Krauthammer Wants Honest Debate

Politics • Views: 3,067

Charles Krauthammer just keeps making sense: Honest Debate Needed on End-of-Life Talk.

Let’s see if we can have a reasoned discussion about end-of-life counseling. [Good luck with that. – ed.]

We might start by asking Sarah Palin to leave the room. I’ve got nothing against her. She’s a remarkable political talent. But there are no “death panels” in the Democratic health-care bills, and to say that there are is to debase the debate.

We also have to tell the defenders of the notorious Section 1233 of H.R. 3200 that it is not quite as benign as they pretend. To offer government reimbursement to any doctor who gives end-of-life counseling — whether or not the patient asked for it — is to create an incentive for such a chat.

Of course, “creating a subtle incentive for end of life counseling” doesn’t have quite the same red meat ring as “death panels” — and Krauthammer’s more reasoned style of criticism probably wouldn’t have resulted in the empty “victory” for the GOP of getting the entire section about end of life counseling removed. Is the health care bill improved by tossing out end of life counseling altogether? Who cares! It’s a “victory!”

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427 comments
1 Fat Bastard Vegetarian  Fri, Aug 21, 2009 10:04:32am

Smartest man in the room lately.

2 Kobalt  Fri, Aug 21, 2009 10:07:59am

I'm calling shenanigans.

3 Baier  Fri, Aug 21, 2009 10:08:14am

Krauthammer is a real role model.

4 Kreuzueber Halbmond  Fri, Aug 21, 2009 10:08:50am

End of life - beginning of death - we don't need government bureaucrats to talk to us about it.

5 Kosh's Shadow  Fri, Aug 21, 2009 10:09:05am

Honest debates don't get TV ratings and sell newspapers.
TV wants debates where chairs are thrown.

6 equable  Fri, Aug 21, 2009 10:09:29am

The government has no business in my choice of continued treatment or hospice.

7 Ward Cleaver  Fri, Aug 21, 2009 10:10:01am

He makes an intelligent point, without waving around an AR-15.

8 realwest  Fri, Aug 21, 2009 10:10:24am

re: #6 equable

The government has no business in my choice of continued treatment or hospice.


Couldn't have said it better myself!

9 Ojoe  Fri, Aug 21, 2009 10:10:29am

I don't mind end of life counseling. But it bothers me greatly to think the government would be in on it.

10 karmic_inquisitor  Fri, Aug 21, 2009 10:10:43am

Krauthammer = RINO!
/

11 Baier  Fri, Aug 21, 2009 10:10:49am

re: #4 Kreuzueber Halbmond

End of life - beginning of death - we don't need government bureaucrats to talk to us about it.

Personally I'd rather not be cast into the wild at the end of my life, I'd like to hear my options on how to die with dignity. No matter who from.

12 Baier  Fri, Aug 21, 2009 10:11:05am

re: #7 Ward Cleaver

He makes an intelligent point, without waving around an AR-15.

That's possible?///

13 Walter L. Newton  Fri, Aug 21, 2009 10:11:21am

This is the part that I have been highlighting over and over on LGF...

We also have to tell the defenders of the notorious Section 1233 of H.R. 3200 that it is not quite as benign as they pretend. To offer government reimbursement to any doctor who gives end-of-life counseling — whether or not the patient asked for it — is to create an incentive for such a chat.

I have no problem with end-of-life counseling, but if you read this whole section carefully, it can be ORDERED by the doctor.

We can extrapolate from that the fact that when a doctor orders some medical procedure and you fail to follow through, then it can effect other coverage.

Read the whole section. No, it's nothing about death panels, no, it's not new, no it's not scary, but, the way they are tweaking it and amending it to current Medicare coverage is bothersome to me.

14 Equable  Fri, Aug 21, 2009 10:11:40am

re: #8 realwest

Somehow I doubt that my fellow distinguished lee-zard. ;-)

15 jcm  Fri, Aug 21, 2009 10:11:41am

re: #7 Ward Cleaver

He makes an intelligent point, without waving around an AR-15.

No one listens anyway till you start waving an RPG.

/;-P

16 Ward Cleaver  Fri, Aug 21, 2009 10:11:43am

re: #11 Baier

Personally I'd rather not be cast into the wild at the end of my life, I'd like to hear my options on how to die with dignity. No matter who from.

As long as there's no coercion or pressure involved.

17 Ward Cleaver  Fri, Aug 21, 2009 10:12:00am

re: #15 jcm

No one listens anyway till you start waving an RPG.

/;-P

LOL!

18 JanglerNPL  Fri, Aug 21, 2009 10:12:07am

Quick (possible) correction: the House Democrats haven't removed anything from their bill, as far as I know. The Senate Finance Committee did. [Link: thehill.com...]

19 realwest  Fri, Aug 21, 2009 10:12:15am

re: #11 Baier
How about from your own doctor(s)? I think I'd prefer that than getting my counseling from someone who would "profit" by my choosing hospice over healthcare.

20 Kenneth  Fri, Aug 21, 2009 10:12:16am

Correct me if I'm wrong, but isn't the whole "end-of-life counseling" thing a very minor detail in the healthcare reform bill? I would think the bigger issues are cost control, quality of care and freedom of choice. Why don't people focus ore on those issues?

21 Sharmuta  Fri, Aug 21, 2009 10:12:22am

I find this "victory" to be pretty hollow in that it didn't stop the bill, it only removed something more Americans need to consider seriously lest we all end up in a circus like Mrs. Schiavo.

22 Ward Cleaver  Fri, Aug 21, 2009 10:13:00am

re: #15 jcm

No one listens anyway till you start waving an RPG.

/;-P

Or carry a thermonuclear missile under your arm.

/like the piranha brothers

23 Czarny_Smok  Fri, Aug 21, 2009 10:13:01am

Love the Hammer, would that more people were exposed to his rationale thought. Be that as it may be, there are a hell of a lot more problems with Socialized Health care i.e. Obamacare than the silly death panel issue.

Up here in the Pacific Northwest we are now hearing that Vancouver BC, just across the border from us, is going to be shutting down some medical facilities, and extending the waiting times for needed medical services due to expense, lack of revenues - how much higher can the Canadian government tax its people - and need to pay for the coming Olympics. Here is Socialism at its finest!

24 karmic_inquisitor  Fri, Aug 21, 2009 10:13:45am

re: #20 Kenneth

Correct me if I'm wrong, but isn't the whole "end-of-life counseling" thing a very minor detail in the healthcare reform bill? I would think the bigger issues are cost control, quality of care and freedom of choice. Why don't people focus ore on those issues?

Those issues don't get people in wheel chairs to go down to a townhall and scream at a Congresscritter to not kill them.

In other words, where is the theater in honest debate?

25 Charles Johnson  Fri, Aug 21, 2009 10:14:17am

re: #13 Walter L. Newton

This is the part that I have been highlighting over and over on LGF...

I have no problem with end-of-life counseling, but if you read this whole section carefully, it can be ORDERED by the doctor.

Please quote the section of the bill that authorizes doctors to ORDER end of life counseling.

It doesn't exist.

26 Equable  Fri, Aug 21, 2009 10:14:18am

re: #21 Sharmuta

(Insert obligatory "word sister!" here).

27 Ward Cleaver  Fri, Aug 21, 2009 10:14:50am

re: #23 Czarny_Smok

Love the Hammer, would that more people were exposed to his rationale thought. Be that as it may be, there are a hell of a lot more problems with Socialized Health care i.e. Obamacare than the silly death panel issue.

Up here in the Pacific Northwest we are now hearing that Vancouver BC, just across the border from us, is going to be shutting down some medical facilities, and extending the waiting times for needed medical services due to expense, lack of revenues - how much higher can the Canadian government tax its people - and need to pay for the coming Olympics. Here is Socialism at its finest!

I heard they were cutting funding for elective surgeries by 15 percent (heard that on Hugh Hewitt's show yesterday).

28 karmic_inquisitor  Fri, Aug 21, 2009 10:15:04am

re: #22 Ward Cleaver

Or carry a thermonuclear missile under your arm.

/like the piranha brothers

There goes Lutton.

Spiny Norman needs to whow up at a townhall in an SEIU t-shirt. That will scare off those astroturfers!

29 Sharmuta  Fri, Aug 21, 2009 10:15:11am

re: #20 Kenneth

Correct me if I'm wrong, but isn't the whole "end-of-life counseling" thing a very minor detail in the healthcare reform bill? I would think the bigger issues are cost control, quality of care and freedom of choice. Why don't people focus ore on those issues?

A little like using a bazooka to kill a mouse while we let the tigers roam free.

30 Walter L. Newton  Fri, Aug 21, 2009 10:15:24am

re: #21 Sharmuta

I find this "victory" to be pretty hollow in that it didn't stop the bill, it only removed something more Americans need to consider seriously lest we all end up in a circus like Mrs. Schiavo.

I agree that if we are going to have a bill, then it would be a meaningful item to have covered. But the way it read currently, it can be ordered without you asking for it, as pointed out by Krauthamer.

31 Kreuzueber Halbmond  Fri, Aug 21, 2009 10:15:32am

re: #11 Baier

Personally I'd rather not be cast into the wild at the end of my life, I'd like to hear my options on how to die with dignity. No matter who from.

Then we have a definite difference when it comes to what we think the role of government should be in our personal lives.

32 Baier  Fri, Aug 21, 2009 10:15:41am

re: #16 Ward Cleaver

As long as there's no coercion or pressure involved.

I agree with that. But to me the end of life counseling is the process I've gone through at the end of loved ones lives. We've talked about the remaining days. How to handle Doctor visits, how to get the best care, etc. That's what I thought it was, and to deny that is a mistake. It is helpful, and frankly it is such a distressing time it is almost cruel to deny the help.

33 Ward Cleaver  Fri, Aug 21, 2009 10:15:51am

re: #28 karmic_inquisitor

There goes Lutton.

Spiny Norman needs to whow up at a townhall in an SEIU t-shirt. That will scare off those astroturfers!

Then he nailed my 'ead to the floor.

34 lawhawk  Fri, Aug 21, 2009 10:15:54am

He talks more sense than most politicians and pundits, which is why his knowledge and experience will be singularly ignored by those who are in a position to act on this.

The fact is that the bills are written in such a way to influence how doctors treat patients. There are built in incentives - however subtle they may appear to be - but they are incentives.

And the purpose of those incentives is cost-control, primarily because most health care dollars goes to those in the last year of life. It's where the most savings is hoped to be attained.

My question (which probably should be added to Keith's invaluable resource) - is what happens when the cost-savings don't materialize? Who will pick up the tab then, seeing how government rarely shuts down entitlements, instead increasing their deficits and/or raising taxes to cover the shortfalls.

35 realwest  Fri, Aug 21, 2009 10:16:11am

re: #20 Kenneth
Well my friend, I think the idea of rationing healthcare based upon cost vs. how much longer you get to live is fairly significant.
But that's just me.

36 lawhawk  Fri, Aug 21, 2009 10:16:15am

re: #15 jcm

No one listens anyway till you start waving an RPG.

/;-P

Tanks. We needed that salvo of reality. /

37 Buck  Fri, Aug 21, 2009 10:16:17am

The death panels comment was NOT about end-of-life counseling.

It was about government decisions about who will get expensive treatments. There is a lot of EVIDENCE (not proof, as the bill is not completed yet) that preference will be given to the young, and 'more productive'. Sarah Palins comment was about her handicapped child, perhaps being denied expensive treatments due to his disability.

The end-of-life counseling issue is different, and Sarah Palin did comment on that as well. That was to ring a warning bell, to make sure it was known to everyone what MIGHT be in the bill, and how it might be interpreted.

38 MandyManners  Fri, Aug 21, 2009 10:16:24am

re: #23 Czarny_Smok

Love the Hammer, would that more people were exposed to his rationale thought. Be that as it may be, there are a hell of a lot more problems with Socialized Health care i.e. Obamacare than the silly death panel issue.

Up here in the Pacific Northwest we are now hearing that Vancouver BC, just across the border from us, is going to be shutting down some medical facilities, and extending the waiting times for needed medical services due to expense, lack of revenues - how much higher can the Canadian government tax its people - and need to pay for the coming Olympics. Here is Socialism at its finest!

I think it was Krauthammer on Brett Baier who said that 1,000,000 Candians already are waiting for necessary surgery and another 1,000,000 are waiting to see a specialist as the first step toward scheduling necessary surgery.

39 Dianna  Fri, Aug 21, 2009 10:16:35am

re: #29 Sharmuta

A little like using a bazooka to kill a mouse while we let the tigers roam free.

At least it would keep the elephants happy.

40 jcm  Fri, Aug 21, 2009 10:16:42am

The Death Book for Veterans

If President Obama wants to better understand why America's discomfort with end-of-life discussions threatens to derail his health-care reform, he might begin with his own Department of Veterans Affairs (VA). He will quickly discover how government bureaucrats are greasing the slippery slope that can start with cost containment but quickly become a systematic denial of care.

Last year, bureaucrats at the VA's National Center for Ethics in Health Care advocated a 52-page end-of-life planning document, "Your Life, Your Choices." It was first published in 1997 and later promoted as the VA's preferred living will throughout its vast network of hospitals and nursing homes. After the Bush White House took a look at how this document was treating complex health and moral issues, the VA suspended its use. Unfortunately, under President Obama, the VA has now resuscitated "Your Life, Your Choices."

Who is the primary author of this workbook? Dr. Robert Pearlman, chief of ethics evaluation for the center, a man who in 1996 advocated for physician-assisted suicide in Vacco v. Quill before the U.S. Supreme Court and is known for his support of health-care rationing.

"Your Life, Your Choices" presents end-of-life choices in a way aimed at steering users toward predetermined conclusions, much like a political "push poll." For example, a worksheet on page 21 lists various scenarios and asks users to then decide whether their own life would be "not worth living."

I haven't looked into this myself, just adding it to the discussion.

41 Ward Cleaver  Fri, Aug 21, 2009 10:16:49am

re: #36 lawhawk

Tanks. We needed that salvo of reality. /

Can we keep this discussion on track?

42 Charles Johnson  Fri, Aug 21, 2009 10:17:15am

re: #30 Walter L. Newton

I agree that if we are going to have a bill, then it would be a meaningful item to have covered. But the way it read currently, it can be ordered without you asking for it, as pointed out by Krauthamer.

Krauthammer did NOT say that at all.

43 Czarny_Smok  Fri, Aug 21, 2009 10:17:41am

re: #27 Ward Cleaver

Correct, but it's not just elective surgeries that are being cut, and we're seeing a steady influx of Canadians coming down to our hospitals here in Bellingham. At least here they can get the care, and services necessary to provide quality of life. Don't you just love socialism!

44 karmic_inquisitor  Fri, Aug 21, 2009 10:17:48am

re: #33 Ward Cleaver

Then he nailed my 'ead to the floor.

Bu' I deserved it! I 'ad violate'd the unwri'en law.

/ Biting sarcasm.

45 Walter L. Newton  Fri, Aug 21, 2009 10:18:01am

re: #25 Charles

Please quote the section of the bill that authorizes doctors to ORDER end of life counseling.

It doesn't exist.

Page 426...

1 ‘‘(F)(i) Subject to clause (ii), an explanation of
2 orders regarding life sustaining treatment or similar
3 orders, which shall include—
4 ‘‘(I) the reasons why the development of
5 such an order is beneficial to the individual and
6 the individual’s family and the reasons why
7 such an order should be updated periodically as
8 the health of the individual changes;
9 ‘‘(II) the information needed for an indi10
vidual or legal surrogate to make informed deci11
sions regarding the completion of such an
12 order; and
13 ‘‘(III) the identification of resources that
14 an individual may use to determine the require15
ments of the State in which such individual re16
sides so that the treatment wishes of that indi17
vidual will be carried out if the individual is un...

46 Walter L. Newton  Fri, Aug 21, 2009 10:19:40am

re: #42 Charles

Krauthammer did NOT say that at all.

I could be wrong, but "whether or not the patient asked for it" sounds like an order.

47 zelnaga  Fri, Aug 21, 2009 10:20:09am
To offer government reimbursement to any doctor who gives end-of-life counseling — whether or not the patient asked for it — is to create an incentive for such a chat.


Whether or not the patient asked for it? That doesn't make any sense. The doctor can't force you to attend counseling you don't want to, unless he's supposed to tie you down, or something.

Sure, he can "recommend" you get such counseling, but then again, if he only got paid for it if you, yourself, asked for it, he'd just "recommend you ask for it" instead of simply "recommending" it. As such, the distinction between patient-initiated and doctor-initiated counseling is, I think, going to be a hard one to make.

Did I go into the major that I did because I wanted to, or on some level, did my parents subliminally encouraged me to pursue that major? I don't know. Probably a bit of both, actually.

48 realwest  Fri, Aug 21, 2009 10:20:15am

re: #40 jcm

The Death Book for Veterans


I haven't looked into this myself, just adding it to the discussion.


I suspect your excellent contribution won't receive much discussion out here. Which is a shame. But I thank you for it!

49 Buck  Fri, Aug 21, 2009 10:20:17am

re: #46 Walter L. Newton

I could be wrong, but "whether or not the patient asked for it" sounds like an order.

That is just for the counseling not the pulling of the plug.

50 Equable  Fri, Aug 21, 2009 10:20:40am

God forbid that any of us are caught in the morass that was the Terri Schiavo fiasco whether we be parent or spouse.

I myself find it more prudent for married or otherwise unmarried couples to have a contract between THEMSELVES. My mother, God rest her soul was staunchly "DNR" when she was fighting her cancer. She decided to stop fighting and she came home and passed with all of us around her.

It was a heart breaking experience, but it was amazing to watch her ascend to glory and it was a privilege to see such a fine woman pass on.

But I digress.

My folks had a blood pact of sorts, and had an agreement on these matters. That's how it should be. Period.

51 Walter L. Newton  Fri, Aug 21, 2009 10:21:03am

re: #49 Buck

That is just for the counseling not the pulling of the plug.

I'm not talking about pulling any plugs, where did I say anything about pulling plugs?

52 kcladderman  Fri, Aug 21, 2009 10:21:10am

re: #11 Baier

Personally I'd rather not be cast into the wild at the end of my life, I'd like to hear my options on how to die with dignity. No matter who from.

Very true but like A LOT of things the government has no business sticking their noses in it.

53 Ward Cleaver  Fri, Aug 21, 2009 10:21:32am

re: #43 Czarny_Smok

Correct, but it's not just elective surgeries that are being cut, and we're seeing a steady influx of Canadians coming down to our hospitals here in Bellingham. At least here they can get the care, and services necessary to provide quality of life. Don't you just love socialism!

Boy, if we go socialized, the Canadians are going to be pissed off. They'll have to go to Mexico for care.

How is it handled when Canadians come here, anyway? Do they have to pay for everything out-of-pocket? Or does their NHS kick in some money?

54 Kragar  Fri, Aug 21, 2009 10:21:35am

So Krauthammer is now part of the right wing conspiracy Obama has begun warning people about?

55 jamgarr  Fri, Aug 21, 2009 10:21:48am

re: #20 Kenneth

Correct me if I'm wrong, but isn't the whole "end-of-life counseling" thing a very minor detail in the healthcare reform bill? I would think the bigger issues are cost control, quality of care and freedom of choice. Why don't people focus ore on those issues?

Might be - but when the people are told that we must make fundamental, broad-ranging changes to the system and that we need to make those changes NOW it should come as no surprise that issues such as this get attention as people try to figure out what the practical effect of the bill would be.

56 MacDuff  Fri, Aug 21, 2009 10:21:54am

re: #35 realwest

Well my friend, I think the idea of rationing healthcare based upon cost vs. how much longer you get to live is fairly significant.
But that's just me.

I agree, even the suggestion of such a thing sends shivers down the the spine of this boomer.

57 karmic_inquisitor  Fri, Aug 21, 2009 10:22:59am

Is there a "the bill" yet?

Or is it still in many parts in many committees of both houses?

58 Ward Cleaver  Fri, Aug 21, 2009 10:23:07am

New thread up? Where'd everybody go?

59 Charles Johnson  Fri, Aug 21, 2009 10:23:13am

re: #45 Walter L. Newton

Page 426...

1 ‘‘(F)(i) Subject to clause (ii), an explanation of
2 orders regarding life sustaining treatment or similar
3 orders, which shall include—
4 ‘‘(I) the reasons why the development of
5 such an order is beneficial to the individual and
6 the individual’s family and the reasons why
7 such an order should be updated periodically as
8 the health of the individual changes;
9 ‘‘(II) the information needed for an indi10
vidual or legal surrogate to make informed deci11
sions regarding the completion of such an
12 order; and
13 ‘‘(III) the identification of resources that
14 an individual may use to determine the require15
ments of the State in which such individual re16
sides so that the treatment wishes of that indi17
vidual will be carried out if the individual is un...

Oh, for Pete's sake.

That section deals with doctors ordering the government program to provide end of life counseling -- at the patient's request.

60 Russkilitlover  Fri, Aug 21, 2009 10:23:56am

re: #46 Walter L. Newton

I could be wrong, but "whether or not the patient asked for it" sounds like an order.

And that's precisely the kind of nebulous language that has had people up in arms over this health bill and why it was RIGHTLY not allowed to be rammed down our throats. There are many versions, I understand, of the health bills, until we have one, clearly outlined, able to be explained by our Congresspeople, understood by the public, then there should be no reason whatsoever that anything gets passed. Kudos to everyone (yes, Sarah, too) for stopping what would by now be de facto. Healthcare debate, by all means! But no backroom deals co-opting 1/6 of our economy and shoved down our necks unread and undebated.

61 Fat Bastard Vegetarian  Fri, Aug 21, 2009 10:24:07am

re: #9 Ojoe

I don't mind end of life counseling. But it bothers me greatly to think the government would be in on it.

Eatin' your gubmint cheese on your gubmint ice-floe.

62 realwest  Fri, Aug 21, 2009 10:24:18am

Well this time I'm headed for lunch for real!
Have a good day y'all.
Just remember that the elderly and seriously ill cost the system the most money. So if you're over 55 or 60 or have a terminal (albeit treatable to extend your life) illness or have a friend or family member who fits either category, that's where government rationed health care can save the most money.

63 BlueCanuck  Fri, Aug 21, 2009 10:24:24am

re: #53 Ward Cleaver

Mostly out of pocket. There are some cases where you can ask for a refund. If the treatment was life saving for example rather then cosmetic. It takes years and reams of paper work to get it back though, and sometimes not the full amount.

64 Land Shark  Fri, Aug 21, 2009 10:24:35am

An honest debate on health care in my opinion starts with the fact a solid majority of Americans are happy with their health care. There is no mass public outcry for health care reform. This is an obsession on the part of Obama and the Democrats, I saw a poll a while ago only 12% on the people polled thought of it as the most important issue.

This is not about what the American people want and need, this is about Obama and the Democrats imposing this on the people whether we want it or not. It's about getting the government involved in everyone's lives. They believe they know what's good for us better than we do.

65 DaddyG  Fri, Aug 21, 2009 10:24:52am

The biggest problem with this vaguely worded legalese is that sooner or later a bureaucrat and accompanying lawyers are going to interpret how this plays out in actual practice. That is when the fine points of honest debate will have a concrete effect on the lives and deaths of those who are being treated under the oversight of government health care.

If I have a problem with the legalese on a personal or work policy I can purchase another option or encourage my employer to do the same. If the government incrementally creeps towards single pay I'm out of choices and at the mercy of the bureaucrat who enacts the legislation.

66 Ward Cleaver  Fri, Aug 21, 2009 10:25:01am

re: #59 Charles

Oh, for Pete's sake.

That section deals with doctors ordering the government program to provide end of life counseling -- at the patient's request.

When I read that legalese, my eyes glaze over and my brain locks up.

/time for a reboot

/whack!

67 Walter L. Newton  Fri, Aug 21, 2009 10:25:32am

re: #59 Charles

Oh, for Pete's sake.

That section deals with doctors ordering the government program to provide end of life counseling -- at the patient's request.

I don't read it that way. But, that's the difference between the legal folks that put this together and the people down here. Putting this in context with the WHOLE section 1233, it read differently to me than the way it does to you.

Just my opinion. Just the way I see it.

68 NelsFree  Fri, Aug 21, 2009 10:25:40am

re: #51 Walter L. Newton

I'm not talking about pulling any plugs, where did I say anything about pulling plugs?


Joe Biden does NOT want any discussion of pulling plugs!
Good Afternoon, all!

69 Cato the Elder  Fri, Aug 21, 2009 10:25:42am

re: #59 Charles

Oh, for Pete's sake.

That section deals with doctors ordering the government program to provide end of life counseling -- at the patient's request.

Don't confuse them with reason, Charles. Many people here believe Sarah Palin had a good point.

70 Czarny_Smok  Fri, Aug 21, 2009 10:26:03am

re: #53 Ward Cleaver

Ward, I'm not sure how the payment is set up but I do know that the Canadian governement (BC in fact) does kick in some amount, the rest is out-of-pocket. We have a superb hospital campus up here, far larger than one would expect in a town our size. The hospitals recent expansions were paid for with a lot of Canadian money, odd how that works... We're about 20 minutes from the border.

71 Son of the Black Dog  Fri, Aug 21, 2009 10:26:20am

But when you also look at the VA's end-of-life counseling program, as discussed in the Wall Street Journal on August 19th, you can see the direction all this is headed in, and it isn't a pretty picture.
[Link: online.wsj.com...]

72 flyovercountry  Fri, Aug 21, 2009 10:26:21am

The issue should never have been, "end of life counseling." This has nothing to do with anything that is wrong with this stinker of a bill. If Sarah Palin had instead railed against the inevitable rationing of health care, and the effects that would have on her parents and/or son, she would have garnered much more respect. By taking the debate to a place of pure hysterical emotion, she wasted time, and opportunity. At the best, she gave Obama a new set of strawmen to knock down. The lost opportunity is of course wasted time arguing about nothing.

73 KenJen  Fri, Aug 21, 2009 10:26:27am

re: #51 Walter L. Newton

I'm not talking about pulling any plugs, where did I say anything about pulling plugs?

You trying to start a Biden pun thread?/

74 Charles Johnson  Fri, Aug 21, 2009 10:26:29am

re: #67 Walter L. Newton

I don't read it that way.

Then you are reading it wrong.

75 Walter L. Newton  Fri, Aug 21, 2009 10:27:07am

re: #69 Cato the Elder

Don't confuse them with reason, Charles. Many people here believe Sarah Palin had a good point.

Fine, but don't include me in you comment, since I don't agree with Palin, I've said (above) that this has nothing to do with hyperbole such as "death panels" and I am discussing this matter, not Palin.

76 J.S.  Fri, Aug 21, 2009 10:27:19am

re: #53 Ward Cleaver

It all depends...(I've heard about cases where treatment isn't available in Canada, so then a mother/father can petition the Canadian government to be allowed to take say, their child, to a clinic elsewhere -- outside Canada -- to receive the treatment -- and on occasion, this will be paid for by Health Care in Canada -- but, it's very "ify" -- they don't allow this for "quack" treatments, for example.)

77 karmic_inquisitor  Fri, Aug 21, 2009 10:27:20am

So will Emergency Room coverage for protester work-accidents associated with Scrotal Inflation be covered?

/ Another probing question.

78 Cato the Elder  Fri, Aug 21, 2009 10:27:54am

A Facebook friend this morning writes that he "wonders why Charles Krauthammer doesn't have Hannity's or O'reilley's job."

He's had three answers so far.

1) "Because he doesn't scream enough and isn't good at repeating the same argument every 5 minutes like it's something new and clever."

2) "And his vocabulary would make H/O'R viewers think he wuz sum kinda libbrul."

3) "And his name has more than two syllables, and it sounds sorta cosmopolitan (nudge, wink), and he's not a bigoted Mick."

Heh.

79 kcladderman  Fri, Aug 21, 2009 10:28:22am

re: #77 karmic_inquisitor

So will Emergency Room coverage for protester work-accidents associated with Scrotal Inflation be covered?

/ Another probing question.

I guess we will find out when itcomes up

80 Lincolntf  Fri, Aug 21, 2009 10:28:31am

re: #78 Cato the Elder

Nothing worse than a "bigoted Mick".

81 Danny  Fri, Aug 21, 2009 10:28:50am

Even if it doesn't give the govt control over end-of-life decisions, I do think it is better that the provision was removed form the bill. If Medicare is paying for such things, there is a real risk that it creates the appearance of a financial incentive to reduce end-of-life expenses.

82 J.S.  Fri, Aug 21, 2009 10:29:18am

re: #76 J.S.

correction -- it's not the Federal government, it would be the Provincial Health Care people (they decide whether or not to pay for/allow treatment outside Canada)...

83 Fat Bastard Vegetarian  Fri, Aug 21, 2009 10:29:33am

re: #61 Fat Bastard Vegetarian

Eatin' your gubmint cheese on your gubmint ice-floe.

Damn.

Crickets.

I thought that was funny.

84 karmic_inquisitor  Fri, Aug 21, 2009 10:29:53am

re: #79 kcladderman

I guess we will find out when itcomes up

It will be hard to ignore.

85 Kragar  Fri, Aug 21, 2009 10:29:56am

Here is what I would like to see as the total government healthcare bill:

"This section intentionally left blank"

86 Cato the Elder  Fri, Aug 21, 2009 10:30:04am

OT for anyone interested in six-degrees-ness:

My friend Alex was one of the first responders at the Black Hawk crash site in CO.

87 Charles Johnson  Fri, Aug 21, 2009 10:30:04am

re: #81 Danny

Even if it doesn't give the govt control over end-of-life decisions, I do think it is better that the provision was removed form the bill. If Medicare is paying for such things, there is a real risk that it creates the appearance of a financial incentive to reduce end-of-life expenses.

Medicare is already giving end of life care:

[Link: www.urban.org...]

88 jcm  Fri, Aug 21, 2009 10:30:15am

re: #48 realwest

I suspect your excellent contribution won't receive much discussion out here. Which is a shame. But I thank you for it!

Here's what I know. It was shelved during the Bush Administration, and brought back by the current Administration.

Here is the pdf of the document "Your Life, Your Choices."

I have not had time to go through the document, therefore the furor may or may not be merited.

End of life decisions are an important discussion for an individual and their family. We used a Catholic publication for my father in law. The concern would be as Towey states '"Your Life, Your Choices" presents end-of-life choices in a way aimed at steering users toward predetermined conclusions,...' would such counseling regardless if its required or merely offered as a service have such a "guided" to predetermined outcome.

89 Ward Cleaver  Fri, Aug 21, 2009 10:30:15am

re: #84 karmic_inquisitor

It will be hard to ignore.

Adhesive tape.

90 JarHeadLifer  Fri, Aug 21, 2009 10:30:19am

re: #37 Buck

The death panels comment was NOT about end-of-life counseling.

It was about government decisions about who will get expensive treatments. There is a lot of EVIDENCE (not proof, as the bill is not completed yet) that preference will be given to the young, and 'more productive'. Sarah Palins comment was about her handicapped child, perhaps being denied expensive treatments due to his disability.

The end-of-life counseling issue is different, and Sarah Palin did comment on that as well. That was to ring a warning bell, to make sure it was known to everyone what MIGHT be in the bill, and how it might be interpreted.

Bingo. And, I'm not really a Palin fan, but her comments have been grossly mischaracterized. In hospitals accross the country, this kind of decision is made everyday. Terminally ill patients are, for lack of a better word, kicked out and sent to hospice or some other care center to make way for people who may actually be able to be cured.

The rub with Obamacare is that eventually these hospital panels would be replaced by government bureaucracies. If you don't like the hospital panel's decision, you can always select a different hospital, but you can't select a different government bureaucracy. That's what is lost in the debate, and that was the point that Palin was making, perhaps a little too clumsily.

91 NelsFree  Fri, Aug 21, 2009 10:30:25am

re: #55 jamgarr

Might be - but when the people are told that we must make fundamental, broad-ranging changes to the system and that we need to make those changes NOW it should come as no surprise that issues such as this get attention as people try to figure out what the practical effect of the bill would be.

That post looks like a lead-in for me to re-post something I posted yesterday:

From The Federalist Papers, No. 62, by James Madison:
"It will be of little avail to the people, that the laws are made by men of their own choice, if the laws be so voluminous that they cannot be read, or so incoherent that they cannot be understood;"

92 Dianna  Fri, Aug 21, 2009 10:30:39am

re: #80 Lincolntf

Nothing worse than a "bigoted Mick".

Particularly when their names also contain more than two syllables! Why, it might confuse someone!

93 DaddyG  Fri, Aug 21, 2009 10:30:55am

re: #77 karmic_inquisitor

So will Emergency Room coverage for protester work-accidents associated with Scrotal Inflation be covered?

/ Another probing question.

Don't laugh about work related scrotal incidents. A guy in a former company of mine got his slammed under a loading dock ramp (tons of steel plates against concrete). He lost more than his dignity.

94 Danny  Fri, Aug 21, 2009 10:30:59am

re: #87 Charles

Then why the need for added provisions?

95 Walter L. Newton  Fri, Aug 21, 2009 10:31:48am

re: #81 Danny

Even if it doesn't give the govt control over end-of-life decisions, I do think it is better that the provision was removed form the bill. If Medicare is paying for such things, there is a real risk that it creates the appearance of a financial incentive to reduce end-of-life expenses.

Medicare is already paying for such a procedure. This tweaks and amends the Medicare provisions. And, some people say tweaks them in a way that becomes more foreboding, as evident from some of the hyperbole that people like Palin has espoused.

I don't think is is that bothersome, but I do think it could be interpreted to be something that a doctor could tell you you had to do.

96 quickjustice  Fri, Aug 21, 2009 10:31:52am

re: #45 Walter L. Newton

As a lawyer, that reads to me as if it mandates what the doctor says IF he or she engages in end of life counseling. It doesn't actually mandate such counseling. In Krauthammer's words, paraphrased slightly, it creates an economic incentive for doctors to do such counseling to make money, and then mandates what the counseling shall include.

In your defense, Walter, this is a great example of the government micromanaging what doctors do, and your doctor being "gently" pushed toward becoming Kavorkian still isn't a pretty picture.

97 karmic_inquisitor  Fri, Aug 21, 2009 10:31:58am

re: #89 Ward Cleaver

Adhesive tape.

That might erect a barrier for those with adhesive tape allergies.

98 jamgarr  Fri, Aug 21, 2009 10:32:00am

re: #79 kcladderman

I guess we will find out when itcomes up


I Bloat Scrote - And I Vote!

99 DaddyG  Fri, Aug 21, 2009 10:32:04am

re: #61 Fat Bastard Vegetarian

Eatin' your gubmint cheese on your gubmint ice-floe.


That won't work for end of life programs any more. All the polar bears have drowned due to anthropomorphic global warming./

100 Cato the Elder  Fri, Aug 21, 2009 10:32:15am

Those who want a taste of what end-of-life counseling actually involves should read this article.

101 Killgore Trout  Fri, Aug 21, 2009 10:32:32am

re: #94 Danny

That was to guarantee that private insurers would provide the service.

102 Charles Johnson  Fri, Aug 21, 2009 10:33:29am

re: #95 Walter L. Newton

I don't think is is that bothersome, but I do think it could be interpreted to be something that a doctor could tell you you had to do.

No, it cannot be interpreted that way, unless you're deliberately trying to misrepresent what it said.

103 lawhawk  Fri, Aug 21, 2009 10:34:18am

re: #87 Charles

Medicare is already giving end of life care:

[Link: www.urban.org...]

The problem is that Obama has said that he wants to get cost savings from reducing costs incurred in the last year of care (where most costs are incurred). How does he go about achieving this? He can incentivize certain behaviors, or make it more difficult to obtain care, or a combination of above.

He's pushing this voluntary program in the hope of seeing cost savings. I don't think we'll see savings at all, which only adds to the cost of this program in toto.

Palin's outrageous statements on calling this a death panel brought attention to the voluntary program for the wrong reason, but if this is where Obama hopes to find real savings, he's barking up the wrong tree.

104 Fat Bastard Vegetarian  Fri, Aug 21, 2009 10:34:28am

re: #99 DaddyG

That won't work for end of life programs any more. All the polar bears have drowned due to anthropomorphic global warming./

The gubmint ice flows are specially made in a 31 degree freezer. Thaws within 8 hours.

105 Kenneth  Fri, Aug 21, 2009 10:34:40am

re: #76 J.S.

And it's a long wait to find out if the Canadian gov't will cover US treatment.

106 ckb  Fri, Aug 21, 2009 10:34:50am

I never associated the "death panel" comment as relating to this "end of life counseling" provision. I associated it with the rationing of care that is bound to happen (and already does with Medicare) under a socialized system.

The "death panel" is the group that makes the standards of what gets covered and what does not. For example, in order to qualify for hospitalization coverage for an infection under Medicare there is a standard that must be met, including things like body temperature. If someone is denied coverage because they do not meet the standard and subsequently is sent home and suffers from complications of the infection... you get the idea.

In the above case, "death panel" is certainly hyperbole, but the whole idea of the thing is that if public resources for health care were scarce, that care for the elderly would suffer, is hardly fiction.

Quoting Mr. Krauthammer:

And when you include it in a health-care reform whose major objective is to bend the cost curve downward, you have to be a fool or a knave to deny that it's intended to gently point the patient in a certain direction, toward the corner of the sickroom where stands a ghostly figure, scythe in hand, offering release.

107 Walter L. Newton  Fri, Aug 21, 2009 10:34:54am

re: #96 quickjustice

As a lawyer, that reads to me as if it mandates what the doctor says IF he or she engages in end of life counseling. It doesn't actually mandate such counseling. In Krauthammer's words, paraphrased slightly, it creates an economic incentive for doctors to do such counseling to make money, and then mandates what the counseling shall include.

In your defense, Walter, this is a great example of the government micromanaging what doctors do, and your doctor being "gently" pushed toward becoming Kavorkian still isn't a pretty picture.

I'm not saying you (or Charles) are wrong, it's just interesting that I read it that way, others read it that way, and I have yet to hear a defense of it from any of the politicians. All I have heard is it isn't what we think it is, and then they take it out.

If the language was rock solid and not open to any other end, then why has it become and issue that couldn't be simply explained and then we go on?

108 karmic_inquisitor  Fri, Aug 21, 2009 10:35:07am

I would gladly support any bill that has "end of fallacy" counseling for internut addicts.

(and end of phallicy counseling for Scrotal Inflators, of course).

109 Kreuzueber Halbmond  Fri, Aug 21, 2009 10:35:09am

re: #77 karmic_inquisitor

So will Emergency Room coverage for protester work-accidents associated with Scrotal Inflation be covered?

/ Another probing question.

Scrotal inflators need their own coop.

110 jamgarr  Fri, Aug 21, 2009 10:35:16am

re: #92 Dianna

Particularly when their names also contain more than two syllables! Why, it might confuse someone!


So, give him Stephanopolous' job.

111 Francisco D'anconia  Fri, Aug 21, 2009 10:35:17am

maybe someone can inform me better, but my impression is that the "death panel" idea sprung not for the end of life counseling session (which is on its own an abhorrent thought). Rather i was in reference to the ideas being floated by Ezekiel Emmanuel (Rahm's brother) on rationing care. Basically the gist being that Dr. Emmanuel doesnt think that granny needs a pacemaker if she has cancer and that panels of bureaucrats will be determining what care is appropriate for people based upon mortality tables. These could very well be termed death panels and would be necessary in any government run scheme, if the goal is to reduce costs.

112 zelnaga  Fri, Aug 21, 2009 10:35:28am

re: #64 Land Shark

An honest debate on health care in my opinion starts with the fact a solid majority of Americans are happy with their health care.

I'm happy with my health care and wouldn't switch to a government sponsored plan, but then again, I'm not exactly the target audience, anyway. If the fact that most people are content, as is, was a valid reason, then the Ryan White Care Act shouldn't have been passed, either, because most people don't have AIDS.

That's not to say that there aren't good reasons to oppose it - I just don't believe the "most people are happy with what they have" reason is a good one.

113 Slumbering Behemoth Stinks  Fri, Aug 21, 2009 10:36:07am
We might start by asking Sarah Palin to leave the room. I’ve got nothing against her. She’s a remarkable political talent. But there are no “death panels” in the Democratic health-care bills, and to say that there are is to debase the debate.

QFT

The "death panel" crap was nothing but a fear-mongering con.

114 Charles Johnson  Fri, Aug 21, 2009 10:36:07am

re: #107 Walter L. Newton

If the language was rock solid and not open to any other end, then why has it become and issue that couldn't be simply explained and then we go on?

Because people are distorting and misrepresenting it, and spreading falsehoods about it.

115 Danny  Fri, Aug 21, 2009 10:36:15am

re: #101 Killgore Trout

I thought it was for additional medicare coverage. No?

116 Rednek  Fri, Aug 21, 2009 10:36:43am

End of life discussions go on as a matter of course every day in clinics and hospitals around the world.

I bet there are lots of doctors who never knew that talking about death with their patients could be reimbursable.

All that money has just been washing down the drain?

I think someone put that in the bill to give it a patina of sympathetic caring in order to make it slide through the congress just a little easier, not realizing it would be such an inadvertent lightning rod.

117 lostlakehiker  Fri, Aug 21, 2009 10:36:50am

re: #34 lawhawk

He talks more sense than most politicians and pundits, which is why his knowledge and experience will be singularly ignored by those who are in a position to act on this.

The fact is that the bills are written in such a way to influence how doctors treat patients. There are built in incentives - however subtle they may appear to be - but they are incentives.

And the purpose of those incentives is cost-control, primarily because most health care dollars goes to those in the last year of life. It's where the most savings is hoped to be attained.

My question (which probably should be added to Keith's invaluable resource) - is what happens when the cost-savings don't materialize? Who will pick up the tab then, seeing how government rarely shuts down entitlements, instead increasing their deficits and/or raising taxes to cover the shortfalls.

Consider the alternative to end-of-life counseling. The doctor must never say die. There's always a treatment, a chance, a hope. Even when there isn't, not really.

I saw this once: patient is dying of lung cancer. He's scheduled for an operation to remove one of the lungs. They're both raddled with cancer. He has but little time left. A week or two, tops. But in one of the lungs, things are to the point that unless it goes, he's dead in a couple of days.

He's not been told, but he knows anyway. And he asks me to not take him in for surgery. He doesn't want it. His number is up and please just let him die.

But that's not my place and not my job. (That's what they all say, they were just following orders. Trust me, it's not easy to make a stink and make a moral stand and quit in a huff, when there's no time to ruminate and you're just a rookie.) So off he goes to get cut up again. His last days will be an ordeal that Dante's imagination would have trouble topping.

There is a legitimate case for doctors laying it on the line with a patient, unless the patient has indicated directly or implicitly that he just doesn't want to talk about or think about anything but persisting with treatment.

If we end up with a state-run health care system, we'll be sorry for many reasons. But things will be yet worse if the state is constrained by law to shy away from these end-of-life issues. Unless a car wreck or something takes the question off the table, everyone is going to face this decision sooner or later: does further treatment serve any purpose?

118 Throbert McGee  Fri, Aug 21, 2009 10:36:55am

re: #4 Kreuzueber Halbmond

End of life - beginning of death - we don't need government bureaucrats to want government bureaucrats OR private-sector insurance executives putting pressure on the doctors who talk to us about it.

There, fixed that.

While the monopolistic character of government-funded ANYTHING justifies treating it with particular skepticism, free-market competition does not inevitably or instantly prevent/correct undesirable practices -- such as a doctor subtly nudging a patient to choose the cup of hemlock, because the doctor feels pressure from those concerned with the bottom-line.

119 Buck  Fri, Aug 21, 2009 10:37:31am

The death panels comments was NOT about "end-of-life counseling".


There is simply no way to cover everyone and hold down the costs at the same time. The rationing system proposed by one of President Obama’s key health care advisors is particularly disturbing. I’m speaking of the “Complete Lives System” advocated by Dr. Ezekiel Emanuel, the brother of the president’s chief of staff. President Obama has not yet stated any opposition to the “Complete Lives System,” a system which, if enacted, would refuse to allocate medical resources to the elderly, the infirm, and the disabled who have less economic potential.

THAT is what Sarah Palin thinks will result in Death Panels.

120 Charles Johnson  Fri, Aug 21, 2009 10:37:47am

And yes, many politicians pointed out over and over and over that the provisions in Section 1233 were completely voluntary, with no compulsion.

Who cares? DEATH PANELS!

121 gnargtharst  Fri, Aug 21, 2009 10:39:05am

The bill is not improved by removing the "end-of-life" counseling section -- the bill is fabulously flawed at its root, and trimming minor leaves here or there does not change its essence at all. Its essence is the establishment of a vast new bueracracy filled with "czars" and "experts" and regulators, whose primary goal will be maintaining and growing their department, just like every other government department in history.

(As for "death panels", of course there will be "death panels", i.e., panels of department functionaries and "experts" whose decisions will allocate the department's finite resources, whose decisions will decide on whether a particular case is worth extra spending to continue a life. It's inherent in the structure of such a agency. Government-rationed health care must include "death panels"; it can't not.)

122 Killgore Trout  Fri, Aug 21, 2009 10:39:26am

Republican lies keep coming...
ObamaCare to undermine financial, home privacy?

The death panel thing worked and they're going to lie their way to victory over socialism!
/Reasonable debate is not an option.

123 flyovercountry  Fri, Aug 21, 2009 10:39:47am

re: #90 JarHeadLifer

Bingo. And, I'm not really a Palin fan, but her comments have been grossly characterized. In hospitals accross the country, this kind of decision is made everyday. Terminally ill patients are, for lack of a better word, kicked out and sent to hospice or some other care center to make way for people who may actually be able to be cured.
The rub with Obamacare is that eventually these hospital panels would be replaced by government bureaucracies. If you don't like the hospital panel's decision, you can always select a different hospital, but you can't select a different government bureaucracy. That's what is lost in the debate, and that was the point that Palin was making, perhaps a little too clumsily.

I think its important to note that there is a difference between acute and chronic care. Hospitals are acute care facilities only. A hospitals duty is to administer immediate care necessary to prolong life or heal. Once that is done, patients are sent home or to a chronic care facility. Once the docs responsible for determining treatment decide that nothing more can be done in the way of acute care, that's it. This is when decisions are made to place a person into either hospice or chronic care, or possibly home. Hospital docs don't always have a human side to them. That is why insurance companies offer grief counseling for family members who had been told by docs, nothing can be done. This counseling is all Palin succeeded in getting removed.

124 Gavriel  Fri, Aug 21, 2009 10:40:09am

re: #37 Buck

The death panels comment was NOT about end-of-life counseling.

It was about government decisions about who will get expensive treatments. There is a lot of EVIDENCE (not proof, as the bill is not completed yet) that preference will be given to the young, and 'more productive'.
...

re: #90 JarHeadLifer

...
The rub with Obamacare is that eventually these hospital panels would be replaced by government bureaucracies.
...

Who's the customer? The party that's paying. When the government becomes the payer it puts a very different spin on the concept of "customer service"

125 DaddyG  Fri, Aug 21, 2009 10:40:12am

re: #88 jcm

Here's what I know. It was shelved during the Bush Administration, and brought back by the current Administration.

Here is the pdf of the document "Your Life, Your Choices."

I have not had time to go through the document, therefore the furor may or may not be merited.

End of life decisions are an important discussion for an individual and their family. We used a Catholic publication for my father in law. The concern would be as Towey states '"Your Life, Your Choices" presents end-of-life choices in a way aimed at steering users toward predetermined conclusions,...' would such counseling regardless if its required or merely offered as a service have such a "guided" to predetermined outcome.

I just scanned the booklet and from what I see it does a good job of making sure the patient is the one who guides the discussion to predetermined conclusions about their own end of life care including their personal beliefs and their own assessment of their quality of life. This is about preparing a living will not a third party conseling someone if their life is worth continuing for financial and convenience reasons.

126 Fat Bastard Vegetarian  Fri, Aug 21, 2009 10:40:28am

re: #117 lostlakehiker

Tragic. Thanks for sharing.

127 quickjustice  Fri, Aug 21, 2009 10:40:55am

re: #107 Walter L. Newton

You've just articulated the problem with ObamaCare. It's an effort to solve the Medicare and Medicaid deficits by adding more layers of government. Obama says those layers will "reduce costs" without reducing services or increases taxes. I don't believe it.

I'll repeat: we should move in the opposite direction, and increase competition and choice in health care. The government should mandate price transparency and quality of care transparency. They should then shrink the existing government programs by means-testing them.

128 karmic_inquisitor  Fri, Aug 21, 2009 10:40:56am

re: #93 DaddyG

Don't laugh about work related scrotal incidents. A guy in a former company of mine got his slammed under a loading dock ramp (tons of steel plates against concrete). He lost more than his dignity.

I rarely wince when reading posts at LGF.

I just did.

129 NelsFree  Fri, Aug 21, 2009 10:41:16am

re: #117 lostlakehiker
"But things will be yet worse if the state is constrained by law to shy away from these end-of-life issues"

It is my opinion that the bold-faced type lies at the crux of the matter. Perhaps we should get the government OUT of the matter and let the Doctors do their jobs.

130 Killgore Trout  Fri, Aug 21, 2009 10:42:35am

John Voight hoping for civil war (via instapundit)...
Voight: Is Obama creating a civil war in America?

"There's a real question at stake now. Is President Obama creating a civil war in our own country?" Mr. Voight tells Inside the Beltway.

"We are witnessing a slow, steady takeover of our true freedoms. We are becoming a socialist nation, and whoever can't see this is probably hoping it isn't true. If we permit Mr. Obama to take over all our industries, if we permit him to raise our taxes to support unconstitutional causes, then we will be in default. This great America will become a paralyzed nation."

Be outraged, Mr. Voight advises.

"Do not let the Obama administration fool you with all their cunning Alinsky methods. And if you don't know what that method is, I implore you to get the book 'Rules for Radicals,' by Saul Alinsky . Mr. Obama is very well trained in these methods," he continues, citing a television campaign critical of the Republican Party and contentious town-hall meetings about health care reform.

Welcome to the Paulified Republican party.

131 Cato the Elder  Fri, Aug 21, 2009 10:43:01am

re: #129 NelsFree

"But things will be yet worse if the state is constrained by law to shy away from these end-of-life issues"

It is my opinion that the bold-faced type lies at the crux of the matter. Perhaps we should get the government OUT of the matter and let the Doctors do their jobs.

I don't think that sentence means what you think it means.

132 Kenneth  Fri, Aug 21, 2009 10:43:19am

re: #106 ckb

That is exactly what will happen. In the Canadian system, chronic underfunding has lead to scarce resources: too few doctors, too few hospital beds and limited number of services. The result is rationed care. Hospitals are allotted a given number of procedures per year. They are compelled to decide who gets the treatment & who does not. That why we have 1 million people on waiting lists for surgery. And the waiting list continue to grow, not shrink.

The hospital panels make life & death decisions, whether you want to call them "death panels" or not.

133 Cato the Elder  Fri, Aug 21, 2009 10:43:32am

re: #130 Killgore Trout

John Voight hoping for civil war (via instapundit)...
Voight: Is Obama creating a civil war in America?

Welcome to the Paulified Republican party.

And Roseanne Barr is right about him.

134 zelnaga  Fri, Aug 21, 2009 10:44:16am

re: #117 lostlakehiker

If we end up with a state-run health care system, we'll be sorry for many reasons. But things will be yet worse if the state is constrained by law to shy away from these end-of-life issues. Unless a car wreck or something takes the question off the table, everyone is going to face this decision sooner or later: does further treatment serve any purpose?


It sounds like you're opposed to Obama's health care plan, as a whole, but would prefer the end-of-life counseling provisions be in it if it were to pass?

135 Sharmuta  Fri, Aug 21, 2009 10:44:21am

I would hope my doctor wouldn't need an incentive to give me end-of-life counseling. If she did- I would have to seriously wonder if she cared about her patients.

136 DaddyG  Fri, Aug 21, 2009 10:44:24am

re: #128 karmic_inquisitor

I rarely wince when reading posts at LGF.

I just did.


Sorry TMI on the work incident. That one makes me pucker too so of course I had to share.

137 Buck  Fri, Aug 21, 2009 10:44:32am

re: #125 DaddyG

I just scanned the booklet and from what I see it does a good job of making sure the patient is the one who guides the discussion to predetermined conclusions about their own end of life care including their personal beliefs and their own assessment of their quality of life. This is about preparing a living will not a third party conseling someone if their life is worth continuing for financial and convenience reasons.

Some people are simply against ALL counseling that would result is what some people think of as holding back treatment for financial reasons.

138 Kreuzueber Halbmond  Fri, Aug 21, 2009 10:44:38am

re: #118 Throbert McGee

There, fixed that.

While the monopolistic character of government-funded ANYTHING justifies treating it with particular skepticism, free-market competition does not inevitably or instantly prevent/correct undesirable practices -- such as a doctor subtly nudging a patient to choose the cup of hemlock, because the doctor feels pressure from those concerned with the bottom-line.

That's the issue. In years past, people knew what they could afford and made choices accordingly. Now they are at the mercy of what someone else thinks their choices should be.

/lunchtime

139 Buster  Fri, Aug 21, 2009 10:44:49am

re: #99 DaddyG

That won't work for end of life programs any more. All the polar bears have drowned due to anthropomorphic global warming./

That's too bad. It's the ultimate carbon credit. Go out on an ice flow, save the bears, and we won't tax your estate./

140 kynna  Fri, Aug 21, 2009 10:45:17am

End-of-life counseling happens already. Why does it need a government mandate. Oops! It's voluntary. Again, why does "voluntary" end-of-life counseling need a government mandate?

"Death panels" was a term brought up in regard to the panels that decide care based on expense and productivity. Yes, it's hyperbolic, but in the end, if the panel decides someone can't have access to care because they'll cost more than they're worth, I think it has a nice ring to it.

Palin's follow-up message should have hammered those who have twisted the first message with their hysterical reaction and insistence that we talk about this counseling rather than the efficacy panels. Instead she responded to the hysteria and manipulative ridicule and the whole conversation has shifted to something that doesn't matter very much and never did.

Too bad. I agree with Krauthammer on the one important point. Honest debate would be nice. I disagree that Palin has been the one to manipulate the conversation.

141 Slumbering Behemoth Stinks  Fri, Aug 21, 2009 10:45:20am

re: #133 Cato the Elder

She could be right about a lot of things, but that recent photo shoot she did pretty much guarantees I won't give her a listen.

142 Ward Cleaver  Fri, Aug 21, 2009 10:45:22am

re: #117 lostlakehiker

Consider the alternative to end-of-life counseling. The doctor must never say die. There's always a treatment, a chance, a hope. Even when there isn't, not really.

I saw this once: patient is dying of lung cancer. He's scheduled for an operation to remove one of the lungs. They're both raddled with cancer. He has but little time left. A week or two, tops. But in one of the lungs, things are to the point that unless it goes, he's dead in a couple of days.

He's not been told, but he knows anyway. And he asks me to not take him in for surgery. He doesn't want it. His number is up and please just let him die.

But that's not my place and not my job. (That's what they all say, they were just following orders. Trust me, it's not easy to make a stink and make a moral stand and quit in a huff, when there's no time to ruminate and you're just a rookie.) So off he goes to get cut up again. His last days will be an ordeal that Dante's imagination would have trouble topping.

There is a legitimate case for doctors laying it on the line with a patient, unless the patient has indicated directly or implicitly that he just doesn't want to talk about or think about anything but persisting with treatment.

If we end up with a state-run health care system, we'll be sorry for many reasons. But things will be yet worse if the state is constrained by law to shy away from these end-of-life issues. Unless a car wreck or something takes the question off the table, everyone is going to face this decision sooner or later: does further treatment serve any purpose?

Fortunately most people are reasonable about about their end-of-life decisions, and choose some type of hospice care when they realize that no amount of money or care will markedly prolong their lives. Plus, how many of us here have heard the, "I don't want to be a burden" line from an elderly relative?

My mom is almost 90, and she's in reasonably good health, and doesn't take any prescription meds. She, like most everybody, just hopes to pass away in their sleep, at home in their own bed. But just in case, she already has a living will and other end-of-life paperwork in order.

143 Walter L. Newton  Fri, Aug 21, 2009 10:45:26am

re: #127 quickjustice

You've just articulated the problem with ObamaCare. It's an effort to solve the Medicare and Medicaid deficits by adding more layers of government. Obama says those layers will "reduce costs" without reducing services or increases taxes. I don't believe it.

I'll repeat: we should move in the opposite direction, and increase competition and choice in health care. The government should mandate price transparency and quality of care transparency. They should then shrink the existing government programs by means-testing them.

Correct. If you read through the bill, there is section after section that amends existing Medicare and Medicaid rules. And then they start dipping in to the IRS tax code, putting a 2.5 percent penalty on us if we have NO care, or don't want any care and this goes on and on and becomes so bloated, that even a honest lawyer can't tell you what is really says.

144 Baier  Fri, Aug 21, 2009 10:45:35am

re: #138 Kreuzueber Halbmond

When in the past was this magic time?

145 quickjustice  Fri, Aug 21, 2009 10:46:05am

re: #132 Kenneth

And to make it perfectly clear, the Canadian government (specifically the Provinces) deliberately chronically underfunds Canadian health care, and deliberately create shortages of doctors, nurses, and resources to save money.

It's called "rationing".

146 Walter L. Newton  Fri, Aug 21, 2009 10:46:13am

re: #132 Kenneth

That is exactly what will happen. In the Canadian system, chronic underfunding has lead to scarce resources: too few doctors, too few hospital beds and limited number of services. The result is rationed care. Hospitals are allotted a given number of procedures per year. They are compelled to decide who gets the treatment & who does not. That why we have 1 million people on waiting lists for surgery. And the waiting list continue to grow, not shrink.

The hospital panels make life & death decisions, whether you want to call them "death panels" or not.

It would be nice if before you make comment like this, it would be nice if you lived in Canada for a while before you start trashing their system.
///

147 Russkilitlover  Fri, Aug 21, 2009 10:46:26am

re: #114 Charles

Because people are distorting and misrepresenting it, and spreading falsehoods about it.

When you have open ended questions that don't get answered, then you have people filling in the blanks. The fact that this provision is at that point is solely the fault of the Politicians - NOT the folks asking the questions.

148 Son of the Black Dog  Fri, Aug 21, 2009 10:46:37am

re: #91 NelsFree

That post looks like a lead-in for me to re-post something I posted yesterday:

From The Federalist Papers, No. 62, by James Madison:
"It will be of little avail to the people, that the laws are made by men of their own choice, if the laws be so voluminous that they cannot be read, or so incoherent that they cannot be understood;"

The language I've seen from the health care bill looks suspiciously like the Internal Revenue Code.

149 DaddyG  Fri, Aug 21, 2009 10:47:15am

re: #130 Killgore Trout
I am shocked I tell you shocked, that a hollywood actor would say incindiary things about the Presidents policies. That never would have happened on the left!

(And before I am accused of Tu Quoque fallacy I am not arguing that Voight is justified in his inflammtory rhetoric)

The left reminds me of the bully on the playground handing out wedgies left and right, who upon being pushed back screams and cries that he is the victim.

150 Walter L. Newton  Fri, Aug 21, 2009 10:47:36am

re: #147 Russkilitlover

When you have open ended questions that don't get answered, then you have people filling in the blanks. The fact that this provision is at that point is solely the fault of the Politicians - NOT the folks asking the questions.

That's what I said above. If I am misreading it, then why haven't I been able to get a reasoned explanation from ANY politician?

151 Cato the Elder  Fri, Aug 21, 2009 10:48:28am

I know! Let's all scream we're going to live forever, and that any discussion of options at the end of life is a subtle push towards euthanasia, and that asking people questions like "do you sometimes feel your life is not worth living?" is a broad hint that it isn't, and that mentioning death summons it up, and that wasting away in Respiratorville is always preferable to the alternative, and that if a government-paid doctor brings up the word "prognosis" you'd better run and get your gun and anyway Sarah Palin is hot!

Then everything will be fine.

152 Danny  Fri, Aug 21, 2009 10:48:29am

I still don't see why, if medicare ALREADY provides end-of-life coverage, yet another provision to "permit Medicare to pay doctors for voluntary conseling sessions on end-of-life issues" is necessary.

Nobody can explain?

153 Baier  Fri, Aug 21, 2009 10:49:01am

re: #149 DaddyG

The left reminds me of the bully on the playground handing out wedgies left and right, who upon being pushed back screams and cries that he is the victim.

The left is more like the kid that got a wedgie just like everyone else, but told the principle and had underwear banned at he school.

154 Cato the Elder  Fri, Aug 21, 2009 10:49:11am

re: #141 Slumbering Behemoth

She could be right about a lot of things, but that recent photo shoot she did pretty much guarantees I won't give her a listen.

Was she wearing a flag bikini?

155 quickjustice  Fri, Aug 21, 2009 10:49:50am

re: #146 Walter L. Newton

He's right, Walter. I have friends and relatives who are physicians in the Canadian system. Canadian doctors actually go on strike against the parsimonious government health care budgets regularly.

156 Sharmuta  Fri, Aug 21, 2009 10:49:53am

re: #147 Russkilitlover

When you have open ended questions that don't get answered, then you have people filling in the blanks. The fact that this provision is at that point is solely the fault of the Politicians - NOT the folks asking the questions.

What responsibility do the people lying about this have?

157 Danny  Fri, Aug 21, 2009 10:49:55am

re: #152 Danny

"counceling" that is...[memo: spell check]

158 Buck  Fri, Aug 21, 2009 10:50:09am

re: #146 Walter L. Newton

It would be nice if before you make comment like this, it would be nice if you lived in Canada for a while before you start trashing their system.
///

I am pretty sure Kenneth does live in Canada... and so do I.

His comment sounds about 100% correct to me.

159 albusteve  Fri, Aug 21, 2009 10:50:37am

re: #152 Danny

I still don't see why, if medicare ALREADY provides end-of-life coverage, yet another provision to "permit Medicare to pay doctors for voluntary conseling sessions on end-of-life issues" is necessary.

Nobody can explain?

my guess would be the writers do not understand Medicare in the first place...astonishing if true

160 Danny  Fri, Aug 21, 2009 10:50:49am

re: #158 Buck

re: #157 Danny

COUNSELING

Dang!

161 karmic_inquisitor  Fri, Aug 21, 2009 10:51:15am

Related - Barone on "Team Ball"

Speaking of partisan Democrats, he says ...


Foremost among their number are the netroots -- the young enthusiasts who flock to the Daily Kos blog and are ready to take direction from MoveOn.org. As my Washington Examiner colleague Byron York reported on Tuesday, the netroots, once almost totally preoccupied with the war in Iraq and suffused with hatred of George W. Bush, have now moved on.

They show little interest in Iraq, now that Obama is seeking (though carefully refraining from using the word) victory there, and little more interest in Afghanistan, where Obama has sent more troops and installed a new commander to pursue a new and, the president hopes, more successful strategy.

Instead, the netroots say their chief goal is "comprehensive health care reform." No. 2 is "working to elect progressive candidates" in 2010.

To me this looks less like conviction politics and more like team ball. I can't help doubting that these activists have given long and deep thought to "government option" health insurance or negotiating, as the Obama White House has, nonaggression pacts with pharmaceutical lobbyists and the like.

They sound much more like a crowd at a stadium, eager for a touchdown and not caring much whether it's accomplished by a quarterback sneak or a runback of a punt. There's always an element of team ball in politics, and in the past decade polls have shown that those identifying with both parties tend to support with suspicious regularity just about every jot and tittle of their side's platform.

But the netroots seem to have cared more about Iraq than they do about health care. It's plain that the netroots and those millions on the Obama campaign's e-mail lists have not been motivated enough about health care legislation to show up at town hall meetings in any significant numbers -- unless they're transported by union or Association of Community Organizations for Reform Now buses. They may be optimists -- their team has put a lot of points on the scoreboard in recent electoral contests -- but they seem puzzled by how hard it suddenly seems to move the ball.

In contrast, those who are opposed are motivated to show up and express their anger, and in far greater numbers than the hapless Republican Party or the various health insurance companies could ever muster. Many denounce Republicans as well as Democrats -- they're not playing team ball. Rather, they seem focused on the ways that public policy will affect their lives and those dear to them. They seem to be pessimists, but pessimists who are determined to resist what looks like a nightmare.

So the fight is between those who care about the specifics of health care policy and those who care more than anything else -- as many Americans on all political sides do -- about the image and aura of the man who is inevitably the symbol, here and abroad, of the kind of nation we are.

[Link: www.rasmussenreports.com...]

Interestingly, the very same can be said of Republicans who seemed to look past Bush's spending (especially the Department of Homeland Security slush money sent to municipalites with no accountability). Team Ball has come to dominate and poison policy discussion, with "Death Panels" being a prime example.

162 Fat Bastard Vegetarian  Fri, Aug 21, 2009 10:51:22am

Have a good physician friend; he and I were together and we saw a man, he must've been 90. Could barely move. Family was helping him with everything. I told him...

"John, if you ever see me get to that stage in my life, will you please euthanize me?"

John responded, "Hell, Hugh. I'll euthanize you right now!"

163 Charles Johnson  Fri, Aug 21, 2009 10:51:29am

re: #147 Russkilitlover

When you have open ended questions that don't get answered, then you have people filling in the blanks. The fact that this provision is at that point is solely the fault of the Politicians - NOT the folks asking the questions.

But this question WAS answered, as soon as it was raised by Sarah "Death Panels" Palin. It was answered repeatedly -- and it didn't stop the smear from spreading on the right. Both Gingrich and Steele actually supported Palin in this.

The GOP cultivated ignorance on this one, and "won" a political "victory" through lying and distortion. As Krauthammer wrote, the GOP deliberately debased the debate, not out of any concern for the people of America, but to score a crappy political win that doesn't help anyone.

164 Walter L. Newton  Fri, Aug 21, 2009 10:51:34am

re: #155 quickjustice

He's right, Walter. I have friends and relatives who are physicians in the Canadian system. Canadian doctors actually go on strike against the parsimonious government health care budgets regularly.

re: #158 Buck

I am pretty sure Kenneth does live in Canada... and so do I.

His comment sounds about 100% correct to me.

You all miss my sarcasm tags? I put three on the comment.

165 Russkilitlover  Fri, Aug 21, 2009 10:51:56am

re: #156 Sharmuta

What responsibility do the people lying about this have?

Oh, stop! People are rightfully asking questions that are not being answered or are being danced around. You do that with people's notion of healthcare security and you're going to get a lot of fear and suspicion. If the Pols can't directly explain their ginormous bill or what, to a lot of people, appear disturbing aspects of it, then the whole bill needs to go back to the drawing board.

166 Kenneth  Fri, Aug 21, 2009 10:52:00am

re: #146 Walter L. Newton

Good thing I noticed the sarc marks under your comment. Yes, I live in Canada. I have had a great deal of interaction with the Canadian health care system in the last few years. There are both pros and cons with it.

One thing that has been learned by every publicly funded health care system in the world: left to it's own demand, costs are never limited. They will always continue to rise faster than the ability of the public to pay for it. Governments are compelled to cut costs and ration care. It's that simple.

167 flyovercountry  Fri, Aug 21, 2009 10:52:23am

re: #152 Danny

I still don't see why, if medicare ALREADY provides end-of-life coverage, yet another provision to "permit Medicare to pay doctors for voluntary conseling sessions on end-of-life issues" is necessary.

Nobody can explain?


Medicare is for Americans 65 years of age or older. Unfortunately, not everyone who needs this service will be because of someone 65 years old or older. That would be my guess.

168 Vicious Babushka  Fri, Aug 21, 2009 10:52:29am

re: #130 Killgore Trout

John Voight hoping for civil war (via instapundit)...
Voight: Is Obama creating a civil war in America?

Welcome to the Paulified Republican party.

Do you agree with Roseanne Barr's opinion of Jon Voight (other than the death threat part)?

169 DaddyG  Fri, Aug 21, 2009 10:53:07am

re: #157 Danny

"counceling" that is...[memo: spell check]

Splel chcek is a wstae uv tmie. Hmuans prcoses the frist and lsat ltters uv a wrod mroe tahn the mddile letres.

170 Buck  Fri, Aug 21, 2009 10:53:29am

re: #164 Walter L. Newton

You all miss my sarcasm tags? I put three on the comment.

You see, I never learn.


I didn't realize the short short short form of the /sarc tag.

I would have accepted /s , but that is as small as I would understand immediately.

171 Curtain of Oz  Fri, Aug 21, 2009 10:53:38am

As far a Palin at "Death Panels". There’s some truth in what she said. Like all goods and services, medical care is a scarce resource that must be rationed. The only question is how: by the market (price) or by government mandate. If government is doing the rationing, what exactly will bureaucrats use to determine who gets what care and who doesn’t? Why is this never addressed as Charles loves to blast Palin.

172 quickjustice  Fri, Aug 21, 2009 10:53:43am

re: #151 Cato the Elder

I'm going to conclude that your obsession with Palin has nothing to do with her gender or her physical appearance. But tell me, do you also think Tina Fey is hot? ;-)

173 Sharmuta  Fri, Aug 21, 2009 10:53:44am

re: #165 Russkilitlover

Oh, stop! People are rightfully asking questions that are not being answered or are being danced around. You do that with people's notion of healthcare security and you're going to get a lot of fear and suspicion. If the Pols can't directly explain their ginormous bill or what, to a lot of people, appear disturbing aspects of it, then the whole bill needs to go back to the drawing board.

No- I'm not going to stop. There is no excuse for lying.

174 zelnaga  Fri, Aug 21, 2009 10:53:45am

re: #137 Buck

Some people are simply against ALL counseling that would result is what some people think of as holding back treatment for financial reasons.

I imagine one thing these proposed counseling sessions would discuss would be do-not-resuscitate orders. My grandfather had one although I'm not really sure why.

Are the medical bills for CPR large? My grandfather had a decent amount of cash in the bank, though, so it doesn't seem like that'd be a valid reason.

Maybe quality of life after CPR is going to be significantly diminished? It's my understanding that CPR on older people will likely break bones, which might not make for a particurarly pleasant life after the fact.

175 wahabicorridor  Fri, Aug 21, 2009 10:53:57am

re: #100 Cato the Elder

Those who want a taste of what end-of-life counseling actually involves should read this article.

I read that piece the other day Cato, it was really very good, thanks for posting it.

176 Russkilitlover  Fri, Aug 21, 2009 10:54:18am

re: #163 Charles

But this question WAS answered, as soon as it was raised by Sarah "Death Panels" Palin. It was answered repeatedly -- and it didn't stop the smear from spreading on the right. Both Gingrich and Steele actually supported Palin in this.

The GOP cultivated ignorance on this one, and "won" a political "victory" through lying and distortion. As Krauthammer wrote, the GOP deliberately debased the debate, not out of any concern for the people of America, but to score a crappy political win that doesn't help anyone.

That "crappy political win" stopped a potentially horrific bill being passed without review or consent by anyone. You may not be happy with the methods used to get a temporary stay on this health bill, but I appreciate that we don't have a signed sealed and delivered bill that no one understands.

177 Kenneth  Fri, Aug 21, 2009 10:54:58am

re: #155 quickjustice

And the Canadian Medical Association is lobbying hard to re-introduce more private medical care as a way of fixing our collapsing system.

178 Cato the Elder  Fri, Aug 21, 2009 10:54:58am

re: #172 quickjustice

I'm going to conclude that your obsession with Palin has nothing to do with her gender or her physical appearance. But tell me, do you also think Tina Fey is hot? ;-)

Smart women always turn me on.

179 Gus  Fri, Aug 21, 2009 10:56:03am

re: #87 Charles

Medicare is already giving end of life care:

[Link: www.urban.org...]

Charles, here is the US Code that is referred to in Section 1233 that people tend to leave out. Section 1233 does not stand alone as you refer:

TITLE 42 > CHAPTER 7 > SUBCHAPTER XVIII > Part E > § 1395x

§ 1395x. Definitions

The following of which is section (dd):

(dd) Hospice care; hospice program; definitions; certification; waiver by Secretary

(1) The term “hospice care” means the following items and services provided to a terminally ill individual by, or by others under arrangements made by, a hospice program under a written plan (for providing such care to such individual) established and periodically reviewed by the individual’s attending physician and by the medical director (and by the interdisciplinary group described in paragraph (2)(B)) of the program—

(A) nursing care provided by or under the supervision of a registered professional nurse,

(B) physical or occupational therapy, or speech-language pathology services,

(C) medical social services under the direction of a physician,

(D)

___(i) services of a home health aide who has successfully completed a training program approved by the Secretary and
___(ii) homemaker services,

(E) medical supplies (including drugs and biologicals) and the use of medical appliances, while under such a plan,

(F) physicians’ services,

(G) short-term inpatient care (including both respite care and procedures necessary for pain control and acute and chronic symptom management) in an inpatient facility meeting such conditions as the Secretary determines to be appropriate to provide such care, but such respite care may be provided only on an intermittent, nonroutine, and occasional basis and may not be provided consecutively over longer than five days,

(H) counseling (including dietary counseling) with respect to care of the terminally ill individual and adjustment to his death, and

(I) any other item or service which is specified in the plan and for which payment may otherwise be made under this subchapter.

180 Sharmuta  Fri, Aug 21, 2009 10:56:05am

re: #176 Russkilitlover

That "crappy political win" stopped a potentially horrific bill being passed without review or consent by anyone.

I think that's an exaggeration.

181 redstateredneck  Fri, Aug 21, 2009 10:56:09am

re: #132 Kenneth

That is exactly what will happen. In the Canadian system, chronic underfunding has lead to scarce resources: too few doctors, too few hospital beds and limited number of services. The result is rationed care. Hospitals are allotted a given number of procedures per year. They are compelled to decide who gets the treatment & who does not. That why we have 1 million people on waiting lists for surgery. And the waiting list continue to grow, not shrink.

The hospital panels make life & death decisions, whether you want to call them "death panels" or not.


Krauthammer's last paragraph:

It's not an outrage. It's surely not a death panel. But it is subtle pressure applied by society through your doctor. And when you include it in a health-care reform whose major objective is to bend the cost curve downward, you have to be a fool or a knave to deny that it's intended to gently point the patient in a certain direction, toward the corner of the sickroom where stands a ghostly figure, scythe in hand, offering release.


Yes.

182 Kenneth  Fri, Aug 21, 2009 10:56:09am

re: #158 Buck

Walter knows. He used sarc tags "///" to indicate he was joking.

183 [deleted]  Fri, Aug 21, 2009 10:56:27am
184 JarHeadLifer  Fri, Aug 21, 2009 10:56:58am

re: #123 flyovercountry

I think its important to note that there is a difference between acute and chronic care. Hospitals are acute care facilities only. A hospitals duty is to administer immediate care necessary to prolong life or heal. Once that is done, patients are sent home or to a chronic care facility. Once the docs responsible for determining treatment decide that nothing more can be done in the way of acute care, that's it. This is when decisions are made to place a person into either hospice or chronic care, or possibly home. Hospital docs don't always have a human side to them. That is why insurance companies offer grief counseling for family members who had been told by docs, nothing can be done. This counseling is all Palin succeeded in getting removed.

Sure, I'll stipulate to everything you've described. The problem is you're not explaining why it would be better for a government bureaucracy to make these decisions, rather than an independent and private insurance company or hospital board.

And, Palin didn't ask for anything to be removed. She was criticize the foundational premise of Obamacare. It was Democrats and their friends in BigMedia that mischaracterized her comments as something critical of "end of life counseling". Those words aren't found anywhere in Palin's original statement.

185 SasquatchOnSteroids  Fri, Aug 21, 2009 10:57:20am

Drive by.
I don't like handing the keys to 1/6 of the economy to any politician.
I'd rather give Winona Ryder the keys to my house.

186 Charles Johnson  Fri, Aug 21, 2009 10:57:51am

re: #176 Russkilitlover

That "crappy political win" stopped a potentially horrific bill being passed without review or consent by anyone. You may not be happy with the methods used to get a temporary stay on this health bill, but I appreciate that we don't have a signed sealed and delivered bill that no one understands.

OK, so I guess you're conceding my point -- that the "questions" were answered right away, but it had no effect because of the campaign of lies.

Now you're simply arguing that because it worked, I should be applauding the liars.

And meanwhile, a section was removed from the health care bill that by all appearances would have provided a valuable service to people reaching the ends of their lives.

187 Cato the Elder  Fri, Aug 21, 2009 10:58:04am

re: #183 buzzsawmonkey

Brain power or superbly turned out?

Preferably both. Which would certainly apply to Tina.

188 Russkilitlover  Fri, Aug 21, 2009 10:58:50am

re: #180 Sharmuta

I think that's an exaggeration.

Really? Did you understand the bill? Do you know that healthcare is 1/6 of our entire economy? Do you feel comfortable with the government co-opting healthcare? You can disagree with me all you want but your dismissiveness is insulting.

189 doubter4444  Fri, Aug 21, 2009 10:59:17am

re: #64 Land Shark

An honest debate on health care in my opinion starts with the fact a solid majority of Americans are happy with their health care. There is no mass public outcry for health care reform. This is an obsession on the part of Obama and the Democrats, I saw a poll a while ago only 12% on the people polled thought of it as the most important issue.

This is not about what the American people want and need, this is about Obama and the Democrats imposing this on the people whether we want it or not. It's about getting the government involved in everyone's lives. They believe they know what's good for us better than we do.

I think you are incorrect.
I think most people are OK with the system, given no other alternatives.
I personally have dealt with the insurance companies and it's been a nightmare.
I had a group plan. My doctor told me to get my prostate check, as I was nearing 50 (lord above!).
I got it checked, the urologist asked for a couple more tests.
Two years later, I started my own business, was on Cobra, then thought (silly me) that it would be cheaper to get it myself, left the plan an looked for private insurance.
Same company, Blue Shield.
I was rejected because of the the tests.
My 6 year old daughter, born with a minor birth effect, takes an anti-acid for reflux. On the group, never a peep.
She was rejected for "preexisting condition".
Fought with the company, we are on at 175 % premium, it's gone up 4 times in 2 years.
The two of us pay almost 1800 a month.
For no fucking reason. Doctors note certified her, certified me as healthy, with no health problems.
No dice.
My case in not special, so "happy with my health care" is not me.
So I think something needs to be done to break the stranglehold insurance companies have.

190 Pianobuff  Fri, Aug 21, 2009 10:59:28am

re: #181 redstateredneck

Krauthammer's last paragraph:

It's not an outrage. It's surely not a death panel. But it is subtle pressure applied by society through your doctor. And when you include it in a health-care reform whose major objective is to bend the cost curve downward, you have to be a fool or a knave to deny that it's intended to gently point the patient in a certain direction, toward the corner of the sickroom where stands a ghostly figure, scythe in hand, offering release.

Sounds like Krauthammer is schooling Palin on more nuanced and poetic way to call this a death panel...

191 Lincolntf  Fri, Aug 21, 2009 10:59:39am

re: #165 Russkilitlover

People seem to forget that much of this opposition started when leading politicians began talking about getting things done "right now" and then being forced to admit that they hadn't read the bill, didn't know what it's effect would be, didn't know how much it would cost, didn't know who would be covered, etc.
That went on for a few days until it became clear that not only were the pols ignorant of the contents, they were determined that we should stay ignorant, too.
There really is no excuse for such a "pig-in-a-poke" approach to such a massive, far-reaching proposal. This isn't like tacking a couple million onto a bill to build a monument to some Senator. This will effect our economy, and lives, for a long, long time.

192 Dianna  Fri, Aug 21, 2009 10:59:53am

re: #120 Charles

I care.

193 Kenneth  Fri, Aug 21, 2009 10:59:58am

Now here's a "death panel" we can all get behind and support...

US Predators target the Haqqanis in North Waziristan

An unmanned US Predator aircraft fired missiles at the Haqqani Network in Pakistan’s Taliban-controlled tribal area of North Waziristan.

Two Hellfire missiles struck in the town of Darpa Khel near Miramshah, a known stronghold of the Haqqani Network. Twelve Taliban fighters from Afghanistan were reported killed, but no high value Taliban or al Qaeda targets have been reported killed at this time.

194 Buck  Fri, Aug 21, 2009 11:00:24am

re: #163 Charles

You know Charles, this wasn't really just Republicans... Obama uses the Republican tag to paint the "other side"... BUT reality is that only Democrats can truly oppose this effectively. If House and Senate Democrats had the votes, they would have pushed this through. They don't have the votes BECAUSE of Democrat opposition.

Democrats oppose this not because they secretly want Obama to fail (as Obama has tried to make it seem) but because they have reservations about it, and will not support it blindly.

You, and the press can try and make the Republicans and Sarah the villains, but REALITY is that many Democrats think they cannot support this bill.

Maybe for a good reason.

195 Kragar  Fri, Aug 21, 2009 11:00:26am

Man, you just can't win with these guys.

Hamas serves the Jewish usurpers

A number of al-Qaida-affiliated groups on Thursday condemned Hamas as an apostate movement that serves the interests of Israel by cracking down on their supporters in the Gaza Strip.

The groups appealed to al-Qaida leader Osama bin Laden and his deputy, Ayman Zawahiri, to issue public condemnations of Hamas, whose security forces last weekend killed and wounded dozens of fundamentalists belonging to Jund Ansar Allah in Rafah.

The leader of Jund Ansar Allah, Abdel Latid Moussa, was also killed in the confrontation with Hamas when he and some of his followers blew themselves up rather than surrender. The fierce clashes erupted shortly after Moussa declared the establishment of an Islamic emirate in the Gaza Strip, accusing Hamas of transforming itself into a secular party.

196 karmic_inquisitor  Fri, Aug 21, 2009 11:00:47am

re: #136 DaddyG

Sorry TMI on the work incident. That one makes me pucker too so of course I had to share.

I actually had an incident about 15 years ago that led to involuntary scrotal inflation for a period of days. Back when people carried briefcases (as I did) I was boarding a plane with my briefcase in front of me and my bag behind. I was walking down the aisle when a rather large woman decided to kinda "roll out" of her seat as I was passing, deflecting the brief case into the seat back of the empty seat across the aisle. All my weight (and that of my bag) went into that briefcase via my privates.

The 5 hour flight was just "swell". I drove home that night and sat on ice. For the next few days I went to work "casual" with baggy pants and an ice pack. My secretary needled out of me what had happened and I could see from the faces in the office how fast news travels and who hears it first.

197 Lynn B.  Fri, Aug 21, 2009 11:00:50am

re: #6 equable

The government has no business in my choice of continued treatment or hospice.

Who said it did?

198 Kenneth  Fri, Aug 21, 2009 11:01:14am

re: #193 Kenneth

Now here's a "death panel" we can all get behind and support...

US Predators target the Haqqanis in North Waziristan

12 Al Qaeda thugs killed by End-of-Life Counseling and Hellfire missiles but mostly Hellfire missiles.

199 Fat Bastard Vegetarian  Fri, Aug 21, 2009 11:01:28am

re: #189 doubter4444

I don't like what I have seen so far. But am sure that some reform is needed.

200 Sharmuta  Fri, Aug 21, 2009 11:02:03am

re: #188 Russkilitlover

Really? Did you understand the bill? Do you know that healthcare is 1/6 of our entire economy? Do you feel comfortable with the government co-opting healthcare? You can disagree with me all you want but your dismissiveness is insulting.

This is completely illogical. Because I think you exaggerated about no one reviewing the bill means I don't understand anything else or somehow disagree with you?

201 Cato the Elder  Fri, Aug 21, 2009 11:02:17am

re: #186 Charles

[...] Now you're simply arguing that because it worked, I should be applauding the liars. [...]

That's exactly what some have been saying here for days.

Sarah Palin, conscious, successful, popular liar.

202 quickjustice  Fri, Aug 21, 2009 11:02:26am

re: #163 Charles

The political risk for the GOP in this very emotional debate is that by elevating issues like "death panels" (which I view as hyperbole), the Democrats can pull the rug out from under these arguments by dropping the counseling provisions.

The larger issues: how do you cover a $38 trillion unfunded liability in Medicare and similar unfunded liabilities in Medicaid, remain unaddressed.

I think President Obama is genuinely dishonest in claiming that people can keep their current plans, because the incentives created in the "reformed" system will drive employers to drop their existing plans, forcing millions of people into the "public option". That's why big corporate employers support this plan: it enables them to dump their existing plans, forcing their employees into the public option, and saves them billions of dollars.

To tell the public "nothing will change" in terms of their benefits is patently untrue. I think it's time to downsize the government programs by means-testing them, and to promote HSAs and catastrophic private health insurance for everyone else.

As for "end of life" counseling: it happens now, and it involves patients, doctors, and their families. Sticking the government payer in that room does change the dynamics of that.

203 Fat Bastard Vegetarian  Fri, Aug 21, 2009 11:02:31am

re: #196 karmic_inquisitor

Did Zombie ever take your picture?

204 Russkilitlover  Fri, Aug 21, 2009 11:03:01am

re: #186 Charles

OK, so I guess you're conceding my point -- that the "questions" were answered right away, but it had no effect because of the campaign of lies.

Now you're simply arguing that because it worked, I should be applauding the liars.

And meanwhile, a section was removed from the health care bill that by all appearances would have provided a valuable service to people reaching the ends of their lives.

Uh, no. I'm not conceding your point. I'm arguing it. The questions were "answered"? Not to many people's satisfaction. And this goes far beyond this one provision. No one wanted a complete restructure rammed down our throats without review and understanding. This one provision was the catalyst, but not the sole reason people were up in arms. They already were long before Sarah's comments.

205 doubter4444  Fri, Aug 21, 2009 11:03:03am

re: #117 lostlakehiker

Consider the alternative to end-of-life counseling. The doctor must never say die. There's always a treatment, a chance, a hope. Even when there isn't, not really.

I saw this once: patient is dying of lung cancer. He's scheduled for an operation to remove one of the lungs. They're both raddled with cancer. He has but little time left. A week or two, tops. But in one of the lungs, things are to the point that unless it goes, he's dead in a couple of days.

He's not been told, but he knows anyway. And he asks me to not take him in for surgery. He doesn't want it. His number is up and please just let him die.

But that's not my place and not my job. (That's what they all say, they were just following orders. Trust me, it's not easy to make a stink and make a moral stand and quit in a huff, when there's no time to ruminate and you're just a rookie.) So off he goes to get cut up again. His last days will be an ordeal that Dante's imagination would have trouble topping.

There is a legitimate case for doctors laying it on the line with a patient, unless the patient has indicated directly or implicitly that he just doesn't want to talk about or think about anything but persisting with treatment.

If we end up with a state-run health care system, we'll be sorry for many reasons. But things will be yet worse if the state is constrained by law to shy away from these end-of-life issues. Unless a car wreck or something takes the question off the table, everyone is going to face this decision sooner or later: does further treatment serve any purpose?



Well said, thanks

206 wahabicorridor  Fri, Aug 21, 2009 11:04:09am

re: #189 doubter4444

The two of us pay almost 1800 a month.

jeebus. We're self employed (and seriously over 50) with cancer and head injury issues and we don't pay that much.

207 Kenneth  Fri, Aug 21, 2009 11:05:11am

Former Top Canadian Dr. Brian Day: Obamacare Will Bring Rationed Care & Skyrocketing Costs

Youtube Video
208 DaddyG  Fri, Aug 21, 2009 11:05:40am

re: #196 karmic_inquisitor

I actually had an incident about 15 years ago that led to involuntary scrotal inflation for a period of days. Back when people carried briefcases (as I did) I was boarding a plane with my briefcase in front of me and my bag behind. I was walking down the aisle when a rather large woman decided to kinda "roll out" of her seat as I was passing, deflecting the brief case into the seat back of the empty seat across the aisle. All my weight (and that of my bag) went into that briefcase via my privates.

The 5 hour flight was just "swell". I drove home that night and sat on ice. For the next few days I went to work "casual" with baggy pants and an ice pack. My secretary needled out of me what had happened and I could see from the faces in the office how fast news travels and who hears it first.

So what you are saying is you got banged by a large woman on an airplaine and it caused you to swell up? /

209 jpkoch  Fri, Aug 21, 2009 11:05:41am

Sarah Palin, for all of her unhinged, irrational, and untutored opinion, did something that everyone else was incapable of: removing Section 1233. Despite Krauthammer's scolding of the former Governor, at the end of the piece he admitted Section 1233 laid the foundations for much mischief. And while this section didn't spell out the word Death Panels, it pretty much guarantees that the end result would be the same. Couple this with the President's endless mentioning of bending the cost curve, and it is no wonder many people reacted as they did.

I am not fan of Palin by any means, but he single Facebook entry accomplished what countless hours of cloakromm horse trading did not.

210 JarHeadLifer  Fri, Aug 21, 2009 11:06:23am

re: #189 doubter4444

I think you are incorrect.
I think most people are OK with the system, given no other alternatives.

From Scott Rasmussen in a WSJ OpEd earlier this month..

The most important fundamental is that 68% of American voters have health-insurance coverage they rate good or excellent. That number comes from polling conducted this past weekend of 1,000 likely voters. Most of these voters approach the health-care reform debate fearing that they have more to lose than to gain.

The people are right to be scared. I can't think of a single area of commerce (health care is certainly part of America's commerce) in which customer satisfaction improved after the government inserted itself. In fact, it's quite the opposite.

[Link: online.wsj.com...]

211 Sharmuta  Fri, Aug 21, 2009 11:06:47am

I fully expect politicians to keep lying to us, and why wouldn't they when we applaud them for it?

212 Ojoe  Fri, Aug 21, 2009 11:07:01am

re: #209 jpkoch

She will be POTUS IMHO

213 Desert Dog  Fri, Aug 21, 2009 11:07:23am

The biggest problem with Obamacare has been the rush to pass this bill. He wanted it passed before the summer break. A bill that was shrouded in mystery and unknown, even to President Obama. 1000 pages of details that the Congressmen themselves did not even read or understand fully. And, that scared the crap out of people. Some reacted poorly and other reacted in a more proper manner.

Obama did not want a debate on this. He wanted us to open up and he was going to shove it down our throats. For our "own good", no doubt. There has been no open and honest debate about this. Obama and his handlers misjudged the citizenry here...misjudged badly. The Dems made it worse by calling people that objected to this plan first insurance company plants and stooges bused in to cause trouble and then as Nazis and a "mob". The Talking Points from the left are still going on and on about "astro-turfing" and trumped up claims that the people against this plan are somehow stupid.

You have misjudged the American people, President Obama. Take it off the table and let's have a real debate. Let's hear from all sides of this issue and come up with a better plan than this slapped together Frankenstein. Healthcare effects everyone.

214 karmic_inquisitor  Fri, Aug 21, 2009 11:07:29am

re: #208 DaddyG

So what you are saying is you got banged by a large woman on an airplaine and it caused you to swell up? /

I never looked at it that way. I should claim simultaneous membership in the Mile High Club / Quarter Ton Club.

215 Desert Dog  Fri, Aug 21, 2009 11:08:03am

re: #190 Pianobuff

Sounds like Krauthammer is schooling Palin on more nuanced and poetic way to call this a death panel...

A rose by another name still stinks in Denmark.

216 Curtain of Oz  Fri, Aug 21, 2009 11:08:30am

Here's another lesson, a philosophical and moral one, not economic or political: When you give something valuable away, there is no end to the NEED.

217 Kenneth  Fri, Aug 21, 2009 11:08:33am

I'm your bottom dollar baby...

Youtube Video
218 LGoPs  Fri, Aug 21, 2009 11:08:40am

re: #186 Charles

OK, so I guess you're conceding my point -- that the "questions" were answered right away, but it had no effect because of the campaign of lies.

Now you're simply arguing that because it worked, I should be applauding the liars.

And meanwhile, a section was removed from the health care bill that by all appearances would have provided a valuable service to people reaching the ends of their lives.

Decisions like that are already made in the thousands, on a daily basis. My wife and I went through one of those a couple years ago when her dad passed away. But there is a crucial difference between making those decisions on a private basis and institutionalizing them through the government. Doing the latter invites the mother of all unintended consequences, IMO.

219 Ojoe  Fri, Aug 21, 2009 11:08:45am

re: #213 Desert Dog

Yes, take it off the table for now, and fix the economy first.

220 NukeAtomrod  Fri, Aug 21, 2009 11:08:50am

Krauthammer deserves a great deal of respect for his reasoned stance in his writing.

Now on to "empty" victories... Sarah Palin tapped into the anger and fear of the public and used it to effect a change in policy. End of Life Counseling is gone and shortly thereafter removing the Public Option "is not a deal-breaker" according to the White House. The Liberal and Centrist Dems are warring over that now.

It seems like a domino effect to me. Palin can only take credit for pushing the first domino, but the majority party has started to listen to an outraged public. And maybe, just maybe, the whole socialized health care mess will topple.

The Death Panel language is very provocative, but the public was concerned about the concept behind the words long before Sarah Palin uttered them.

221 jpkoch  Fri, Aug 21, 2009 11:08:50am

Consider the alternative to end-of-life counseling. The doctor must never say die. There's always a treatment, a chance, a hope. Even when there isn't, not really.

Actually, the end of life counseling goes on all the time. Talk to any oncologist, or geriatric doctor. This is none of the government's business.

222 HelloDare  Fri, Aug 21, 2009 11:08:53am

The Death Book for Veterans
Ex-soldiers don't need to be told they're a burden to society.

If President Obama wants to better understand why America's discomfort with end-of-life discussions threatens to derail his health-care reform, he might begin with his own Department of Veterans Affairs (VA). He will quickly discover how government bureaucrats are greasing the slippery slope that can start with cost containment but quickly become a systematic denial of care.

Last year, bureaucrats at the VA's National Center for Ethics in Health Care advocated a 52-page end-of-life planning document, "Your Life, Your Choices." It was first published in 1997 and later promoted as the VA's preferred living will throughout its vast network of hospitals and nursing homes. After the Bush White House took a look at how this document was treating complex health and moral issues, the VA suspended its use. Unfortunately, under President Obama, the VA has now resuscitated "Your Life, Your Choices."

Who is the primary author of this workbook? Dr. Robert Pearlman, chief of ethics evaluation for the center, a man who in 1996 advocated for physician-assisted suicide in Vacco v. Quill before the U.S. Supreme Court and is known for his support of health-care rationing.

"Your Life, Your Choices" presents end-of-life choices in a way aimed at steering users toward predetermined conclusions, much like a political "push poll." For example, a worksheet on page 21 lists various scenarios and asks users to then decide whether their own life would be "not worth living."

The circumstances listed include ones common among the elderly and disabled: living in a nursing home, being in a wheelchair and not being able to "shake the blues." There is a section which provocatively asks, "Have you ever heard anyone say, 'If I'm a vegetable, pull the plug'?" There also are guilt-inducing scenarios such as "I can no longer contribute to my family's well being," "I am a severe financial burden on my family" and that the vet's situation "causes severe emotional burden for my family."

When the government can steer vulnerable individuals to conclude for themselves that life is not worth living, who needs a death panel?

One can only imagine a soldier surviving the war in Iraq and returning without all of his limbs only to encounter a veteran's health-care system that seems intent on his surrender.

I was not surprised to learn that the VA panel of experts that sought to update "Your Life, Your Choices" between 2007-2008 did not include any representatives of faith groups or disability rights advocates. And as you might guess, only one organization was listed in the new version as a resource on advance directives: the Hemlock Society (now euphemistically known as "Compassion and Choices").

This hurry-up-and-die message is clear and unconscionable. Worse, a July 2009 VA directive instructs its primary care physicians to raise advance care planning with all VA patients and to refer them to "Your Life, Your Choices." Not just those of advanced age and debilitated condition—all patients. America's 24 million veterans deserve better.

223 Fat Bastard Vegetarian  Fri, Aug 21, 2009 11:10:03am

Wonder which country this guy went to for his surgery...

Cool story.

224 kansas  Fri, Aug 21, 2009 11:10:28am

If you want honest debate you are going to have to remove the politicians from it.

225 Danny  Fri, Aug 21, 2009 11:10:40am

re: #186 CharlesAnd meanwhile, a section was removed from the health care bill that by all appearances would have provided a valuable service to people reaching the ends of their lives.

But you said that medicare already provides this valuable service? Sorry to belabor it, but I truly don't understand.

226 Throbert McGee  Fri, Aug 21, 2009 11:10:41am

re: #112 zelnaga

I'm happy with my health care and wouldn't switch to a government sponsored plan, but then again, I'm not exactly the target audience, anyway. If the fact that most people are content, as is, was a valid reason, then the Ryan White Care Act shouldn't have been passed, either, because most people don't have AIDS.

First year of Ryan White funding (1990): $220 million
Annual funding as of 2006: $2.1 billion (i.e., about a ten-fold ballooning in less than 20 years)
Fraction of current annual funds spent to provide free anti-viral drugs for qualifying patients: only about 1/3

I sigh to think how much of the remaining 2/3 goes to highly dubious "educational outreach" programs as well as pure overhead...

227 Charles Johnson  Fri, Aug 21, 2009 11:10:59am

re: #194 Buck

You, and the press can try and make the Republicans and Sarah the villains, but REALITY is that many Democrats think they cannot support this bill.

Yep, me and the press, in bed together. Why, just this morning, I was discussing how best to demonize Sarah Palin, with Pinchy Sulzberger and Maureen Dowd, on a conference call with the editors of the LA Times and the Washington Post. We'll be coordinating our efforts from now on. Sarah's goin' down.

/need I?

228 Curtain of Oz  Fri, Aug 21, 2009 11:11:02am

We should ask our left-leaning friends to explain how our existing public plans, Medicare, is sustainable with 34 trillion in unfunded liabilities? And they want to expand the scope? Most agree that we don't need reform, and we need to discuss how to address the 10 million that don't qualify for assistance (Medicare) and the 10+- million illegal immigrants. How we pay for it is the problem. In fact it is THE problem. You don't destroy the system to address 3-4% of the population with Obamacare. I'll go out on a limb here - THERE IS NO HEALTHCARE CRISIS IN THIS COUNTRY. Everybody gets treatment. I'll quote the late Madeleine Cosman who wrote: "The Emergency Medical Treatment and Active Labor Act (EMTALA) requires every emergency department to treat anyone who enters with an 'emergency,' including cough, headache, hangnail, cardiac arrest, herniated lumbar disc, drug addiction, alcohol overdose, gunshot wound, automobile trauma, HIV, mental problems, or personality disorder. The definition of emergency is flexible and vague enough to include almost any condition. Any patient coming to a hospital ED requesting 'emergency' care must be screened and treated until ready for discharge. or stabilized for transfer - whether or not insured, 'documented,' or able to pay. A woman in labor must remain to deliver her child...High technology EDs have degenerated into free medical offices." Americans have the highest cancer survival rates in the world ([Link: www.ncpa.org...] despite American's unique challenges, the 'safety net' for Europeans and Canadians, illegal immigrants, and the fringe benefits that American innovation has given the world.

229 Racer X  Fri, Aug 21, 2009 11:11:20am

Speaking as someone who has lost a relative recently, and went through the experience of home hospice care, end of life discussions are crucial for the individual and family members. This should be a group discussion with the care provider, so everyone is on the same page.

IMHO the government, and that includes all government medical professionals, should be left out of that conversation.

In other words - the government should NOT be involved in health care. If the government wishes to provide tax breaks, or some form of financial assistance to individuals to help them obtain health care, fine. But the idea of a doctor who is on the payroll of the state making end of life decisions concerns me greatly.

230 Cato the Elder  Fri, Aug 21, 2009 11:12:00am

re: #212 Ojoe

She will be POTUS IMHO

There was a time when I thought that even America could not be that lost to imbecility.

Given the number of people who admire and support the Quitta from Wasilla even here, in a crowd not known for brainlessness, I am no longer sure.

231 Flyovercountry  Fri, Aug 21, 2009 11:12:56am

re: #184 JarHeadLifer

Sure, I'll stipulate to everything you've described. The problem is you're not explaining why it would be better for a government bureaucracy to make these decisions, rather than an independent and private insurance company or hospital board.

And, Palin didn't ask for anything to be removed. She was criticize the foundational premise of Obamacare. It was Democrats and their friends in BigMedia that mischaracterized her comments as something critical of "end of life counseling". Those words aren't found anywhere in Palin's original statement.

I think I should explain my position here, to help clarify where I'm coming from. I am against this bill. I don't want our government anywhere near health care.

End of Life counseling is a standard and nescessary thing in almost all health insurance policies today, as is respite care, hospice care, and family grief counseling. The congress folk who wrote this bill, lazy people that they are, simply took the language from an existing policy somewhere, (my guess is Assurant,) and copied it word for word into their bill. I realize this, not because I am smart, but because I am in the business. My problem with Sara Palin, is that the dynamic of the argument was changed. The debate had been about facts, and whether or not beaurocrats would be making decisions regarding acute health care instead of patients and doctors. The very real issue of rationing and choice became an emotional appeal based on a falsehood. While this has garnered a short term victory, if Gives a very unprincipled President plenty of new Strawmen to knock down.

That is my problem with Palin's comments.

232 reine.de.tout  Fri, Aug 21, 2009 11:13:30am

re: #181 redstateredneck

Yes.

It's not an outrage. It's surely not a death panel. But it is subtle pressure applied by society through your doctor. And when you include it in a health-care reform whose major objective is to bend the cost curve downward, you have to be a fool or a knave to deny that it's intended to gently point the patient in a certain direction, toward the corner of the sickroom where stands a ghostly figure, scythe in hand, offering release.

Krauthammer had that part right, but also this part:

You are told constantly how very important it is to write your living will years in advance. But the relevant question is what you desire at the end -- when facing death -- not what you felt sometime in the past when you were hale and hearty and sitting in your lawyer's office barely able to contemplate a life of pain and diminishment.
. . . My own living will, which I have always considered more a literary than a legal document, basically says: "I've had some good innings, thank you. If I have anything so much as a hangnail, pull the plug." I've never taken it terribly seriously because unless I'm comatose or demented, they're going to ask me at the time whether or not I want to be resuscitated if I go into cardiac arrest. The paper I signed years ago will mean nothing.

And I don't see that that would have changed with the Obamacare "end of life" provisions.

However, I am opposed to this reform as it is written in this bill, and I really hope the whole thing fails.

But let's say that it doesn't fail - does having that section of the bill removed mean that people can not be offered the opportunity to draw up a "living will" etc.? If not, then what purpose was there having it in there to begin with?

233 DaddyG  Fri, Aug 21, 2009 11:14:12am

re: #222 HelloDare
That pamphlet was linked above. I read through it and found it to be a very balanced and informative document that asks the patient to evaluate and consider their choices legally and in light of their preferences and beliefs. It is primarily a document on living wills and preparing your family and health care providers to respond to your choices. I just don't see the boogey man in this regardless of who helped prepare it.

The health care bill on the other hand is a vague legalese monstrisity and I don't care to see the government hand over my care to bureaucrats who will enact these measures in as yet unknown ways.

234 Buck  Fri, Aug 21, 2009 11:15:39am

re: #227 Charles

Yep, me and the press, in bed together. Why, just this morning, I was discussing how best to demonize Sarah Palin, with Pinchy Sulzberger and Maureen Dowd, on a conference call with the editors of the LA Times and the Washington Post. We'll be coordinating our efforts from now on. Sarah's goin' down.

/need I?

I didn't say that. I Didn't even hint it. You are doing something, and so is some of the press.

You know the Death Panels comment was NOT about end of life counseling. (because you can read)

You know that the bill is really held up by Blue Dog Democrats (because you can count).

235 Kenneth  Fri, Aug 21, 2009 11:17:11am

This is what it boils down to:

rationed medical care = life & death panels

236 Lynn B.  Fri, Aug 21, 2009 11:17:22am

re: #135 Sharmuta

I would hope my doctor wouldn't need an incentive to give me end-of-life counseling. If she did- I would have to seriously wonder if she cared about her patients.

The issue isn't whether your doctor is given an incentive. She'll be paid for giving counseling (if she charges for it and I would expect her to) one way or the other. The question is, by whom? This provision of the bill was designed to provide that she'd be reimbursed by Medicare rather than by supplemental insurance (if your insurer elects to cover such counseling) or by you.

BTW, this provision of the bill, while it includes end of life counseling, also includes advice and information about things like living wills and health care proxies, things far too few people avail themselves of that have nothing whatsoever to do with "end of life." In fact, every adult should have them.

237 Ojoe  Fri, Aug 21, 2009 11:17:22am

re: #230 Cato the Elder

She would be better than O, IMHO.
Here is Victor Hanson's take on S.P.

Nothing in politics is perfect.

238 karmic_inquisitor  Fri, Aug 21, 2009 11:17:56am

One point that is not brought up often is that a single payer system in the US will remove much of the "reward" portion of the risk/reward trade off that goes into the funding of R&D for new treatments and drugs.

While the US is not the only place where drugs and therapies are developed, it is the huge market that represents the bulk of profitability for both domestic and foreign drug and medical device makers.

The cost efficiency that single payer offers is the absolute power over buying health care resources. A drug or device maker gets no bargaining leverage when presented with only one payer for such a large market.

In a very real sense, the more capitalist US market creates a tailwind in terms of new therapies and drugs that the rest of the world benefits from. For example, the NHS in the UK gets to buy drugs that would not have been developed if there was only one payer - yet the UK is the only payer for the UK market. Same for Canada (part of the reason the same drugs are cheaper in Canada).

I'd like a system that makes the single payer countries pay the same as we do, frankly, so that the costs were spread around instead of less efficient models getting to exploit the efficiencies our system creates.

239 Charles Johnson  Fri, Aug 21, 2009 11:18:00am

re: #234 Buck

You know the Death Panels comment was NOT about end of life counseling. (because you can read)

Really? What I'm reading is a whole lot of people declaring victory on the issue because the end of life section was removed. If the "death panel" remark had nothing to do with it, why crow about winning?

240 doubter4444  Fri, Aug 21, 2009 11:18:09am

re: #137 Buck

Some people are simply against ALL counseling that would result is what some people think of as holding back treatment for financial reasons.

I don't get the myopia people have on this issue.
Insurance companies do this EVERYDAY, and have been doing it for decades.
People are acting like the entire panoply of care is available to everyone at every moment in every case.
That is not true, there is rationing going on now, with major emphasis given to maximizing profit and avoiding expense where ever possible.
I grant that having the government try to enter in the space will mean a lot of things, but the constant fixation on the concern that availability to treatment will somehow be dramatically reduced because of cost reasons seems way off base, and seems to me to be a losing argument.
If anything, argue that standers will be lower, that paperwork will be greater, or any number of things, but for Pete's sake, to pretend that this rationing is not happening now (and will only get worse, given the economy), is absurd.

241 wahabicorridor  Fri, Aug 21, 2009 11:18:32am

re: #231 Flyovercountry

The congress folk who wrote this bill, lazy people that they are, simply took the language from an existing policy somewhere, (my guess is Assurant,) and copied it word for word into their bill. I realize this, not because I am smart, but because I am in the business.

Having read thru that monster my guess is the members never saw a word of it until their staffs handed them the damn thing. Staff wrote this (not uncommon) IN A REAL BIG HURRY

242 Cato the Elder  Fri, Aug 21, 2009 11:18:40am

re: #235 Kenneth

This is what it boils down to: rationed medical care = life & death panels

We already have all three.

243 Sharmuta  Fri, Aug 21, 2009 11:18:51am

re: #231 Flyovercountry

My problem with Sara Palin, is that the dynamic of the argument was changed. The debate had been about facts, and whether or not beaurocrats would be making decisions regarding acute health care instead of patients and doctors. The very real issue of rationing and choice became an emotional appeal based on a falsehood. While this has garnered a short term victory, if Gives a very unprincipled President plenty of new Strawmen to knock down.

Thank you- well stated.

244 JarHeadLifer  Fri, Aug 21, 2009 11:19:27am

re: #231 Flyovercountry

... My problem with Sara Palin, is that the dynamic of the argument was changed. The debate had been about facts, and whether or not beaurocrats would be making decisions regarding acute health care instead of patients and doctors. The very real issue of rationing and choice became an emotional appeal based on a falsehood. While this has garnered a short term victory, if Gives a very unprincipled President plenty of new Strawmen to knock down.

That is my problem with Palin's comments.

As I said in an earlier post, Palin's comments were clumsily written, at best. While I'm not a fan of the "death panel" phrase, I believe it could have been explained MUCH better than she did,. Since it wasn't , it probably should have been avoided altogether. As you state, it has muddied already complicated waters.

Having said that, I still think the larger point Palin was attempting to make, is a good one. Government intervention is not the answer, especially and specifically if that intervention means that the government is going to be expanding it's role as health insurance provider beyond what it already is. On this, it sounds like we may agree.

245 SFGoth  Fri, Aug 21, 2009 11:20:19am

Palin should just go away, period. She's gotten full of herself - the GOP's own Messiah.

246 DaddyG  Fri, Aug 21, 2009 11:21:05am

re: #239 Charles

Really? What I'm reading is a whole lot of people declaring victory on the issue because the end of life section was removed. If the "death panel" remark had nothing to do with it, why crow about winning?

The fact that some on the right think this has been won scares me as much as anything. The removal of one provision does not make a victory when the whole bill is based on some bad premises like "health care is broken" and "the government can do better than private industry".

I pray the American public is that easy to appease and lull into a sense of false security.

247 Lynn B.  Fri, Aug 21, 2009 11:21:12am

re: #135 Sharmuta

I would hope my doctor wouldn't need an incentive to give me end-of-life counseling. If she did- I would have to seriously wonder if she cared about her patients.

The issue isn't whether your doctor is given an incentive. She'll be paid for giving counseling (if she charges for it and I would expect her to) one way or the other. The question is, by whom? This provision of the bill was designed to provide that she'd be reimbursed by Medicare rather than by supplemental insurance (if your insurer elects to cover such counseling) or by you.

BTW, section 1233, while it included end of life counseling as one element, also included advice and information about other elements of "advance care planning" like living wills and health care proxies, things far too few people avail themselves of that have nothing whatsoever to do with "end of life." In fact, every adult should have them.

248 Fat Bastard Vegetarian  Fri, Aug 21, 2009 11:21:19am

A few years ago, my mom (who is currently kicking cancers ass all over the floor) and dad and my brothers and sisters were all in the same place.

Out of nowhere, the smartest of the six children (ahem...) brought up mom and dads wishes for their end of days.

The drama queen (the oldest freaked out and ran out of the room) came back in ten minutes later and we had a very measured frank discussion.

All six of us know exactly where both of them stand on all of their "end of life" issues.

The smartest of the six children (ahem... again) was thanked profusely for bringing it up.

It is the "elephant in the room" that many families ignore, but, once it is brought up, is actually very educational... and the right thing to do.

Even for the Drama Queen.

249 Desert Dog  Fri, Aug 21, 2009 11:21:19am

re: #245 SFGoth

Palin should just go away, period. She's gotten full of herself - the GOP's own Messiah.

Sorry, Goth. She has been sent down from heaven to punish Cato for his sins...it appears he has been a very bad boy too.

250 SanFranciscoZionist  Fri, Aug 21, 2009 11:22:20am

re: #4 Kreuzueber Halbmond

End of life - beginning of death - we don't need government bureaucrats to talk to us about it.

We do, however, need DOCTORS to talk to us about it.

251 Mikey_Dallas  Fri, Aug 21, 2009 11:23:15am

Charles,
Please address the funding of the bill requiring cuts in spending on care. This leads to HOW are the cuts going to be done. If they are done like they are in Canada /Europe, then they will be achieved by denying certain more expensive procedures using some process.

If it's not QARY / QALY, then it will be something similar, because there's a whole lot of spending being done on elderly. And it's all based on averages, not on any individual's particular prognosis.

So no, they won't unplug grandma, but as noted, grandma might be denied being plugged in, in the first case.

Denying a bypass or chemo to someone who needs it, without getting into whether it should be denied or not, is, essentially, a death sentence to the person denied the services.

Instead of arguing about whether it's a "death panel", it is, in the most likely rationing scenarios to the elderly, certainly going to handing down some "death sentences" by solely the denial of treatment options that MIGHT provide them more years of life.

I think that's much more important an issue than whether a doctor has to or can discuss EOL issues with people.

252 DaddyG  Fri, Aug 21, 2009 11:23:36am

I have had a living will since I was 38 years old. I do not have a death wish.

253 NukeAtomrod  Fri, Aug 21, 2009 11:23:47am

re: #181 redstateredneck

...it is subtle pressure applied by society through your doctor. And when you include it in a health-care reform whose major objective is to bend the cost curve downward, you have to be a fool or a knave to deny that it's intended to gently point the patient in a certain direction, toward the corner of the sickroom where stands a ghostly figure, scythe in hand, offering release.

As a layman, I'd be tempted to shorten that concept to something like a "Death Option" and the doctor as a "Death Adviser" and if it was promoted by a council of bureaucrats... a "Death Panel."

254 Curtain of Oz  Fri, Aug 21, 2009 11:23:51am

For years the status quo politicians have used carefully staged "town hall events" as photo-ops to get their message out to the "great unwashed." (I am NOT speaking about campaign rallies, which are a different breed of cat.) Attendance was by invitation only. Questions were carefully screened in advance by the staff of the elected official. A politically correct and telegenic mix of the right faces and a suitable number of flags was arranged as a backdrop for the cameras. But now that the former "backdrop" has decided to resume its rightful role as citizens, and to ask sometimes hard questions of its representatives, many of our legislators are declaring such conduct "uncivil," "counter-productive," and "out-of-line." They appear to believe that it is their job to explain things to us, and our job is to listen and applaud when allowed. Their response defines the term "out of touch." Their behavior smacks more of that of colonial authorities, who transmit directives from on high to the subjects of the king. This healthcare debate episode should be seen for what it is - a challenge to American democracy. Those who rise to the challenge and seek out their representatives in order to give them a piece of their mind, whether at town hall meetings, Labor Day parades, emails or phone calls, are meeting the demands of a representative republic. And those who do not, who gainsay such efforts and declare that it is all a useless charade, will get the government that they deserve. Are you subjects or are you citizens?

255 Kenneth  Fri, Aug 21, 2009 11:24:21am

No Health Care Reform Without Legal Reform

President Obama's health care "reform" plan has met with significant criticism across the country. Many Americans want change and reform in our current health care system. We recognize that while we have the greatest medical care in the world, there are major problems that we must face, especially in terms of reining in costs and allowing care to be affordable for all. However, as we have seen, current plans being pushed by the Democratic leadership represent change that may not be what we had in mind -- change which poses serious ethical concerns over the government having control over our families’ health care decisions. In addition, the current plans greatly increase costs of health care, while doing lip service toward controlling costs.

...So what can we do? First, we cannot have health care reform without tort reform. The two are intertwined. For example, one supposed justification for socialized medicine is the high cost of health care. As Dr. Scott Gottlieb recently noted, “If Mr. Obama is serious about lowering costs, he'll need to reform the economic structures in medicine—especially programs like Medicare.” [1] Two examples of these “economic structures” are high malpractice insurance premiums foisted on physicians (and ultimately passed on to consumers as “high health care costs”) and the billions wasted on defensive medicine.

256 Kragar  Fri, Aug 21, 2009 11:24:30am

'Romney care' touted as a model for national health care reform

"You don't have to have a public option," Romney said. "You don't have to have the government getting into the insurance business to make it work."

Three years after enacting its own version of reform, Massachusetts now has near-universal coverage.

Taxpayer watchdogs say it's affordable.

"There is this widespread assumption, that is treated as fact, that it's breaking the bank in Massachusetts ... it's not breaking the bank at all." said Michael Widmer of Massachusetts Taxpayers Foundation.

And health care experts say it's popular.

"Seven in 10 people in the state support the program, and no more than one in 10 would repeal it." said Robert Blendon with the Harvard University School of Public Health.

Unlike Democratic proposals that would give Americans the choice of joining a government-run health care plan, Massachusetts has no public option. Instead, people in the state are required to buy private insurance, and the poor get subsidies.

257 Eowyn2  Fri, Aug 21, 2009 11:24:57am

re: #7 Ward Cleaver

He makes an intelligent point, without waving around an AR-15.

the msm isn't going to show rational people discussing the health care bill. They will attempt to show all those against the bill to be raving lunatics and the stupid bastards that are raving will give them all the fodder they need to paint ALL dissenters with the same brush.

258 SanFranciscoZionist  Fri, Aug 21, 2009 11:25:04am

re: #19 realwest

How about from your own doctor(s)? I think I'd prefer that than getting my counseling from someone who would "profit" by my choosing hospice over healthcare.

Who has this talk with you under the bill?

259 Slumbering Behemoth Stinks  Fri, Aug 21, 2009 11:25:14am

If anyone is interested, here is Palin's facebook post on "death panels", complete with her "shout out" to Michele Bachmann.

260 debutaunt  Fri, Aug 21, 2009 11:25:27am

re: #83 Fat Bastard Vegetarian

Damn.

Crickets.

I thought that was funny.

Three of us!

261 Buck  Fri, Aug 21, 2009 11:25:39am

re: #239 Charles

Really? What I'm reading is a whole lot of people declaring victory on the issue because the end of life section was removed. If the "death panel" remark had nothing to do with it, why crow about winning?

Well, first of all because people are tying the two together, even though it was never said by Sarah Palin. Specifically Obama is being misleading about the "Death Panels" comment.

She did make comments about BOTH issues. BUT the death panel comment was NOT about end of life counselling. If it was, then you and everyone else should be able to find it easily.

Her comments about end of life counselling was this (although she made other comments as well, this sums up her feelings on the subject) :

Our senior citizens are right to be wary of this health care bill. Medical care at the end of life accounts for 80 percent of all health care. When care is rationed, that is naturally where the cuts will be felt first. The “end-of-life” consultations authorized in Section 1233 of HR 3200 were an obvious and heavy handed attempt at pressuring people to reduce the financial burden on the system by minimizing their own care. Worst still, it actually provided a financial incentive to doctors to initiate these consultations. People are right to point out that such a provision doesn’t sound “purely voluntary.”

In an article I noted yesterday, Charles Lane wrote:

“Ideally, the delicate decisions about how to manage life’s end would be made in a setting that is neutral in both appearance and fact. Yes, it’s good to have a doctor’s perspective. But Section 1233 goes beyond facilitating doctor input to preferring it. Indeed, the measure would have an interested party -- the government -- recruit doctors to sell the elderly on living wills, hospice care and their associated providers, professions and organizations. You don’t have to be a right-wing wacko to question that approach.”

She is entitled to an opinion, and that one seems to be reasoned and well thought out.

262 SFGoth  Fri, Aug 21, 2009 11:25:51am

I'm seriously writing in Krauthammer for president in '12. One of the few bright spots about growing up in the D.C. area was seeing him on the *local* talking head shows.

263 Ben Hur  Fri, Aug 21, 2009 11:26:34am

I'm suprised at the lack of outrage over Obama urging religious leaders to preach his Health Reform Plan from the pulpit.

We are a separation of Church and State group.

264 Fat Bastard Vegetarian  Fri, Aug 21, 2009 11:26:45am

re: #260 debutaunt

heh

265 wahabicorridor  Fri, Aug 21, 2009 11:28:09am

re: #248 Fat Bastard Vegetarian

A few years ago, my mom (who is currently kicking cancers ass all over the floor) and dad and my brothers and sisters were all in the same place.

Out of nowhere, the smartest of the six children (ahem...) brought up mom and dads wishes for their end of days.

The drama queen (the oldest freaked out and ran out of the room) came back in ten minutes later and we had a very measured frank discussion.

All six of us know exactly where both of them stand on all of their "end of life" issues.

The smartest of the six children (ahem... again) was thanked profusely for bringing it up.

It is the "elephant in the room" that many families ignore, but, once it is brought up, is actually very educational... and the right thing to do.

Even for the Drama Queen.

My sister and I had the same discussion with the 'rents. Then, when they actually started the dying process, they both changed their minds. HA! Not to worry, tho, they still did it the way they wanted to. My point is that you probably should revisit the subject matter every now and then.

266 KingKenrod  Fri, Aug 21, 2009 11:28:58am

As lies and exaggerations go, Palin's "Death Panel" comment is a last place finisher to the whoppers being told by Obama and the Democrat leadership daily about getting to keep your current insurance, controlling costs, rationing, and improving quality.

Everyone knows this is about redistribution, and creating a new entitlement and Democrat-voting political class.

267 doubter4444  Fri, Aug 21, 2009 11:29:29am

re: #206 wahabicorridor

I just looked it's more about 1300, sorry for over stating it, but it's still killing us.
My wife and 2 years old one pay 900.
It's a joke.

268 Kenneth  Fri, Aug 21, 2009 11:29:36am

re: #35 realwest

Well my friend, I think the idea of rationing healthcare based upon cost vs. how much longer you get to live is fairly significant.
But that's just me.

I agree with you entirely. Gov't funded healthcare is rationed healthcare which means waiting growing lists for treatments.

269 Slumbering Behemoth Stinks  Fri, Aug 21, 2009 11:29:48am

re: #154 Cato the Elder

Was she wearing a flag bikini?

Dressed up like hitler, pulling burnt jew-cookies out of an oven...

I'm sure you've heard this before.

270 Flyovercountry  Fri, Aug 21, 2009 11:30:10am

re: #244 JarHeadLifer

As I said in an earlier post, Palin's comments were clumsily written, at best. While I'm not a fan of the "death panel" phrase, I believe it could have been explained MUCH better than she did,. Since it wasn't , it probably should have been avoided altogether. As you state, it has muddied already complicated waters.

Having said that, I still think the larger point Palin was attempting to make, is a good one. Government intervention is not the answer, especially and specifically if that intervention means that the government is going to be expanding it's role as health insurance provider beyond what it already is. On this, it sounds like we may agree.

I'd be willing to concede that point except for one thing. This woman is not some novice. Her speach at the Republican National Convention was tremendous. I read a link here on LGF written by Palin that was brilliant, (on drilling in ANWR.) This woman is well read and polished. This woman knew what she was doing. I will not accept for one moment that Governor Palin meant the appeal to be anything but emotional. This was a calculated move to switch the argument to the lowest possible denominator. If we lose this battle, Sarah is one of the people I will blame.

271 wahabicorridor  Fri, Aug 21, 2009 11:30:11am

re: #263 Ben Hur

I'm suprised at the lack of outrage over Obama urging religious leaders to preach his Health Reform Plan from the pulpit.

We are a separation of Church and State group.

I'm surprised at the lack of outrage that some guy who spent 20 yeasrs in a racist church is preaching to the clergy about the religious obligations that should be the purview of the gov't.

272 Ojoe  Fri, Aug 21, 2009 11:30:17am

re: #263 Ben Hur

That won't go over with the "can't stand religion" Lefties.

I detect the wafting vapors of One Term President more and more these days.

273 Ben Hur  Fri, Aug 21, 2009 11:30:37am

suRprised.

274 NukeAtomrod  Fri, Aug 21, 2009 11:31:46am

re: #242 Cato the Elder

We already have all three.

Only if you consider rationing to mean "being able to afford." In that case, the only things that aren't rationed are unicorns, moonbeams, and love.

275 doubter4444  Fri, Aug 21, 2009 11:31:54am

re: #199 Fat Bastard Vegetarian

Thanks, and you are right, something needs to be done, that's why I think doing nothing just can't be an option.

276 wahabicorridor  Fri, Aug 21, 2009 11:31:57am

re: #267 doubter4444

Ah, that's close to what we pay also. I was thinking 'Geez, I wonder if it's because of regs in the state they live in or something'.

277 SasquatchOnSteroids  Fri, Aug 21, 2009 11:32:05am

re: #273 Ben Hur

suRprised.


How's Mrs. Hur doin' stud ?

Sending you out for pickle and peanut butter ice cream yet ?

278 [deleted]  Fri, Aug 21, 2009 11:32:11am
279 Racer X  Fri, Aug 21, 2009 11:32:16am

LGF is wonky. Pages won't load; new comments button just teases me.

just me?

280 Lynn B.  Fri, Aug 21, 2009 11:33:15am

re: #247 Lynn B.

Ooops. Sorry about the (almost) duplicate post. I've been having trouble connecting today and I thought the first one didn't make it.

281 debutaunt  Fri, Aug 21, 2009 11:33:19am

re: #111 Francisco D'anconia

maybe someone can inform me better, but my impression is that the "death panel" idea sprung not for the end of life counseling session (which is on its own an abhorrent thought). Rather i was in reference to the ideas being floated by Ezekiel Emmanuel (Rahm's brother) on rationing care. Basically the gist being that Dr. Emmanuel doesnt think that granny needs a pacemaker if she has cancer and that panels of bureaucrats will be determining what care is appropriate for people based upon mortality tables. These could very well be termed death panels and would be necessary in any government run scheme, if the goal is to reduce costs.

All I want is for my doctor and family to be first in line in making medical decisions.

282 Buck  Fri, Aug 21, 2009 11:33:26am
The Democrats promise that a government health care system will reduce the cost of health care, but as the economist Thomas Sowell has pointed out, government health care will not reduce the cost; it will simply refuse to pay the cost. And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care. Such a system is downright evil.

- Sarah Palin
Emphasis mine.

Nothing to do with end of life counselling.

283 SasquatchOnSteroids  Fri, Aug 21, 2009 11:33:31am

re: #279 Racer X

LGF is wonky. Pages won't load; new comments button just teases me.

just me?

Ok for me.

284 Desert Dog  Fri, Aug 21, 2009 11:33:38am

re: #279 Racer X

LGF is wonky. Pages won't load; new comments button just teases me.

just me?

Me too, i switched to Safari to see if it helps

285 Ben Hur  Fri, Aug 21, 2009 11:33:55am

re: #277 SasquatchOnSteroids

How's Mrs. Hur doin' stud ?

Sending you out for pickle and peanut butter ice cream yet ?

Watermelon.

Weird.

Otherwise she's doing great! Thanks!

286 Syrah  Fri, Aug 21, 2009 11:34:19am

Putting politicians in charge of health care.

Nothing could go wrong with that now could it?

287 MikeAlv77  Fri, Aug 21, 2009 11:34:29am

re: #279 Racer X

LGF is wonky. Pages won't load; new comments button just teases me.

just me?

I am getting the same thing.. Press new comments and it just spins.

288 wahabicorridor  Fri, Aug 21, 2009 11:34:30am

re: #279 Racer X

LGF is wonky. Pages won't load; new comments button just teases me.

just me?

nope. I started noticing crappy behavior yesterday.

289 jamgarr  Fri, Aug 21, 2009 11:35:10am

re: #279 Racer X
no - it gets all wee-weed

290 Cato the Elder  Fri, Aug 21, 2009 11:35:31am

re: #270 Flyovercountry

This woman is well read and polished.

Oh, what would I not give to have a peep at her library.

291 Spider Mensch  Fri, Aug 21, 2009 11:35:45am

re: #272 Ojoe

That won't go over with the "can't stand religion" Lefties.

I detect the wafting vapors of One Term President more and more these days.

I'm getting that sense also..and for the life of me I thought he was a lock for 8 years...maybe I'm wrong...but oblama and his admin are looking like the bunch of rank amatuers many here saw way before the election...this health bill and it's possible failure could mean 1 term for him...even his little program cash for clunkers turned out to be a mess basically, at least for the dealers, so if he can't get this bill passed, he could be a one termer for sure. but that of course depends also on the repubs putting upa capable candidate. whomever that may be.

292 Lynn B.  Fri, Aug 21, 2009 11:35:51am

re: #279 Racer X

LGF is wonky. Pages won't load; new comments button just teases me.

just me?

Nope.

293 reine.de.tout  Fri, Aug 21, 2009 11:35:58am

re: #248 Fat Bastard Vegetarian

A few years ago, my mom (who is currently kicking cancers ass all over the floor) and dad and my brothers and sisters were all in the same place.

Out of nowhere, the smartest of the six children (ahem...) brought up mom and dads wishes for their end of days.

The drama queen (the oldest freaked out and ran out of the room) came back in ten minutes later and we had a very measured frank discussion.

All six of us know exactly where both of them stand on all of their "end of life" issues.

The smartest of the six children (ahem... again) was thanked profusely for bringing it up.

It is the "elephant in the room" that many families ignore, but, once it is brought up, is actually very educational... and the right thing to do.

Even for the Drama Queen.

My parents talked with all of us about this; and actually, 10 years before either of them was sick, my mom went to her back and to her investment fund, and had me listed as a co-signer (not co-owner), but I could sign checks and draw money from the investment account if needed to take care of them, plus I had power of attorney. All of that saved having to wait for some sort of court order to allow somebody access to those funds to pay their bills and keep things going for them.

294 kansas  Fri, Aug 21, 2009 11:36:15am

re: #87 Charles

Medicare is already giving end of life care:

[Link: www.urban.org...]

Medicare paid 6000 per month for over a year for my Mom's Hospice care.

295 Cato the Elder  Fri, Aug 21, 2009 11:36:31am

re: #269 Slumbering Behemoth

Dressed up like hitler, pulling burnt jew-cookies out of an oven...

I'm sure you've heard this before.

Shakes head...sorry...I thought you were talking about Sarah.

296 wahabicorridor  Fri, Aug 21, 2009 11:36:33am

re: #277 SasquatchOnSteroids

How's Mrs. Hur doin' stud ?

Sending you out for pickle and peanut butter ice cream yet ?

Great. Now the mocha frap ice cream is calling my name.

I hate you.

297 Kragar  Fri, Aug 21, 2009 11:36:40am

My LGF just crapped out, had to refresh page

298 Digital Display  Fri, Aug 21, 2009 11:36:50am

Phil over at Bad Astronomy just destroys a Young Earth Creationist From a Boston Lecture...
[Link: blogs.discovermagazine.com...]

299 Danny  Fri, Aug 21, 2009 11:37:00am

re: #281 debutaunt

All I want is for my doctor and family to be first in line in making medical decisions.

A legit concern if you ask me. From HR3200 p. 421-432:

‘‘(A) IN GENERAL.—For purposes of re-
porting data on quality measures for covered
professional services furnished during 2011 and
any subsequent year, to the extent that meas-
ures are available, the Secretary shall include
quality measures on end of life care and ad-
vanced 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.

‘‘(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 profes-
sionals to use to submit data to the Secretary.
The Secretary shall provide for a period of pub-
lic comment on such set of measures before fi-
nalizing such proposed measures.’’.

300 ray2  Fri, Aug 21, 2009 11:37:17am

Still looking into the "Hike & Bike" trails in the health bill. They are a means to a healthy life, BUT, this is Not the Bill to Pay for Them.

301 SasquatchOnSteroids  Fri, Aug 21, 2009 11:38:15am

re: #285 Ben Hur

Watermelon is awesome. Cantaloupe is better.
Now I'm humgry.

302 doppelganglander  Fri, Aug 21, 2009 11:38:23am

re: #248 Fat Bastard Vegetarian

I didn't know about your mom. Best wishes for her continued ass-kicking of the disease.

303 BlueCanuck  Fri, Aug 21, 2009 11:38:40am

re: #295 Cato the Elder

Oh, btw you do realize that the gun and flag bikini picture was photoshopped right?

304 [deleted]  Fri, Aug 21, 2009 11:38:58am
305 Kragar  Fri, Aug 21, 2009 11:39:23am

Obama to finance offshore drilling...in Brazil

The U.S. is going to lend billions of dollars to Brazil's state-owned oil company, Petrobras, to finance exploration of the huge offshore discovery in Brazil's Tupi oil field in the Santos Basin near Rio de Janeiro. Brazil's planning minister confirmed that White House National Security Adviser James Jones met this month with Brazilian officials to talk about the loan.

The U.S. Export-Import Bank tells us it has issued a "preliminary commitment" letter to Petrobras in the amount of $2 billion and has discussed with Brazil the possibility of increasing that amount. Ex-Im Bank says it has not decided whether the money will come in the form of a direct loan or loan guarantees. Either way, this corporate foreign aid may strike some readers as odd, given that the U.S. Treasury seems desperate for cash and Petrobras is one of the largest corporations in the Americas.

306 Racer X  Fri, Aug 21, 2009 11:39:48am

re: #303 BlueCanuck

Oh, btw you do realize that the gun and flag bikini picture was photoshopped right?

You're ruining it.

307 Occasional Reader  Fri, Aug 21, 2009 11:40:06am

A truly great government health care program would include meaning of life counseling.

/

308 Dr. Shalit  Fri, Aug 21, 2009 11:40:21am

Ok Everyone -

As was said years ago - "Politics 'Ain't Beanbag." I see former Governor Palin's comments in the same light as years back when a Democratic Congressional Majority called a GOP Proposal for a slower rate in the increase of Social Security benefits a "CUT" and campaigned against it.
Doesn't feel good, does it, when someone on the other side with talent and a following "dishes it back." Sarah Palin framed the debate, and WON it - FULL STOP. Something unusual on domestic issues for a Republican to have done.

That said, end of life counseling happens anyway, for patients, their families and close friends - went through it at the end of this past April and first week of May - not fun, and necessary nonetheless. The argument really is about subsidizing the counseling. Remember, whatever you want "more of" - Subsidize it, "Less Of" - TAX IT.

-S-

309 karmic_inquisitor  Fri, Aug 21, 2009 11:40:28am

re: #287 MikeAlv77

I am getting the same thing.. Press new comments and it just spins.

Stinky is experimenting with the new Dirvish Scripting functionality.

/noticed it too, but I generally have funkiness at LGF on Firefox - scripts sometimes timeout, especially after using ctrl-f to find text on the page.

310 Kosh's Shadow  Fri, Aug 21, 2009 11:40:35am

re: #304 buzzsawmonkey

Carnegie melons are too rich for me.

Honey, dew you think we really need a melon pun thread.

311 [deleted]  Fri, Aug 21, 2009 11:40:41am
312 Occasional Reader  Fri, Aug 21, 2009 11:40:50am

re: #304 buzzsawmonkey

Carnegie melons are too rich for me.

"Carnegie Melons" would be a great stage name for a very high-class stripper.

313 kansas  Fri, Aug 21, 2009 11:41:11am

re: #307 Occasional Reader

A truly great government health care program would include meaning of life counseling.

/

Make them watch Monty Python?

314 Charles Johnson  Fri, Aug 21, 2009 11:41:17am

The web server had a little hiccup and restarted itself...

315 Fat Bastard Vegetarian  Fri, Aug 21, 2009 11:41:27am

re: #302 doppelganglander

Thanks. Got a call a few minutes ago. Her CA125 (I think that's what it is) is down to 29. Hell, that's probably lower than mine.

316 Kosh's Shadow  Fri, Aug 21, 2009 11:41:29am

re: #309 karmic_inquisitor

Stinky is experimenting with the new Dirvish Scripting functionality.

/noticed it too, but I generally have funkiness at LGF on Firefox - scripts sometimes timeout, especially after using ctrl-f to find text on the page.

I've had this for a couple of days. If I have something to post, I can copy it and refresh, otherwise just refresh, and the problem goes away.

317 doppelganglander  Fri, Aug 21, 2009 11:41:42am

re: #309 karmic_inquisitor

Stinky is experimenting with the new Dirvish Scripting functionality.

/noticed it too, but I generally have funkiness at LGF on Firefox - scripts sometimes timeout, especially after using ctrl-f to find text on the page.

I have that problem constantly. Firefox also crashes on me up to 5 or 6 times a day, especially when I have LGF open (which is most of the time). I'm in Safari now and I hate the way it looks, but it's working fine. Meanwhile, I've got Firefox open for other things and it's much more stable than usual.

318 Rexatosis  Fri, Aug 21, 2009 11:41:48am

While much is being debated about the exact meaning of "end of life counseling" and whether the debate over interpretation of the terms in the House Bill are over reactions or not my position on this is that I do not trust the Congress, President, or Courts regarding any benign interpretation of "end of life counseling." I have good reason for this position. When I was younger everyone seemed to have a specific understanding of what "public use" was. Now "public use" is "public benefit" and the protection of one's property against arbitrary government seizure is much less than it once was. Don't believe me I can show you some lovely weed covered property seized in New London, Connecticut where such was the case. Now I am supposed to trust this same government as they take a step towards a "Logan's Run" disutopia with my life. No way. Burn me once shame on you, burn me twice shame on me.

319 [deleted]  Fri, Aug 21, 2009 11:41:50am
320 kansas  Fri, Aug 21, 2009 11:42:10am

re: #307 Occasional Reader

A truly great government health care program would include meaning of life counseling.

/

Also would include what the fuck does this 1017 page bill mean?

321 DaddyG  Fri, Aug 21, 2009 11:42:22am

re: #314 Charles

The web server had a little hiccup and restarted itself...

Did the routine get end of life counseling?

322 Occasional Reader  Fri, Aug 21, 2009 11:42:22am

re: #311 buzzsawmonkey

I had no idea you were a Tao-and-spend kind of guy.

Keep that up, wise guy, and you'll have to figure out "what is the sound of one foot kicking your ass"!

/

323 doppelganglander  Fri, Aug 21, 2009 11:42:59am

re: #315 Fat Bastard Vegetarian

Thanks. Got a call a few minutes ago. Her CA125 (I think that's what it is) is down to 29. Hell, that's probably lower than mine.

Not sure what that means, but it sounds good. I lost my sister to breast cancer a few months ago and I gotta say, cancer sucks. I'm walking the 3 Day in her memory in October.

324 Kenneth  Fri, Aug 21, 2009 11:43:02am

re: #304 buzzsawmonkey

nice melons

maybe NSFW, maybe ok

325 Lynn B.  Fri, Aug 21, 2009 11:43:13am

re: #299 Danny

A legit concern if you ask me. From HR3200 p. 421-432:

‘‘(A) IN GENERAL.—For purposes of re-
porting data on quality measures for covered
professional services furnished during 2011 and
any subsequent year, to the extent that meas-
ures are available, the Secretary shall include
quality measures on end of life care and ad-
vanced 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.

‘‘(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 profes-
sionals to use to submit data to the Secretary.
The Secretary shall provide for a period of pub-
lic comment on such set of measures before fi-
nalizing such proposed measures.’’.

Do you understand that all this provision does is add to the data already required to be reported by health care providers under the Physician Quality Reporting Initiative which was part of the 2006 Tax Relief and Health Care Act enacted, obviously, under the Bush administration?

It has NOTHING WHATSOEVER to do with the government making medical decisions. NOTHING.

326 karmic_inquisitor  Fri, Aug 21, 2009 11:43:15am

re: #305 Kragar (Proud to be Kafir)

Obama to finance offshore drilling...in Brazil

Perhaps drilling in Brazil was ahta he ahd in mind when this happened.

327 Cato the Elder  Fri, Aug 21, 2009 11:43:26am

re: #303 BlueCanuck

Oh, btw you do realize that the gun and flag bikini picture was photoshopped right?

But the one of her strangling a wolf cub while its dying mother howled from beneath a chopper's landing rails was not.

328 wahabicorridor  Fri, Aug 21, 2009 11:43:35am

re: #316 Kosh's Shadow

Since yesterday, I've been agetting a pop-up every now and then that says there is a script running that may slow down IE - and sometimes it even closes down IE. Also, there is just the slightest delay in the appearance of what I type.

329 lawhawk  Fri, Aug 21, 2009 11:43:53am

re: #322 Occasional Reader

Keep that up, wise guy, and you'll have to figure out "what is the sound of one foot kicking your ass"!

/

Who are you? Red Foreman?

Youtube Video
330 Occasional Reader  Fri, Aug 21, 2009 11:44:06am

re: #326 karmic_inquisitor

Perhaps drilling in Brazil was ahta he ahd in mind when this happened.

Heh.

The link doesn't work for me, but I already know what the photo is...

331 Kragar  Fri, Aug 21, 2009 11:44:17am

re: #326 karmic_inquisitor

Perhaps drilling in Brazil was ahta he ahd in mind when this happened.

Isn't drilling in Brazil what got Sanford in trouble?

/

332 reine.de.tout  Fri, Aug 21, 2009 11:44:24am

re: #323 doppelganglander

Not sure what that means, but it sounds good. I lost my sister to breast cancer a few months ago and I gotta say, cancer sucks. I'm walking the 3 Day in her memory in October.

CA125 is a marker for ovarian cancer (which is what my mom died from).
The lower, the better.
I have mine checked every 6 months. No probs yet.

333 Danny  Fri, Aug 21, 2009 11:44:57am

BTW, I answered part of my own question. HR 3200 amends Medicare with added end-of-life benefits and/or regulations (I say "or" because it's unclear if any benefits are actually added).

334 Lincolntf  Fri, Aug 21, 2009 11:45:25am

This little bill got exposed
This little Senate said no
This little Speaker got owned
And this little President went
Wee wee wee all the way home...

335 Racer X  Fri, Aug 21, 2009 11:45:32am

re: #331 Kragar (Proud to be Kafir)

Isn't drilling in Brazil what got Sanford in trouble?

/

Rimshot!

336 kynna  Fri, Aug 21, 2009 11:45:39am

re: #282 Buck

The Democrats promise that a government health care system will reduce the cost of health care, but as the economist Thomas Sowell has pointed out, government health care will not reduce the cost; it will simply refuse to pay the cost. And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care. Such a system is downright evil.

- Sarah Palin
Emphasis mine.

Nothing to do with end of life counselling.

Shush! Nobody wants to acknowledge that. How dare you pull this out during an honest debate? ///

337 wintercat  Fri, Aug 21, 2009 11:45:52am

I have always wanted the government (no matter who is in power) to stay out of my life as much as possible. My feelings regarding this haven't changed with the health care bill except that I feel I now need to stipulate that I want the government to stay out of my death as well.

338 Occasional Reader  Fri, Aug 21, 2009 11:46:03am

re: #331 Kragar (Proud to be Kafir)

Isn't drilling in Brazil what got Sanford in trouble?

/

Argentina, boludo!

339 karmic_inquisitor  Fri, Aug 21, 2009 11:46:09am

re: #317 doppelganglander

I have that problem constantly. Firefox also crashes on me up to 5 or 6 times a day, especially when I have LGF open (which is most of the time). I'm in Safari now and I hate the way it looks, but it's working fine. Meanwhile, I've got Firefox open for other things and it's much more stable than usual.

I was using Chrome for a few days but it would get freaked out on LGF after I used the ctrl-f even once. I would start typing a comment and then the whole page would refresh after the second "i" char was entered in the comment box. Got to where I'd paste in the comment from an editor. Then I just went back to Firefox.

340 Kragar  Fri, Aug 21, 2009 11:46:31am

re: #338 Occasional Reader

Argentina, boludo!

same difference :P

341 SixDegrees  Fri, Aug 21, 2009 11:46:35am

re: #4 Kreuzueber Halbmond

End of life - beginning of death - we don't need government bureaucrats to talk to us about it.

Apparently, we need someone to talk to us about it. The number of people who don't have wills, powers of attorney, medical powers of attorney and end of life procedures drawn up with responsible parties designated to act on their behalf in the event of sudden death or incapacitation is absolutely staggering, and it far too often leads to events taking a turn directly opposed to a person's wishes and leading to horrendous personal tragedy for survivors. One need look no further than the Schiavo case to see what a miserable outcome can occur, that could have been completely prevented by an hour or two of consultation and thought.

342 Dr. Shalit  Fri, Aug 21, 2009 11:46:37am

re: #314 Charles

The web server had a little hiccup and restarted itself...

Charles -

Which Hamster called the "Rulebook Slowdown?"

-S-

343 doppelganglander  Fri, Aug 21, 2009 11:46:46am

re: #332 reine.de.tout

CA125 is a marker for ovarian cancer (which is what my mom died from).
The lower, the better.
I have mine checked every 6 months. No probs yet.

That's good. Ovarian cancer sucks even more than breast cancer, IMO, because it so often goes undetected until a very late stage. Do they recommend that test for all women after a certain age, or only if you have a family history?

344 karmic_inquisitor  Fri, Aug 21, 2009 11:47:38am

re: #330 Occasional Reader

Heh.

The link doesn't work for me, but I already know what the photo is...

This one should work.

Image: gallery_main_annalynne_mccord_nice_ass_11.jpg

345 Slumbering Behemoth Stinks  Fri, Aug 21, 2009 11:47:58am

re: #295 Cato the Elder

It's too late, the damage is done. Report immediately to your local authorities so that you may begin you six month sentence in pr0n hell for the offense of inserting the image of a bikini clad Barr into my head.

346 kynna  Fri, Aug 21, 2009 11:48:09am

re: #308 Dr. Shalit

Palin didn't win anything. Those who changed the debate based on the two words "death panel" won. We haven't had the debate that should have happened and it's not likely we will at this rate.

347 DaddyG  Fri, Aug 21, 2009 11:48:28am

re: #327 Cato the Elder

Dude.

Youtube Video
348 jcm  Fri, Aug 21, 2009 11:49:37am

re: #307 Occasional Reader

A truly great government health care program would include meaning of life counseling.

/

re: #320 kansas

Also would include what the fuck does this 1017 page bill mean?

It would be a 42 page bill.

349 reine.de.tout  Fri, Aug 21, 2009 11:49:48am

re: #343 doppelganglander

That's good. Ovarian cancer sucks even more than breast cancer, IMO, because it so often goes undetected until a very late stage. Do they recommend that test for all women after a certain age, or only if you have a family history?

It's what my mom died from.
And you are correct, it often goes undetected until late, and because the symptoms are similar to other things - her doctor was treating her for acid reflux for at least 9 months prior to her diagnosis. By the time they made the diagnosis, she was 3 weeks away from death. It was just too late.

350 Dr. Shalit  Fri, Aug 21, 2009 11:49:52am

re: #346 kynna

kynna -

We shall respectfully disagree on this issue. That is all.

-S-

351 The 1SG  Fri, Aug 21, 2009 11:51:14am

I am not sure I understand the need for these "double underlined" words that are links to an alternate site. Is this necessary? Mostly because once your whisked away, like a stupid tourist hiking next to a dictatorial country, you can't get back using any back button.

352 Slumbering Behemoth Stinks  Fri, Aug 21, 2009 11:51:43am

re: #329 lawhawk

Mistlefoot FTW! Red is awesome.

353 NJDhockeyfan  Fri, Aug 21, 2009 11:52:04am

"Wee wee" is also a Nigerian slang name for pot.

In Nigeria cannabis is known by various names including "pot", "igbo", "wee wee", "marijuana", "ganja" and "Morocco". The active ingredient in all of these is tetrahydrocannabinol (THC). The mode of consumption in Nigeria is by smoking the prepared leaves and flowering seeds. There has been no reported use of other preparations.

354 The 1SG  Fri, Aug 21, 2009 11:52:16am

And good luck getting the consulate to help you out,

355 Cato the Elder  Fri, Aug 21, 2009 11:52:39am

re: #345 Slumbering Behemoth

It's too late, the damage is done. Report immediately to your local authorities so that you may begin you six month sentence in pr0n hell for the offense of inserting the image of a bikini clad Barr into my head.

As your friend, I recommend immediate intraretinal infusions of Laetitia Casta as the safest, fastest, most reliable remedy.

356 doubter4444  Fri, Aug 21, 2009 11:53:07am

re: #325 Lynn B.

Do you understand that all this provision does is add to the data already required to be reported by health care providers under the Physician Quality Reporting Initiative which was part of the 2006 Tax Relief and Health Care Act enacted, obviously, under the Bush administration?

It has NOTHING WHATSOEVER to do with the government making medical decisions. NOTHING.

That doesn't matter anymore.
It's like a fun-house mirror, the whole debate has gone pear shaped.
Reality is what people want it to be.

357 kansas  Fri, Aug 21, 2009 11:53:20am

re: #348 jcm

It would be a 42 page bill.

I think the complexity of the language of HR 3200 is adding to the confusion, as we can cut and paste sections and disagree as to what they mean, which means that will happen when the bill is enacted. Then there are other versions of bills floating around that nobody has read and then there is Obama referring to his plan, but it is isn't clear what plan he means. He can't hold up a plan and quote sections from it when he makes his argument.

358 Occasional Reader  Fri, Aug 21, 2009 11:54:29am

re: #355 Cato the Elder

As your friend, I recommend immediate intraretinal infusions of Laetitia Casta as the safest, fastest, most reliable remedy.

Obligatory upding for any Laetitia link.

359 Slumbering Behemoth Stinks  Fri, Aug 21, 2009 11:55:33am

re: #355 Cato the Elder

Yowza! Nice palette cleanser. Okay, time off for bad behavior.

360 Lynn B.  Fri, Aug 21, 2009 11:56:11am

I need to get to the gym and work off some of this frustration. But before I do ...

You know, it's really really excellent that so many Americans are taking enough interest in this bill to pore over all 1017 pages of it (is that the right number?), although I suspect that a lot of people are cherry-picking what they read and are taking much of it completely out of context. The thing is, though, as I've pointed out here before and with all due respect, reading congressional legislation isn't like reading the front page. You can be really smart and pay a lot of attention, but if you're not used to reading legislative documents and (dare I say) perhaps have had at least a bit of training in doing the same, you're probably going to get a lot of confused and wrong impressions from what you read. And that goes for many of our legislators as well, who do tend to rely on their (legally trained) staff to parse and interpret the bills they're voting on. It's not pretty but, as they say, neither is the making of sausage.

Anyway, for the record, it is my devout wish to see this whole health care reform plan go away just like Hillary's did. I truly believe it's a misguided effort that will dramatically reduce the quality of health care in this country while doing little or (more likely) nothing to reduce costs. Real health care reform is a worthwhile goal. This ain't it. But section 1233 was, IMO, one of the few GOOD things in there. A hollow "victory," indeed.

361 LoquaciousLady  Fri, Aug 21, 2009 11:56:23am

I think we're all aruging the wrong argument.

I don't care if the bill makes us all healthy as horses for free, no end of life counseling, or whatever the beef of the day with the House bill is. I could be the best healthcare ever and give us all free iPhones. I'm still opposed because we loose our freedom over our bodies to choose what is best for ourselves and our families when the government becomes the financier of our healthcare. Sadly I think we lost some freedom when we allowed our employers to be our financiers of healthcare. Most of us no longer pay for the insurance we use, we're stuck with whatever the boss will pay and whatever your HR rep decides he/she likes.

362 doppelganglander  Fri, Aug 21, 2009 11:56:25am

re: #341 SixDegrees

Apparently, we need someone to talk to us about it. The number of people who don't have wills, powers of attorney, medical powers of attorney and end of life procedures drawn up with responsible parties designated to act on their behalf in the event of sudden death or incapacitation is absolutely staggering, and it far too often leads to events taking a turn directly opposed to a person's wishes and leading to horrendous personal tragedy for survivors. One need look no further than the Schiavo case to see what a miserable outcome can occur, that could have been completely prevented by an hour or two of consultation and thought.

Then how about an educational campaign? Government produces PSAs and runs print ads all the time to tell us to eat our veggies, get checked for breast or prostate cancer, stay away from drugs, etc. I'd rather see an effort to raise awareness than have something written into legislation.

363 doppelganglander  Fri, Aug 21, 2009 11:57:28am

re: #349 reine.de.tout

{{{reine}}}

364 Lynn B.  Fri, Aug 21, 2009 11:58:19am

re: #332 reine.de.tout

CA125 is a marker for ovarian cancer (which is what my mom died from).
The lower, the better.
I have mine checked every 6 months. No probs yet.

Sigh. It is not.

[Link: www.snopes.com...]

365 Occasional Reader  Fri, Aug 21, 2009 11:59:25am

re: #359 Slumbering Behemoth

Yowza! Nice palette cleanser. Okay, time off for bad behavior.

The irony: Her last name means "chaste" in Spanish, Portugese and Italian (I don't know about in her native Corsican).

I don't know about you, but her image does not induce chaste thoughts in me.

366 BARACK THE VOTE  Fri, Aug 21, 2009 12:00:46pm

Sorry for the driveby, folks, I'm multitasking. This may have been mentioned already, if so apologies.

In reference to "orders" for life sustaining treatment, what needs to be looked at is sec 5 of 1233 where they are defined. An "order" refers to the orders left by an individual about their preferences regarding treatment. These orders are the product of the end of life counselling, assuming that the individual wants it at all. Their entire purpose is to ensure that the individual's wishes about his treatment be respected, should he become incapacitated. The section also outlines who can sign off on ('witness', basically) those orders: doctors, etc.

‘‘(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—

‘‘(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;

‘‘(ii) effectively communicates the individual’s preferences regarding life sustaining treatment, including an indication of the treatment and care desired by the individual;

‘‘(iii) is uniquely identifiable and standardized within a given locality, region, or State (as identified by the Secretary); and

‘‘(iv) may incorporate any advance directive (as defined in section 1866(f)(3)) if executed by the individual.

This issue has been shamelessly distorted and manipulated by the Republicans. The entire purpose of 1233 was to ensure that end of life counselling would be available to everyone. The AARP wanted this provision.

Now, thanks to the GOP and the general state of our political discourse today, this provision is out. Some "victory".

367 BARACK THE VOTE  Fri, Aug 21, 2009 12:04:57pm

re: #366 iceweasel

One more thing- I'm still amazed at the way the GOP was able to spin this so that the vast majority of Americans now believe that the section was about the exact opposite of reality. This was a provision that intended to safeguard the wishes of the individual at every step regarding treatment-- intended to ensure that each individual had complete say about their treatment in the event of being incapacitated.

Instead, people believe it's about euthanasia and death panels and killing Grandma. Unbelievable.

368 The 1SG  Fri, Aug 21, 2009 12:06:10pm

re: #362 doppelganglander

Ah, yes: the Government, who is poisoning the food with the pesticide of the day and allowing mono-culture to ruin our food stores and the ever present 1970s decree to farming "get big or get out" mantra. This is the real reason we should be wary about letting anyone who we can't put a hand on decide what choices we make in our health.

I support free health care. A lot of pit falls to be sure. But we can just look around and see what has worked and not worked. US Army (biggest employer) has free health care, doesn't do too badly. Not great but not so bad, don't confuse it with the VA (another animal all together).

Taiwan has free health care, not to bad but has problems as well. Probably fairs better than most.

We have mandatory schooling (some to well others not so much) mandatory legal representation so why not health care?

May not be the right time or right way now. But we got to start somewhere.

369 LoquaciousLady  Fri, Aug 21, 2009 12:07:54pm

re: #368 The 1SG

Ah, yes: the Government, who is poisoning the food with the pesticide of the day and allowing mono-culture to ruin our food stores and the ever present 1970s decree to farming "get big or get out" mantra. This is the real reason we should be wary about letting anyone who we can't put a hand on decide what choices we make in our health.

I support free health care. A lot of pit falls to be sure. But we can just look around and see what has worked and not worked. US Army (biggest employer) has free health care, doesn't do too badly. Not great but not so bad, don't confuse it with the VA (another animal all together).

Taiwan has free health care, not to bad but has problems as well. Probably fairs better than most.

We have mandatory schooling (some to well others not so much) mandatory legal representation so why not health care?

May not be the right time or right way now. But we got to start somewhere.

I grew up as a military brat, and believe me you do NOT want what they get.

370 kreuzueber halbmond  Fri, Aug 21, 2009 12:08:07pm

re: #341 SixDegrees

Apparently, we need someone to talk to us about it. The number of people who don't have wills, powers of attorney, medical powers of attorney and end of life procedures drawn up with responsible parties designated to act on their behalf in the event of sudden death or incapacitation is absolutely staggering, and it far too often leads to events taking a turn directly opposed to a person's wishes and leading to horrendous personal tragedy for survivors. One need look no further than the Schiavo case to see what a miserable outcome can occur, that could have been completely prevented by an hour or two of consultation and thought.

It's a personal and family issue, and people should not expect or hope for government to play a role. That's not to say people shouldn't be taking care of their responsibilities either. Schiavo should be an object lesson in that regard.

371 The 1SG  Fri, Aug 21, 2009 12:09:29pm

re: #369 LoquaciousLady

Ditto, and then 22 years Army. Got banged up along the way. Some areas are better than others. Let just say you get what you pay for.

372 LoquaciousLady  Fri, Aug 21, 2009 12:11:28pm

I remember being a little girl with a "girl" problem. I was seem by a different doc every time. Every visit was a 1-2 hour wait in the waiting room, followed by 45-60 minutes in the exam room followed by a 2-3 hour wait in the pharmacy area for the prescription. Consequently I think I saw a doctor about 5 times before I was 18.

373 Lynn B.  Fri, Aug 21, 2009 12:14:07pm

re: #362 doppelganglander

Then how about an educational campaign? Government produces PSAs and runs print ads all the time to tell us to eat our veggies, get checked for breast or prostate cancer, stay away from drugs, etc. I'd rather see an effort to raise awareness than have something written into legislation.

But Medicare and Medicaid already reimburses your doctor for telling you eat your veggies, get checked for breast or prostate cancer and stay away from drugs. Are you suggesting that those reimbursements should stop because you can get that information from PSA?

Medicare and Medicaid, being government programs, can only reimburse doctors for services that are "written into legislation." PSAs are no substitute for your own doctor advising you of the existence and medical implications of health care proxies and living wills.

374 The 1SG  Fri, Aug 21, 2009 12:15:37pm

re: #372 LoquaciousLady

At least it wasn't two weeks.

375 Curtain of Oz  Fri, Aug 21, 2009 12:17:52pm

People at these protests (and I) fear the growing specter of socialism - the marriage between the federal government and big business. This does not promote competition, free markets, or efficiency. When criticizing capitalism's so-called structural defect - monopoly - it is wise to bear in mind that no monopoly can exist without the sanction of government. (Doubt that? Name it.) Which makes the situation something other than capitalism. A good article on the subject: [Link: article.nationalreview.com...] Pick up a copy of "Free to Choose," by Milton and Rose Friedman. Turn to the back, to Appendix A. Appendix A is the American Socialist Party Platform of 1928. All 14 points of the platform are listed, with the Friedmans' comments in parentheses. Each one of the 14 points has been adopted by the Democrat Party. Several have been adopted by the Republican Party, as well. Many of the goals that are listed in the platform are now fact. Some, like Social Security and Unemployment Insurance, were enacted quickly; others, like nationalization of the railroads (Amtrak) took far longer, or are as yet only partially accomplished. Look at the list of the ten cities with the highest percentage of people living below the poverty line. What do all ten have in common? Long-time Democrat Party rule. Now one could say that Democrat Party rule helped to cause this impoverishment - and I do - but what is more germane and less remarked upon is that once these cities were rendered economic basket cases, the Democrat Party became supreme, virtually unchallenged. Ponder this: "The Government breaks your leg, hands you a crutch and then says, "See! Without me you couldn't walk!" That's the future coming to you. Do not gloss over the "partisan" differences in an attempt to find "common ground." You will be selling out millions of your fellow Americans, misguided people who were first deceived into supporting Democrats, then pauperized by Democrats, and finally made utterly dependent on Democrats. You can mix one gallon of chocolate ice cream with one gallon of vanilla ice cream. They are basically the same. What do you get when you mix one gallon of vanilla ice cream with one gallon of cow manure? The mixture will taste a lot more like cow manure than like ice cream, won't it? Witness what is going on in Washington. Let me quote Benjamin Franklin "When the people find they can vote themselves money, that will herald the end of the republic." I have issue with the erosion of personal liberty and the destruction socialism will bring to this country.

376 BARACK THE VOTE  Fri, Aug 21, 2009 12:18:32pm

re: #373 Lynn B.

Excellent comment Lynn, totally agree. Also loved your 360 as well.

Don't know if people have seen this, but Joe Klein has a good piece (for a change) in Time about the end of life provision and the GOP. He talks about his family as well and it's a good illustration IMO.


The GOP Has Become a Party of Nihilists

In one of those awful collisions between public policy and real life, I was in the midst of an awkward conversation about end-of-life issues with my father when Sarah Palin raised the remarkable idea that the Obama Administration's attempt to include such issues in its health-care-reform proposal would lead to "death panels."

377 turn  Fri, Aug 21, 2009 12:19:57pm

turn had to pull the plug on dad. He was in the hospital for congestive heart failure and was due to be released in a few days. They were going to have him tote one of those little oxygen bottles around. Well it turns out he had a heart attack before his release (I think he willed it upon himself) and the doctor worked on him for over an hour before they could restore his heart beat. I'm sure the doctor thought he was doing the best thing but guess what? He was brain dead after that long. That evening my brother and I pondered his fate over the living will he had left behind. We agreed to remove him from life support and called the hospital and spoke with his doctor. He told us he would consult with some other doctors and meet with us in the morning. I cried in the shower that morning, the absolutely most difficult decision I will ever make. At the hospital the doctors spoke with us and concurred. Then they asked us if we would like to see him one more time, and we did (dang just writing this is making me tear up). I'll never forget seeing him lying there lifeless with all those wires and pumps hooked up to him. They removed him from life support after we left and he passed a few hours later. I don't ever regret making that decision, but it was tough let me tell you.

378 BARACK THE VOTE  Fri, Aug 21, 2009 12:23:43pm

re: #377 turn
Much hugs to you {turn}.

I don't think people understand what it's like until they have to go through it. My dad hadn't left any instructions. It was very hard.

love, ice

379 korla pundit  Fri, Aug 21, 2009 12:24:14pm

The "death panel" is not about end-of-life counseling. That is a great deflection, though!

The problem is with the unelected and unaccountable commissions being set up (in current versions of the "bill") to decide who will get life-extending treatment and who will be allowed to die without treatment because of their diminished "value as a contributing member of society" as the plan's architect put it.

There are such commissions (or panels, if you will) in the UK system, that decide how much a human life is worth, and whether it is worth giving a transplant to somebody who may only live a few more years. How much is a year of somebody's life worth?

Mine is worth a great deal to me and my family. But it's not worth a dime to a Democratic bureaucracy that has already shown no compunctions about abusing their power over the system to punish people who have political differences or who embarrass them by pointing out the holes in their propaganda.

That's why NO government should have this level of absolute power over an individual's life and death. The darn government is already corrupted absolutely; it doesn't need any more motivation.

380 Rancher  Fri, Aug 21, 2009 12:47:46pm

In my mind the death panels have nothing to do with the end of life counseling. What the death panels consists of are the bureaucrats who will set policy on how and to whom scarce medical resources are allocated. I would argue that taking life and death economic decisions about rationing finite resources out of the free market and placing them in governmental control, i.e. socialism as opposed to capitalism, amounts to a more costly and less efficient allocation of resources and that's basically where my opposition to the President's plan lies. Joseph Ashby at American Thinker points out that death panels are already here, they came with that stimulus bill that no one read.

H.R. 1 (more commonly known as the Recovery and Reinvestment Act, even more commonly known as the Stimulus Bill and aptly dubbed the Porkulus Bill) contains a whopping $1.1 billion to fund the Federal Coordinating Council for Comparative Effectiveness Research. The Council is the brain child of former Health and Human Services Secretary Nominee Tom Daschle. Before the Porkulus Bill passed, Betsy McCaughey, former Lieutenant governor of New York, wrote in detail about the Council's purpose.
Daschle's stated purpose (and therefore President Obama's purpose) for creating the Council is to empower an unelected bureaucracy to make the hard decisions about health care rationing that elected politicians are politically unable to make. The end result is to slow costly medical advancement and consumption. Daschle argues that Americans ought to be more like Europeans who passively accept "hopeless diagnoses."

McCaughey goes on to explain:

Daschle says health-care reform "will not be pain free." Seniors should be more accepting of the conditions that come with age instead of treating them.
381 scogind  Fri, Aug 21, 2009 12:54:49pm

Lo, There Do I See My Father…
Lo, There Do I See My Mother…
And My Sisters and My Brothers…
Lo, There Do I See The Line
Of My People Back to the Beginning…
They Do Bid Me To Take My Place Among Them…
In The Halls of Valhalla
Where The Brave May Live Forever

382 reine.de.tout  Fri, Aug 21, 2009 1:09:00pm

re: #364 Lynn B.

Sigh. It is not.

[Link: www.snopes.com...]

Interesting! Probably why my doctor also does an ultrasound every 6 months.

383 Korla Pundit  Fri, Aug 21, 2009 1:14:47pm

Beyond the scary potential of a government monopoly controlling healthcare (and it WILL become a monopoly despite all the lies of the current President), this mad rush to take over such a huge chunk of our economy will result in horrible side effects.

There will be greatly diminished incentive to become a doctor, as great minds do not generally like working for a bureaucracy, which specializes in limiting, not promoting, innovation. Add to this the racial quotas that medical schools and hospitals will be forced to adhere to, and you will see quality of doctors decline precipitously.

Therapeutic and procedural innovations that currently benefit not just the U.S., but the whole world, will cease.

The ability to work outside the system, to pay out of pocket, will be taken away, just as it has been illegalized in Canada. If you want care that the government won't pay for, you are out of luck. You will be prosecuted for seeking it. When the government decides you should "accept" your death, nay, embrace it, then you damn well better accept it.

As such, all those hapless Europeans and Canadians who come here to escape their states' draconian limits on healthcare will also finally have to accept their own demise.

Unless they are illegal aliens. Or looking to get an abortion.

384 victor_yugo  Fri, Aug 21, 2009 1:26:21pm

Late to the conversation.

I'd like a "reasoned discussion," as well, but if the Libs were interested in "reason," they wouldn't be touting this nanny-state bullshit, which has been proven over and over to be detrimental to a population's health.

In their world, "compromise" applies only to conservatives. I'm grateful for the conservatives who are refusing to back down.

385 ckb  Fri, Aug 21, 2009 1:28:35pm

re: #230 Cato the Elder

There was a time when I thought that even America could not be that lost to imbecility.

Given the number of people who admire and support the Quitta from Wasilla even here, in a crowd not known for brainlessness, I am no longer sure.

Unfortunately we cannot pick the leaders we want, but instead must choose among the leaders we have.

Contending that a supporter of hers is an imbecile is terribly harsh. Say in an alternate universe she somehow got the nomination and ran vs. Obama in 2008. In choosing among the leaders you had, would you really have come down on the Obama side?

386 S'latch  Fri, Aug 21, 2009 1:28:44pm

Is the health care bill improved by tossing out end of life counseling? Good question. Better yet, would the health care bill improve our system of health care? I don't think it would. So, whether or not the health care bill contains end of life counseling seems unimportant. The fact that the bill is diminished seems like a victory.

387 BARACK THE VOTE  Fri, Aug 21, 2009 1:28:51pm

re: #383 Korla Pundit


Unless they are illegal aliens. Or looking to get an abortion.

Utterly false. No version of the bill will cover illegal aliens.

No Free Care for Illegal Aliens in the HealthCare Bill

And as for abortions, they're only covered to the same extent they always were:

First, we checked a claim by Rep. John Boehner that the plan would require Americans to "subsidize abortion with their hard-earned tax dollars." While there are several versions of the health care plan floating around Congress, and it seems that full abortion coverage would be permitted in the government-sponsored program, we didn't see anything in them that would put taxpayers on the hook for subsidizing abortions. In fact, we found an amendment in a key version of the House plan that specifically seeks to ensure that federal funds are not used to subsidize abortion coverage. And so we ruled that claim False

There are reasonable worries and concerns to have about the health care plans, in particular involving unintended consequences, such as the effect of a public option on private insurance companies. But repeating lies and distortions that are easily debunked, such as above, makes one distrust all of your analysis, quite frankly. If you can't be bothered to use google to factcheck such easily dispovable assertions, it becomes very difficult to take any of your aseertions seriously.

388 Czarny_Smok  Fri, Aug 21, 2009 1:34:23pm

Canadian Helath Care Issues

Sure hope this works, first time I've tried to post a link. Anyway this is from the Vancouver Sun in regards to the issues they are facing with Socialized Health Care

389 Wendya  Fri, Aug 21, 2009 1:36:11pm

Illegals get free care now. That's not going to change. The difference will be they won't be forced to purchase insurance.

What a deal, eh?

390 ckb  Fri, Aug 21, 2009 1:40:01pm

re: #256 Kragar (Proud to be Kafir)

'Romney care' touted as a model for national health care reform

It is worthy to note that the Massachusetts plan is a legally required catastrophic plan - not a HMO. You are forced to pay the premiums if you can afford them. If you cannot they are paid for you. It was made in a partnership with industry, meaning the plans are run by commercial insurance carriers.

I would certainly consider a national version of this. It seems a lot better than showing up at the emergency room with no insurance and looking at dumping the costs the way they are dumped now.

391 [deleted]  Fri, Aug 21, 2009 1:51:35pm
392 Korla Pundit  Fri, Aug 21, 2009 2:32:58pm

> No Free Care for Illegal Aliens in the HealthCare Bill

Of course not. Not after "comprehensive immigration reform" aka Amnesty. Then there won't be any "illegals." Problem solved. Well, that was easy.

You see, illegals already get free health care. And taxpayers are footing the bill. I'm not up in arms about that. I believe in charity, but can we as a nation please get some credit for it? We are diluting our own medical resources and crowding ourselves out of hospital beds with the free treatments such illegals already get. Then, to be called a heartless nation by the Obama crowd, after such immense charity, is maddening.

The policy goal now is not to elevate the care of illegals, the "poor" and the "uninsured" to some ideal level. It is to lower the standards of people who enjoy some level of satisfaction with their current coverage to the lowest denominator. It is also to force those millions who CHOOSE not to spend money on insurance to cough up their hard earned dollars on something they don't feel they need.

Where's the "choice" Obama promises us?

> And as for abortions, they're only covered to the same extent they always were...

I don't buy it, since what is specifically covered by the government plan will be decided by the statist medical politburo, and when they say it's covered, that makes it the law. And they don't have any political worries tempering their decisions. They can't be voted out or fired. And winks have been exchanged between the Administration and Planned Parenthood.

I see a slippery slope toward a China-like policy: One child per couple. No coverage for second children. No coverage for IVF, certainly. Abortion, yes. But that's what the 'right to choose' means these days.

Anybody who believes the promises of these proven liars is a fool.

393 Macker  Fri, Aug 21, 2009 2:34:30pm

re: #391 Billy Bob

Oh Stinky!...

394 Danny  Fri, Aug 21, 2009 2:50:59pm

re: #325 Lynn B.

Do you understand that all this provision does is add to the data already required to be reported by health care providers under the Physician Quality Reporting Initiative which was part of the 2006 Tax Relief and Health Care Act enacted, obviously, under the Bush administration?

It has NOTHING WHATSOEVER to do with the government making medical decisions. NOTHING.

No I did not understand that. I thought it was adding new regulatory guidelines that would need to be followed for coverage. Thanks for enlightening me, though. I'll look into this more closely.

395 tveitskog  Fri, Aug 21, 2009 2:58:04pm

How can Krauthammer have an honest debate without Palin in the room? If it weren’t for Palin there would have never been this much debate.

396 tveitskog  Fri, Aug 21, 2009 3:20:00pm

re: #190 Pianobuff

It’s playing with words for the same result.

397 Chekote  Fri, Aug 21, 2009 3:22:04pm

re: #395 tveitskog

How can Krauthammer have an honest debate without Palin in the room? If it weren’t for Palin there would have never been this much debate.

People started protesting Obamacare BEFORE Palin's Death Panels posts. Let's give credit to the people of the US who organized themselves and started the protests. Palin is like your typical politician who is following public opinion while pretending to be leading it.

398 Chekote  Fri, Aug 21, 2009 3:23:57pm

re: #392 Korla Pundit


They won't have to want for amnesty. Some group will file a lawsuit on behalf of the illegals as soon as the legislation is passed and a judge will force the government to cover illegals.

399 Rancher  Fri, Aug 21, 2009 3:30:09pm

re: #397 Chekote

Let's give credit to the people of the US who organized themselves and started the protests.


Ah yes, the mob, the terrorists, the klansmen, the Nazis, and the un-American.

400 tveitskog  Fri, Aug 21, 2009 3:32:45pm

re: #255 Kenneth

Great article by Palin

401 Rancher  Fri, Aug 21, 2009 3:38:37pm

re: #325 Lynn B.

Do you understand that all this provision does is add to the data already required to be reported by health care providers under the Physician Quality Reporting Initiative which was part of the 2006 Tax Relief and Health Care Act enacted, obviously, under the Bush administration?

It has NOTHING WHATSOEVER to do with the government making medical decisions. NOTHING.

We aren't talking about specific provisions, at least not all of us, we are talking about the rationing of care that will be decided by the government instead of the marketplace. Such rationing will be making decisions affecting what care we get. No one seems to address this. If I am told I can't get a test, or have to wait for x months for a test, or can't get a second opinion, or any of the other snafus on the long list of complaints we hear from Canada or the U.K. will I be able to get it on my own if I am willing to pay for it? Canadians have always had the option to come here and many do. Where will I go?

402 voirdire  Fri, Aug 21, 2009 3:40:59pm

Yes, I'm impressed by the amount of debate the dems wanted at the start of August.

403 Sloppy  Fri, Aug 21, 2009 3:41:10pm

My grown children have assuaged my concerns about end-of-life issues:

"Don't worry, Dad. We won't let you suffer."

Hmmm.

404 tveitskog  Fri, Aug 21, 2009 4:18:19pm

re: #401 Rancher

Interesting article by Andrew C. McCarthy of National Review titled “Killing Obamacare, ‘Death panels’ cuts to the chase, which is the only way Democrats can be stopped.”

405 Charles Johnson  Fri, Aug 21, 2009 4:24:51pm

re: #236 Lynn B.

BTW, this provision of the bill, while it includes end of life counseling, also includes advice and information about things like living wills and health care proxies, things far too few people avail themselves of that have nothing whatsoever to do with "end of life." In fact, every adult should have them.

Totally agree, Lynn. You read it the same way I did -- there's nothing threatening or unusual about that section. That's why I get frustrated when people continue to post things about it that I know are wrong.

406 JacksonTn  Fri, Aug 21, 2009 4:28:37pm

re: #405 Charles

Totally agree, Lynn. You read it the same way I did -- there's nothing threatening or unusual about that section. That's why I get frustrated when people continue to post things about it that I know are wrong.

Charles ... it is really no more invasive than the "smoking" consultations that doctors give now and are paid for ... it is a few minutes of time ... it was just played as a scare tactic ... I have many many issues with the healthcare bill or whatever it is called now but the problem as I see it is that the administration did not address the issue properly when it first came up ... more straight talk as to the real issues to be discussed during a consultation would have gone a long way in the beginning ...

407 BARACK THE VOTE  Fri, Aug 21, 2009 5:25:11pm

re: #406 JacksonTn

... I have many many issues with the healthcare bill or whatever it is called now but the problem as I see it is that the administration did not address the issue properly when it first came up ... more straight talk as to the real issues to be discussed during a consultation would have gone a long way in the beginning ...

But all the straight talk was right there in the bill, for anyone to read.

I certainly won't deny that Democrats excel at shooting themselves in the foot, and the admin probably could have done a better job of tamping down the wingnut hysteria on this--- but let's not put the whole blame on them. The cynical and manipulative pundits and GOP pols, who knew perfectly well what the bill actually said, chose to run with something false-- to get the reaction they wanted. And it worked.

I've nothing against putting blame on the Dems, but at some point shouldn't the Republicans be blamed for their own tactics?

408 JacksonTn  Fri, Aug 21, 2009 5:28:02pm

re: #407 iceweasel

But all the straight talk was right there in the bill, for anyone to read.

I certainly won't deny that Democrats excel at shooting themselves in the foot, and the admin probably could have done a better job of tamping down the wingnut hysteria on this--- but let's not put the whole blame on them. The cynical and manipulative pundits and GOP pols, who knew perfectly well what the bill actually said, chose to run with something false-- to get the reaction they wanted. And it worked.

I've nothing against putting blame on the Dems, but at some point shouldn't the Republicans be blamed for their own tactics?

IW ... I don't care who you want to blame ... does not matter to me ... go for it ...

409 BARACK THE VOTE  Fri, Aug 21, 2009 5:34:58pm

re: #408 JacksonTn

IW ... I don't care who you want to blame ... does not matter to me ... go for it ...

Fair enough, but I think it's odd that the party which lauds personal responsibility has such trouble taking any responsibility, or criticism, ever.

I also think it's really not healthy for either party to only ever blame 'the other side' for everything. It can be emotionally satisfying, but the world's a lot more complicated than that.

That kind of attitude is also a big part of the reason for the current polarisation of our politics.

410 JacksonTn  Fri, Aug 21, 2009 5:38:18pm

re: #409 iceweasel

Fair enough, but I think it's odd that the party which lauds personal responsibility has such trouble taking any responsibility, or criticism, ever.

I also think it's really not healthy for either party to only ever blame 'the other side' for everything. It can be emotionally satisfying, but the world's a lot more complicated than that.

That kind of attitude is also a big part of the reason for the current polarisation of our politics.

IW .. really ... well ... who cares ... they all suck and the far left dems wanted to throw out all the center right in their party ... so I guess they are left with what they have to fight the fight ... I am not one of them ... so I guess you will have to do the heavy lifting ... and I am sure you are able and willing ... so you go for it ...

411 sixoh1  Fri, Aug 21, 2009 5:39:56pm

re: #387 iceweasel

I'm just curious - if there is going to be no coverage for Illegal aliens, why do they keep getting counted in the Uninsured number

Per NPR even this morning
"5 million of those are undocumented"

So now we're down to 41 million, even before we add in the "1 in 5 covered by medicare/medicaid and not enrolled"...

412 sixoh1  Fri, Aug 21, 2009 5:47:46pm

re: #405 Charles

Charles - is there any chance you would be willing to accept the fact that there are separate issues regarding Palin's "death panels" posting? Perhaps by going back to the actual Facebook post text...

It fairly clear in hindsight that she wanted to point out the fact that this medicare-on-steroids proposal will require rationing, and that somewhere, someone will have to make decisions about what is covered and what isnt?

Palin even attempted to clear this up in a later Facebook post about this remarking that "end of life counseling" was NOT what she intended to attack.

I'm entirely with you and many other rational conservatives that believe we SHOULD have end of life counseling to provide succor to those who are dying instead of leaving them without palliative care when they need to know their options. There is absolutely no reason this cannot be reconciled with the fact that rationing must occur under ObamaCare, just as we must all recognize that rationing occurs today, its merely disguised as discrimination between those who are employed and those who are not (ie who has a heath care plan that will pay for experimental Chemo etc.)

While I want end of life counseling, I dont want the US government, or any designated panel of doctors, rationing my healthcare dollars by first taking them from me by force (tax) and then reapportioning them back to me (minus a fee of course) "for your own good".

413 BARACK THE VOTE  Fri, Aug 21, 2009 5:52:35pm

re: #411 sixoh1

I'm just curious - if there is going to be no coverage for Illegal aliens, why do they keep getting counted in the Uninsured number

Because the stats for the uninsured are based on the US Census data-- which includes the illegal aliens. But nothing that's been proposed will cover them, and Obama (and others) have stated that they won't be covered.

This is a good breakdown on where the 46 million number comes from and what it actually means:

hat 46 million number -- which to be exact, is actually 45.7 million -- comes from the U.S. Census Bureau, which releases estimates of the uninsured yearly. That estimate is for 2007, and the data was released in 2008. (The 2008 data is scheduled for release on Sept. 10, 2009.)

The Census Bureau is not the only government agency that collects numbers on the uninsured, but it is often cited because it has the biggest sample, contacting about 97,500 households to ask about their insurance and other factors.

(snip)

Looking back to Obama's statement, though, he said nearly 46 million Americans don't have insurance. Actually, the census data include noncitizens. The Census Bureau breaks out that information and reports that 9.7 million of the uninsured are noncitizens. So the number of Americans without insurance is actually closer to 36 million.

[Link: www.politifact.com...]

414 BARACK THE VOTE  Fri, Aug 21, 2009 5:55:04pm

re: #413 iceweasel

Actually I should amend that-- the Census data includes noncitizens-- who won't be covered. That's different from containing illegal aliens. (Noncitizens will also include people here legally who are not yet naturalised citizens)

415 Promethea  Fri, Aug 21, 2009 6:25:21pm

So . . . my question is: Why do we need a national healthcare system? What's wrong with the current system that can't be fixed by a few laws addressing specific problems that the Big Brains in Congress should be able to describe?

I'm personally tired of all this hysteria regarding healthcare. I'd like to see some effort made before the current national debt triggers runaway inflation. That will wipe me out, and THEN I will need to depend on the kindness of taxpayers.

The national debt is a much more important threat to our well-being as a nation than the flaws in our current healthcare system.

Even Warren Buffet agrees with me, and he was a big Obama supporter.

416 Kaymad  Fri, Aug 21, 2009 6:36:20pm

It's a 'victory' because if I decide I need end of life counseling for myself or a loved one, it's not the governments god-damned business on how I do it or when I do it or if I do it. What's so complicated about that?

417 Billy Bob  Fri, Aug 21, 2009 6:37:30pm

Not sure what this means. Stinky? My coment sucks; what?
Love Billy Bob.
re: #393 Macker

418 Pupdawg  Sat, Aug 22, 2009 5:59:43am

Here are a couple of additional excellent paragraphs from the Krauthammer piece.

"So why get Medicare to pay the doctor to do the counseling? Because we know that if this white-coated authority whose chosen vocation is curing and healing is the one opening your mind to hospice and palliative care, we've nudged you ever so slightly toward letting go.

It's not an outrage. It's surely not a death panel. But it is subtle pressure applied by society through your doctor. And when you include it in a health care reform whose major objective is to bend the cost curve downward, you have to be a fool or a knave to deny that it's intended to gently point you in a certain direction, toward the corner of the sick room where stands a ghostly figure, scythe in hand, offering release."

419 quickjustice  Sat, Aug 22, 2009 6:13:49am

re: #377 turn

My father was a physician and a very tough veteran of WWII. During his last days, he fully understood what was happening to him. He had signed an advance directive (no heroic measures to keep him alive). When his kidneys failed, the hospital put him on dialysis, meaning there were wires and tubes sticking out of him from everywhere. Dialysis is an "heroic", and very expensive, kidney replacement technology without which you die. He woke up, gestured us close, and whispered, "I want to go home."

I turned to the family and said, "He's pulled the trigger." We took him home to die without wires and tubes sticking out of him. He totally controlled the circumstances and timing of his death. As I've said elsewhere, a piper of the Black Watch Regiment piped him to his final rest.

420 Drider  Sat, Aug 22, 2009 7:24:54am

I have always liked alot of what CK says but we have to be honest.

If it wasn't for the tea party/town hall loony, faux Nazi, loud mouthed code pink mirror images, we would already have this abomination of a health care plan passed.
The people are having a debate and have been being the Republican representatives have been completely shut out of voicing any opinions whatsoever.
CK needs to come to grips that the fate of this bill passing is in the hands of the people and so far they have done a bang up job.

421 Alone in NY  Sat, Aug 22, 2009 8:50:30am

Krauthammer is the best journalist out there.

422 Charles Johnson  Sat, Aug 22, 2009 10:22:10am

re: #412 sixoh1

Palin even attempted to clear this up in a later Facebook post about this remarking that "end of life counseling" was NOT what she intended to attack.

Maybe you folks who are trying to make this excuse should let Charles Krauthammer know that he's wrong too.

423 sixoh1  Sat, Aug 22, 2009 1:00:21pm

re: #422 Charles

I'm far less concerned about idiotarians like Krauthammer than about you and the potential for the buzz word fight to drag down the standing of your commentary as serious and valuable - I've come to trust the LGF community and your commentary as sources of sanity in a world gone ridiculous. The idea of bureaucratic rationing is a serious topic that merits serious discussion - all of the sound and fury about the buzzwords allows these health-care "reform" zombies to keep on repeating their mantras, and to me thats the really scary thing going on.

424 DANEgerus  Sat, Aug 22, 2009 5:18:04pm

Sure... there are no "Death Panels"... and the WSJ is totally full of it on the implementation of mandatory "Death book" counseling for our Veterans reinstated by... Barack Hussein Obama.

If President Obama wants to better understand why America's discomfort with end-of-life discussions threatens to derail his health-care reform, he might begin with his own Department of Veterans Affairs (VA). He will quickly discover how government bureaucrats are greasing the slippery slope that can start with cost containment but quickly become a systematic denial of care.

Last year, bureaucrats at the VA's National Center for Ethics in Health Care advocated a 52-page end-of-life planning document, "Your Life, Your Choices." It was first published in 1997 and later promoted as the VA's preferred living will throughout its vast network of hospitals and nursing homes. After the Bush White House took a look at how this document was treating complex health and moral issues, the VA suspended its use. Unfortunately, under President Obama, the VA has now resuscitated "Your Life, Your Choices."

Who is the primary author of this workbook? Dr. Robert Pearlman, chief of ethics evaluation for the center, a man who in 1996 advocated for physician-assisted suicide in Vacco v. Quill before the U.S. Supreme Court and is known for his support of health-care rationing.

"Your Life, Your Choices" presents end-of-life choices in a way aimed at steering users toward predetermined conclusions, much like a political "push poll." For example, a worksheet on page 21 lists various scenarios and asks users to then decide whether their own life would be "not worth living."

The circumstances listed include ones common among the elderly and disabled: living in a nursing home, being in a wheelchair and not being able to "shake the blues." There is a section which provocatively asks, "Have you ever heard anyone say, 'If I'm a vegetable, pull the plug'?" There also are guilt-inducing scenarios such as "I can no longer contribute to my family's well being," "I am a severe financial burden on my family" and that the vet's situation "causes severe emotional burden for my family."

When the government can steer vulnerable individuals to conclude for themselves that life is not worth living, who needs a death panel?

One can only imagine a soldier surviving the war in Iraq and returning without all of his limbs only to encounter a veteran's health-care system that seems intent on his surrender.

I was not surprised to learn that the VA panel of experts that sought to update "Your Life, Your Choices" between 2007-2008 did not include any representatives of faith groups or disability rights advocates. And as you might guess, only one organization was listed in the new version as a resource on advance directives: the Hemlock Society (now euphemistically known as "Compassion and Choices").

How odd Ted Kennedy hasn't been afforded the chance to explore his choices.

425 tobariv  Sat, Aug 22, 2009 9:03:25pm

I worked for the government health system (VA). Dreadful experience. If I wanted to place a patient on a specific medication not on formulary (because it was detrimental to my patient) I had to fill out request forms and go through bureaucratic crap just to get my patient proper anthypertensive medicine. The delay alone to get scans ,EKGs ,surgeries,made me realize they were getting inferior care.

426 claire  Sun, Aug 23, 2009 10:05:16am

I asked a friend who's a VA surgeon about this- I said something like "What's the deal? You guys don't talk to your patients about this now if you don't get paid for it?" He was like- Nonsense-that portion of the bill would have no real effect on doctor/patient conversations. Doctors talk about this stuff anyway with their patients, of course. They'll just bill it under a different code to get reimbursed (like they already do now) if an "end-of-life counseling" code is specifically not available.

427 reaganII  Sun, Aug 23, 2009 9:50:46pm

I've had to make the decision for my mother in final stages of cancer. What I wanted for her was peace, to discontinue research treatments, and she died 3 days later.
When it came time for "the talk" with my dad, we discussed this, made formal legal document to cover what we had talked about. Years later, he had a stroke, DNR (do not resuscitate) was place on his wall in the hospital, when it appeared he would not come out of it. Had one final stroke, did not resuscitate, he wouldn't have wanted to be a vegetable. It was harder to answer for my mother when she was unable to tell us what she wanted, than it was for my dad because he made the decision.
I have the same legal documents for myself.


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