill Goozner | MedCitizen

"Death panel fears force OBama, health reformers to hide

The OBama administration may come to regret its decision to sneak a rule into a Medicare’s annual update for reimbursement rates that would reimburse physicians for helping the elderly write end-of-life directives. As The New York Times revealed, the rule was published in ’early November,’ yet was deliberately kept quiet by supporters to avoid invoking the wrath of the ’death panels’ crowd. By violating their own promise to run an open government, they’ve needlessly endangered a much-needed policy.

First, let’s be plain about the importance of this measure. As I and millions of other Americans know from first hand experience (in my case, from my mother, who passed away two years ago at age 86 after a long, debilitating physical decline that involved crippling arthritis, diabetes and heart disease), it is crucial to begin these discussions before an elderly person loses the capacity to make decisions on his or her own. Doctors need to be encouraged, i.e., reimbursed, to engage individuals and their families in these discussions. As I sat with mom in her final days, which were spent more or less in a coma, I was glad I could spend those final hours holding the hand of a person who did not have a single tube attached to her body, and who had made that decision to die that way on her own when she had the capacity to do so.

Similar scenes take place every day and in every state and community in the nation. If people like Elizabeth D. Wickham, executive director of LifeTree, which is described in the Times story as a pro-life Christian educational ministry, wants to die with tubes sticking out every orifice, unconscious for days or weeks, and cut off from family and friends while surrounded by machines that go ’ping,’ that’s their business. But they should not be allowed to impose their religious values on anyone else.

If certain politicians want to win votes by stoking ignorance about the realities of end-of-life decision-making, such as happened earlier this year during the debate over health care reform and was preceded by the Terry Schiavo circus, they need to be confronted. Their political opportunism is not only cruel, it is fiscally irresponsible, since creating an environment where individuals can make voluntary decisions to reduce or eliminate useless interventions near the end of life can save Medicare billions of dollars annually.

It would have been better if the new leadership at the Centers for Medicare and Medicaid Services used adoption of this new rule to educate the public about the importance of developing end-of-life directives, while simultaneously stressing that such actions are totally voluntary. Instead, CMS chief Donald Berwick snuck it into a rule that no one reads. If this winds up becoming the next political football for opponents of health care reform, reformers like Berwick will have no one but themselves to blame."

So, what are your thoughts?

[no name joe]

The "death panel" allegations were outright lies propagated to build opposition to the health care bill.

I am not saying the health care bill is a good one or bad one...that is an entirely different discussion. However, the "death panels" were a figment of someones imagination and completely took things out of context and should be called out on their lies.

http://onfaith.washingtonpost.com/onfaith/georgetown/2009/08/the_death_panel_lies.html

Edited December 28, 2010 by kindofblue1977

[JerryNumbers]

And they call it lies, yet its not, for Mr. OBama has been working hard to get this in there. If they can get enough people to think its a lie it surely makes it easier to get their way.

12.27.10 | Merrill Goozner | MedCitizen
Death panel fears force OBama, health reformers to hide

If your going to call this a lie, you need to get updated information, the article you posted calling it lies is from 2009. The above is speaking of what it taking place right now with out president.

[no name joe]

And they call it lies, yet its not, for Mr. OBama has been working hard to get this in there. If they can get enough people to think its a lie it surely makes it easier to get their way.

12.27.10 | Merrill Goozner | MedCitizen
Death panel fears force OBama, health reformers to hide

If your going to call this a lie, you need to get updated information, the article you posted calling it lies is from 2009. The above is speaking of what it taking place right now with out president.

It is an out right lie. There are no death panels. This is pure fear mongering.

The rule that OBama enacted this month allows Medicare to reimburse doctors for visiting with patients about advance health care directives. Doctors can openly discuss end of life care and what care the patient does and does not want. I discuss this with people every week as one who does estate planning work and prepares Living Wills for people.

There is no such thing as a death panel. There is no such concept. It is a lie that was created to build opposition to the law, and the same lie is being stirred up again with the new rules and regulations coming out containing compensation for doctors for discussing end of life care with patients.

Let's talk about the real issues. Not some figmant of someone's paranoid imagination.

What are the facts?

The new Medicare regulations allow physicians to be compensated for discussing end-of-life care for the patient. For example, if a person is terminally ill, the doctor can take his time and discuss the treatment options, including the need for the person to sign an advanced care directive stating that they want life sustaining treatment withheld if such treatment will only prolong the process of death (i.e. breathing machines, life support, etc.).

The rules do not permit a physician to withhold treatment from a person who has not requested that such treatment be withheld. The rules do not allow for euthenasia or anything remotely similar. The rules do allow the physician to discuss in deatail end of life care and what the patient wants to do in certain scenarios.

In my 7 years of law practice, I have never once prepared estate planning docuemnts ofr someone who told me they wanted to be on life support, or they want their doctor to prolong their life as long as possible. They have universally said they would like to, if possible, die a comfortable death and for life support to be withheld.

This rule allows doctors to spend time discussing and informing patients of what end of life treatment is like, what options are, and what can be withheld if they want.

"Death panels" are entirely made up, and it takes away from the productive conversations that should be happening. Edited December 28, 2010 by kindofblue1977

[chev1958]

It is an out right lie. There are no death panels. This is pure fear mongering.

The rule that OBama enacted this month allows Medicare to reimburse doctors for visiting with patients about advance health care directives. Doctors can openly discuss end of life care and what care the patient does and does not want. I discuss this with people every week as one who does estate planning work and prepares Living Wills for people.

There is no such thing as a death panel. There is no such concept. It is a lie that was created to build opposition to the law, and the same lie is being stirred up again with the new rules and regulations coming out containing compensation for doctors for discussing end of life care with patients.

Let's talk about the real issues. Not some figmant of someone's paranoid imagination.

What are the facts?

The new Medicare regulations allow physicians to be compensated for discussing end-of-life care for the patient. For example, if a person is terminally ill, the doctor can take his time and discuss the treatment options, including the need for the person to sign an advanced care directive stating that they want life sustaining treatment withheld if such treatment will only prolong the process of death (i.e. breathing machines, life support, etc.).

The rules do not permit a physician to withhold treatment from a person who has not requested that such treatment be withheld. The rules do not allow for euthenasia or anything remotely similar. The rules do allow the physician to discuss in deatail end of life care and what the patient wants to do in certain scenarios.

In my 7 years of law practice, I have never once prepared estate planning docuemnts ofr someone who told me they wanted to be on life support, or they want their doctor to prolong their life as long as possible. They have universally said they would like to, if possible, die a comfortable death and for life support to be withheld.

This rule allows doctors to spend time discussing and informing patients of what end of life treatment is like, what options are, and what can be withheld if they want.

"Death panels" are entirely made up, and it takes away from the productive conversations that should be happening.

Why would doctors need to be re-imbursed by the government to discuss end-of-life care? Is that not part of the treatment regimen? You are advocating tax money to be paid to doctors for something they're already doing.

[no name joe]

[chev1958]

If doctors are not compensated for spending the extra time, they will rush through and not discuss to get to the next paying patient. That is the thinking.

I know what Medicare is. It could be argued that the Medicare program has led to this mindset. And when our government debt bankrupts us, the government will be looking to cut programs. So, while the term "death panels" may not be addressed in the current unconstitutional legislation being considered, the groundwork for such "panels" is being laid down. And what better way to save Medicare money than by "encouraging" doctors to get people to end their lives when they become "useless" and a "drain on society."

[no name joe]

I know what Medicare is. It could be argued that the Medicare program has led to this mindset. And when our government debt bankrupts us, the government will be looking to cut programs. So, while the term "death panels" may not be addressed in the current unconstitutional legislation being considered, the groundwork for such "panels" is being laid down. And what better way to save Medicare money than by "encouraging" doctors to get people to end their lives when they become "useless" and a "drain on society."

I don't want to get into whether Medicare is a good program, though I think it largely is.

I cannot see where groundwork is being laid for these so called "death panels."

WHat in the world is wrong with encouraging doctors to counsel people about end of life decisions? If I am terminally ill and in tremendous pain, I want my doctor to counsel me as to my options such as continuing a painful treatment that may have a 1% chance of success, or giving me morphine that will ease my pain which carries a risk of perhaps ending my life a little bit early. I don't want my doctor to ruch through speaking to me about options because insurance or Medicare will not pay for his time. They will certainly pay if he does not spend the time and the default route is more expensive care because the doc needs to do that to cover his rear end froma malpractice suit.

I just do not see how this can lead to "death panels." I think this is preying on people's fear. Euthenasia is illegal right now I believe in all 50 states. That is an entirely separate debate than whether Medicare or insurance should pay for time to counsel people on end of life treatement. A little work now can save huge money down the line (whether through private insurance or Medicare).

All I am saying is this "death panel" allegation is ridiculous and gets people fearful. It is the politics of fear.

As a side note, whether the Medicare provisions become bankrupt, or private insurance companies go bankrupt once health care costs rise to an unsustainable level, as the trend is heading, this solution can save either system a lot of moeny. So this is not so much a private v. government issue, but a systemic health care issue.

I guess my point is there is no reason to bring untrue statements to the table and prey on fear when there are very important issues to be discussed. Why can't we just talk about the actual law? Well, for one that would not sell papers. So media has promoted these "death panels." That will sell papers. FOr another, it is easier for politicians to build opposition by spewing lies instead of discussing real issues.. This is not a Rep. Dem. issue, but they all are the same. Edited December 28, 2010 by kindofblue1977

[Bro Jim]

The ground work for this was laid by the Veterans Admin. ylyc.pdf I think I have posted this before, its from the VA and a section of it is to be used to discuss whether or not it is worth living.

[chev1958]

What in the world is wrong with encouraging doctors to counsel people about end of life decisions?

Nothing is wrong with it; doctors should be doing it anyway. What is wrong is taking my tax dollars and paying a doctor to do what he/she is supposed to be doing anyway. And when my desire to live as long as possible collides with the government's desire to save money in Medicare, whose position will win out? That's the groundwork that's being laid - guaranteed.

[JerryNumbers]

Nothing is wrong with it; doctors should be doing it anyway. What is wrong is taking my tax dollars and paying a doctor to do what he/she is supposed to be doing anyway. And when my desire to live as long as possible collides with the government's desire to save money in Medicare, whose position will win out? That's the groundwork that's being laid - guaranteed.

Some are very easily deceived, that makes it easier for them to insert death panels. Usually those who are deceived, are deceive because of their political affiliation, prejudices.

Our politicians can't seem to cut spending, so perhaps they hope to save money by with holding treatment to the elderly that depend on Medicare, perhaps Medicaid thus letting them die. For you see, that will not have no effect of our politicians health care, they have saw to it that their health care will cover all things. Which they feel they deserve because of their importance and the citizens of America cannot get along without them.

[John81]

It's clear the push is growing, and this is especially true among the liberal-socialists, to do all they can to remove as many of the elderly from the population so they can save money by not having to provide them with healthcare, social security and other things.

Just because they aren't officially putting forth a "death panel" doesn't mean that's not exactly where the road is headed.

[trc123]

First, let’s be plain about the importance of this measure. As I and millions of other Americans know from first hand experience (in my case, from my mother, who passed away two years ago at age 86 after a long, debilitating physical decline that involved crippling arthritis, diabetes and heart disease), it is crucial to begin these discussions before an elderly person loses the capacity to make decisions on his or her own. Doctors need to be encouraged, i.e., reimbursed, to engage individuals and their families in these discussions. As I sat with mom in her final days, which were spent more or less in a coma, I was glad I could spend those final hours holding the hand of a person who did not have a single tube attached to her body, and who had made that decision to die that way on her own when she had the capacity to do so.

I believe this aspect of the article is what I related to the most. We've had 4 close family members pass away in 2 years. Two unexpectedly at young ages and then my mother-in-law and father-in-law after a substantial stay in a nursing home (which was after living with us as long as we were able to properly take care of them). It was a huge benefit to have worked end-of-life issues out with them and their primary care physician before they finally got to the point that they were mentally incapacitated. In their final hours they were able to choose to take no further life prolonging medications and they stopped eating. We were with them and held their hands for hours and days. Our Pastor was able to be there to comfort them. We were able to tell them how much we loved them and would miss them and to let them know it was okay to go be with God. It was a very peaceful and intimate time with them. I can't imagine not having things worked out a head of time with their doctor and having to fight him because he was under some sort of "legal" OBligation to extend their lives unnaturally.

One of the things about the OBama Heatlhcare legislation around this matter is that I don't see a need to have this law in place in order to reimburse the doctor's for this type of service rendered when in fact that they should be providing this under usual and customary services that bill out to the person's normal insurance carrier.

[Anon]

My dad's doctor just told him that under OBamacare, the doctors have to get permission from the insurance company/government (whichever applies) to use treatments on the patient, starting next year. Don't know all the details, but it sounds very much as if authority for health care is being transferred from doctors, to the institutions paying for it, which will eventually be solely the government.

If there are no "official death panels" then the idea is still out there. Its very expensive to keep people on end-of-life care. I imagine that luxury will be ending eventually.

[trc123]

In my opinion, if an individual at the end of their life wishes to not have any extraordinary means used to keep them alive (as expressed during a time of lucid thought), then they should be afforded that dignity. This includes being able to choose whether to eat or not or to be force fed or not.