Health Provisions Slipped into Stimulus Package

UM Review RN, ASN, RN · Feb 10, 2009

But we're already letting insurance companies do that for us. What's the difference? That we'll be moving toward a universal health plan?

tulip928 · Feb 10, 2009

Uh, yeah. And the government, according to this plan deceptively put into a "stimulus" bill, will dictate to your doctor what he can and can't do to treat YOU. He will be required to follow the government's protocol, regardess of his own critical thinking skills. He will be required by law or not allowed to practice. This is the truth, folks. Look it up for yourself. When it comes home to you or a family member, and it not some hypothetical situation, you will finally get it.

Quark09 · Feb 10, 2009

Although in the big picture this would seem to be more cost-effective, when it comes to individual care it seems very harsh. As the child of parents with various health issues, I'd hate to be sitting next to them and have to listen to the doctor explain that according to the formula he just punched into his computer, the numbers said they woudn't really benefit from available treatments long enough to make them cost-effective. However, my parents do their part to try to stay healthy: they work out together, visit a chiropractor, and have started eating a health diet. I do hope I won't get lambasted for saying this, but I do feel that if you have one resource (hypothetically, lets say it's a vaccine) and two people who need it, it should go to the person who is at least trying to stay healthy; i.e. not smoking, trying to exercise, not eating McDonald's 5 times per week...again, I apologize in advance if this gives anyone personal offense, but people do need to take responsibility for their own health, and a huge drain on healthcare resources comes from people who don't want to manage specific conditions such as HTN, type II diabetes, etc with diet and exercise, or people with chronic bronchitis who continue to smoke. Yes, I do realize that after a certain point, these conditions MUST be managed chemically, however oftentimes before they get to that point an alteration in lifestyle is all that was needed. People need to start making healthy choices for themselves, and setting an example for their kids, not showing up to the doctor reeking of cigarette smoke, 50 lbs overweight, and demanding some Plavix and Advair to try to counteract their own bad habits.

Jolie, BSN · Feb 10, 2009

Thank you for posting this vitally important information!

It is criminal that this is buried in a stimulus bill with the obvious intent of avoiding public scrutiny.

Trauma Columnist · Feb 10, 2009

I work in dialysis which is extremely costly. Some of my own comments:

1. Is it cost effective to start dialysis on a 97 y/o?

2. Should a pt who has had one renal transplant which failed due to his cocaine abuse, be allowed to receive another transplant?

3. Should a pt who refuses to stop smoking and take their HTN meds, be allowed to have a transplant?

I see such an abuse of our system it is staggering.

Home Health Columnist / Guide · Feb 10, 2009

One new bureaucracy, the National Coordinator of Health Information Technology, will monitor treatments to make sure your doctor is doing what the federal government deems appropriate and cost effective. The goal is to reduce costs and “guide” your doctor’s decisions

I already get "guidance" from my health plan: yearly mamography, medication refill reminders, eligible for initial bone density testiing as over 50.... DH got his prostate screening reminder. My PCP has been ahead of the curve using an EMR for about 9 yrs now: he is often ahead of health plan in giving me RX for screening exams....like many Americans due to work delay in getting some tests scheduled.

HOWEVER, being in homecare, I see too many physicians that are carrying huge patient loads and only focus on cheif complaint during vist, never check diabetics HgbA1C, check their feet -- (homecare RN's find many foot ulcers) or recommend that patient get testing done so I see results opposite side of arguement: advanced conditions that could have been minimized/prevented with early testing if PCP had only offered/provided.

When I check patients homecare eligibility, have access to screen where screening tests last paid for listed: ~ 60% are blank for prostate + mamography exams in 60-80 YO.

Any provider signed up for CMS listserve been getting bombarded 2-3x week with CMS message to include screening exams, offer flu/pneumonia vaccine, diabetes tesing supplies covered under Medicare etc so fully expected to see this type language in next healthcare legislation as part of push to reduce long term treatment costs.

All those tests now covered by Medicare/Medicad will being in patients into labs, radiology, outpt depts therefore increasing facilites healthcare activity + keeping healthcare staff employed: find a problem now obligated to treat it.

Doctors and patient always have the last word to accept/reject based on INDIVIDUAL's unique healthcare needs.

Jolie, BSN · Feb 10, 2009

This article does not describe an appointed government entity providing guidance to physicians and patients regarding "best practices." It describes an appointed government entity dictating care that will be allowed, with no consideration for individual circumstances.

No wonder there is a rush to pass the stimulus bill with minimal examination and scrutiny by the public.

A new era of transparency in government? Yeah, right!

Halinja, BSN, RN · Feb 10, 2009

I'm sure I'll get myself in trouble with my opinion, but it isn't always necessary to take the worst case scenario. This is just my opinion. (and yes, Angie, having just run headlong into the insurance company's brick wall, it doesn't sound much different to me)

We do sometimes carry out heroic measures on someone who's quality of life will not benefit from it. I remember a gentleman in ICU, his kidneys were shot, his liver was failing, he was on a respirator. He'd been in ICU a month, but his relatives were begging to keep him alive just a little longer...until the first of the month when his social security check would come in.

I don't ascribe to life at any and all costs. When I get to a certain state of decrepitude, ill health, or multiple organ failures, let me go. Cremate me and use me as fertilizer. I don't want to be a burden to my family, and I don't want to sit forgotten in some corner, unable to enjoy life, just marking time until my heart stops.

Jolie, BSN · Feb 10, 2009

I understand and respect the opinion that we over treat many patients with end stage conditions. But this article describes deliberate action to prevent medical research and development of new treatments due to cost. Do we really want to forgo advances in research and treatment of cancer, heart disease, diabetes, spinal cord injury, prematurity, etc. Are we satisfied with the current state of health care and see no need for innovation and improvement? If you are suffering from any disease that is not currently curable 100% of the time, I doubt you would agree with this. There is a big difference between providing treatment appropriate to a patient's condition versus halting all medical advances for the sake of saving money.

Secondly, some posters have compared this proposal to current insurance plans which may not cover all available treatments. There is no comparison. While we may currently have to fight with our insurance plans to get coverage, or find other means of paying for services that our plans exclude, those services still exist. We are not legally prohibited from obtaining treatment not covered by our plan. This proposal sets up a government entity that will dictate care of all patients. Not just those covered by government plans. If the government board says, "No," then no it is. No where to appeal. No where else to go to pay out of pocket. Just accept your fate like a good little soldier. No thanks.

missmoe · Feb 10, 2009

all pt's deserve care. even if they are overweight, smoke, drink, w/e. its not up to me if their life is worth living. its up to them. if someone wants treatment, i can not judge weather or not they deserve it based on their lifestyle. the gov is now putting a dollar amount on something that has always been priceless. if someone i love is sick, i dont care about the costs. they dont care about me or my loved ones, i do. they wont put the time or money into saving ppl they dont think are worth saving. so sad.

cjmjmom · Feb 10, 2009

Question: So many of you have posted your "ideas" about not liking this aspect of the stimulus, sooo... how many of you called your senator asking for him/her not to support it and WHY IT'S A BAD IDEA!