If the government weren’t involved, it seems like a perfectly reasonable thing to plan for. But since it is, for some odd reason, Soylent Green comes to mind.
When a proposal to encourage end-of-life planning touched off a political storm over “death panels,” Democrats dropped it from legislation to overhaul the health care system. But the Obama administration will achieve the same goal by regulation, starting Jan. 1. Under the new policy, outlined in a Medicare regulation, the government will pay doctors who advise patients on options for end-of-life care, which may include advance directives to forgo aggressive life-sustaining treatment.
Congressional supporters of the new policy, though pleased, have kept quiet. They fear provoking another furor like the one in 2009 when Republicans seized on the idea of end-of-life counseling to argue that the Democrats’ bill would allow the government to cut off care for the critically ill.
The final version of the health care legislation, signed into law by President Obama in March, authorized Medicare coverage of yearly physical examinations, or wellness visits. The new rule says Medicare will cover “voluntary advance care planning,” to discuss end-of-life treatment, as part of the annual visit.
Under the rule, doctors can provide information to patients on how to prepare an “advance directive,” stating how aggressively they wish to be treated if they are so sick that they cannot make health care decisions for themselves.
Yes, paying doctors for medical services is just so weird. We should go back to the barter method for advice on end of life care…
#1
Bring a chicken to the doctor?
Note this from the story:
“It will give people more control over the care they receive,” Mr. Blumenauer said in an interview. “It means that doctors and patients can have these conversations in the normal course of business, as part of our health care routine, not as something put off until we are forced to do it.”
and this:
“In a recent study of 3,700 people near the end of life, Dr. Maria J. Silveira of the University of Michigan found that many had “treatable, life-threatening conditions” but lacked decision-making capacity in their final days. With the new Medicare coverage, doctors can learn a patient’s wishes before a crisis occurs.
For example, Dr. Silveira said, she might ask a person with heart disease, “If you have another heart attack and your heart stops beating, would you want us to try to restart it?” A patient dying of emphysema might be asked, “Do you want to go on a breathing machine for the rest of your life?” And, she said, a patient with incurable cancer might be asked, “When the time comes, do you want us to use technology to try and delay your death?”
My mother back 2001 was diagnosed with senile dementia. She was in NO condition to make decisions for herself. I had to. She died in 2002 from a stroke finally. It was the BEST thing that could have happened to her because she was no longer the woman she was.
No one should have to go through that kind of fear and despair as I saw her on my visits. She was not at all happy as she regressed into a fearful child who was haunted by random images and sounds from her past with my father who was the worst person anyone could ever know.
To make choices over your care when you are right in mind and body is far better than letting everything deteriorate into just meat and be at the whims of whomever cares for you. Or in many cases, no one who cares for you.
Cursor_
Right now standard treatment is to use the most technically aggressive treatment methods in ICU to maintain “life” as long as possible, usually delaying death by 2-3 weeks. But the problem is you spend those weeks in extreme pain, barely kept alive, and it costs 2/3rds of your total life’s medical expenses. This isn’t responsible health care, it’s grasping at straws.
This always was such a non-story. I was embarrassed for the Repubs who made it such an issue. There were (and are) so many other more important things wrong with the health care bill.
Hey, any law that requires an additional 16,000 IRS agents to enforce it, has to have a major flaw. Now if it had been 16,000 additional doctors…
Without a “reasonable chance at recovery or stabilization at some functional level” old people/their kiddies/society needs to “get real” and recognize that old people have a duty to die and get out of the way.
Now, I’m still for rich people getting every unrealistic thing they want, so no “forced” government programs here BUT the government shouldn’t be in the business of FORCING continued unwanted painful life on people.
Once that hurdle is cleared, THEN we can start on people choosing to die a few weeks/months earlier than the technology available could avoid.
Its a voluntary euthanasia program a la Soylent Green. Like abortion, the only reason to be against it is religious dogma. You know dogman? Simplistic idea that at its root doesn’t make any sense that people will kill others over? Yes Dogma.
Yea Verily.
Planning ahead is such a strange thing in America, that I’m not surprised that this is an issue. The average American has 1/5 as much saved by retirement age as they will need to live comfortably during retirement, few people have wills, and even fewer have “living wills” where they can determine in advance what will happen to them in case of catastrophic disability. Buy a house with too big a mortgage in 5 years? The American way. Spend until you can’t possibly pay the credit card company fees? Why plan your spending, somehow it will get figured out.
The “end of life” counseling should not only be encouraged, it should be mandatory after certain age and under certain conditions. Preparing a will and a “living will” should be fully tax deductible, and there should be a severe “death tax” penalty for those that do not have a will. You didn’t plan… that will be a 90% tax, thank you.
When you think about it, it is really selfish to leave the final decisions of this type to your “loved ones”… let them fight and agonize over the end of your life, let them fight over your material things. What do you care, you will be dead soon anyway.
Fortunately Big Government is willing and able to help us make the “right” decision and if for some reason we don’t there are forms of gentle persuasion like that 90% tax Awake suggested.
Now if it could only stop my Doctor from putting those “We no longer accept new Medicare patients” signs around his office.
NextLie==good to see you’ve finally come around to supporting single payer. Heh, heh. Imagine: Docs in medicine to provide care rather than to be a millionaire 3 years out of med school: what a concept.
no c in counseling
counsel = advice; a lawyer
council = a tribunal or legislative body
BloHard
It will be single payer all right. That’s the number of people that will be able to afford medical treatment when we get through paying for every lazy ass in the country. You want that life go smoke a cigar with Fidel.
Heh, heh. Live free, cut the safety net!
NextLie–you are so retarded, its cute. Imagine everyone covered by healthcare which in 13 other western countries provides better outcomes at half the cost than in the USA, and your criticism is that people won’t be able to pay for it?
Haahhahahahahahahahahaahah.
What a dolt.
I must have missed something.
Unlike the “Death Panels”, this is “voluntary advance care planning” which sets “how aggressively they wish to be treated if they are so sick that they cannot make health care decisions for themselves.”
I like the idea. If I were catatonic, I would rather have the plug pulled and allow what’s left of me which is of any use to be given to someone who could benefit, and it sounds like this legislature will allow me to do just that.
So like I said, am I missing something?
Ah Yea–did you miss something? Well, not only the entire healthcare debate of 1-2 years ago but the lead in to this thread. What? You’re reader hasn’t shown up for his Sunday review?
The whole issue is off point, as usual? In Calif anyway for at least 15 years it has been a requirement that patients be informed of Living Wills and such as part of their Hospital Admission. Only thing new here, as usual, is additional money to be paid to doctors for what they are already being paid for to begin with.
Only in america.
As I understand this, I thought that doctors legally had to keep a patient alive even if there was no brain activity. It doesn’t matter if it is against the wishes of the patient or immediate family to be kept alive, the final say was with the doctor.
What I am reading is this changes that and allows the final decision, when made voluntarily in advance by the patient to be. Therefore it would seem to be something new.
Ah Yea==are there two of you, or what gives?
For 20 years, if there is no brain electrical activity over a 24 hour period, the doc is REQUIRED to pronounce you dead and get on with it. No options there at all. Are there exceptions in real life because its possible two stupid people meet each other? Yes, of course.
The patient has ALWAYS had the final/actual/real decision. This is a law to pay the doctor to confirm that with his individual patients, who like you, don’t know shit from shinola.
Sounds good to me so long as my death is accompanied by Beethoven’s 6th symphony before
my carcas is removed to the Soylent factory.
You could make a living will years ago.
What this is going to come down to in the end is somebody offering you a pill or a shot if you can’t pay for other alternatives.
Actually I think I’d prefer two to the head if I’m going out slow but they will never go for that.
They want to do “mercy killings” of worthless old coots that aren’t worth the cost of keeping them alive but they object strenuously to being forthright about what they plan to do.
Just remember unless you die young you will be a worthless old coot and this is what you are going to get unless you somehow come up with the money to get better care.
>which in 13 other western countries provides better outcomes
Hilarious how people think that a person overdoses on drugs, then his dealer shoots someone who was trying to take over the corner, then wrecks his car on the highway and dies, has any impact on the quality of a health care system.
Mikey–I was gonna respond, but then I read my nom de flame and I shamed myself out of it. Ha, ha.
but yea, because being 18th on the list for live birth survivability is all about drug shoot outs.
What a silly person you are. You and your ilk.
Ilk. Ha, ha. Nice sound to it.
Simple, this is the 21st century, forget the hoary old 20th century thinking, support exsisiting research projects like SENS and the Mprize and invest about 2 bilion into these projects and by financing advanced R&D (biotech/nanotech, synthetic biology, whatever) we need to create a massive project to control the aging process (even though the popes scientists say that this is against what they believe).
We need to do this by taking from the military budget just 2 billion(from a 10,000 billion budget, spent over the last 10 years fighitng two wars). We need to do this because, supporting an aging population using an outdated 20th century tech will produce death panels and also a vast crumbling empire supported by military solutions will also lead to a further “panic” of the military/political institutions that will result in futher wars to regain world power (identical to the dynamics that brought down the USSR empire).
Remeber, as Kurzwiel says, we are on an exponential growth of science/tech/computing power and this tech will develop and harness the capability of reverse engineering the dna machinery of our cells, modifying and fixing them using programmable nanobots (both synthetic and organic design) and essentially reverse aging by making old people young again and young people from getting old. plus nanotech manufacturing will enable us to make any products in desktop nanotech manufacturing devices.
#22
sO YOU CREATE A WORKER FORCE THAT lives to 120…
When do you retire?
They will REQUIRE you to work 40(we do it now), 50, 60,80 years???
The CRUMBLING empire is based on OLD TECH.
WE created pollution laws to SAVE the land, sea,… ANd the corps VACATED. They were using 100-400 year old TECH, and couldnt figure out a BETTER/SAFER/.. way to create ANYTHING, in the USA under the restrictions and regulations Imposed. The JOBS went with the WORK.
Corps found out, it was CHEAPER to make it overseas, and EVEN ship it to the USA, and they could make EVEN MORE profit.
Even when we placed IMPORT taxes on them, we also created FREE PORTS..places that goods are Dropped, then SHIPPED to the USA for NO TAXES.
What we NEED, is FAIR Prices on goods. WE need to FORCE corps to ADVANCE tech..but, its to late.
IF we could DO THE TECH here in the USA, it could/would STILL be cheaper in other countries. The only thing that would make a GREAT advancement, is the ability to MAKE things in the USA, that would cost LESS, then the SHIPPING to the USA.
The only death panels are under conservative healthcare.
My doctor recently prescribed me a life-saving but expensive drug which I couldn’t get it until my case went before an insurance company death panel to determine whether I should get the drug.
Fortunately they said “yes” but if they said now, I would have to chose between death and financial ruin.
And this is the system that the conservatives rioted to protect.
… if the death panel said “no” I would have to chose between death and financial ruin.
Remember, when conservatives accuse liberals of something they are always deflecting from their own worst policies and sins.
Conservatives want a (insurance company) bureaucrat “getting between you and your doctor.”
Conservatives want (insurance company) “death panels.”
So, to deflect from their own outrageous conservative policies, they accuse liberals of wanting this.
Typical Republicans, just lying and making up stuff. Obama is a secret Muslim! No, he’s a radical anti-white Christian! No, it’s not even an American! He’s here to steal you guns! He’s here to outlaw Christianity! Lookout for death panels! Oh, and the Earth is 6,000 years old and dinosaur bones are just fake planted evidence by an invisible demon.
Seriously. Why does ANYONE listen to Republicans? They’re liars each and every one. There are no death panels, EXCEPT by the Republican Gov of Arizona who is RATIONING HEALTH CARE and causing folks to die because HER Republican government is limiting care.
This on the other hand is just a GOOD common sense fantastical sensible concept. Everyone should do end of life planning and let their love ones know their decisions and desires. Leave it to Republicans to lie and make something good into something bad.
So now you are ditching life expectancy for infant mortality?
Drugs are involved there too with crack babies.
If you don’t live in Africa, the numbers just aren’t that different between countries with various health care systems. I expect cultural factors are a major driver in the difference, but there is also the ‘live births’ mortality rate. A better health care system can also lower this number by delivering more weak babies.
Act now:
I will court challenge your death panel decision for small fee (no chickens accepted).
The CIA lists the US at about #50 or so, with a 99.4% success rate, higher rate than I expected. I think it is foolish to think that a different health care system would change that number higher.
Mikey Twit–of course if you remove a group of people with bad outcomes (crack babies) from the larger group, the larger group gets better results. Of course, “if” you have the money to access it, America has the best healthcare system in the World. The entire issue is how to get healthcare to the rest of us.
Dopey to argue the tautology you use.
Imagine: how to best provide the best healthcare possible to the most number of people: go!!!!
Bobbo, you are getting there. You see that the US infant mortality ranking is being lowered by things that have nothing to do with its health care system.
Now if more people would stop thinking that that rate is evidence of a weak system, we would be getting somewhere.
Actually, both of those groups were instrumental in passing Obamacare. Drug companies spent 80 million on ads.