I'm not proposing rationing or coercion. I don't want to make decisions for pts or families. What I DO want is someone objective, to honestly and compassionately provide hard truths about what death and dying looks like.
Doctors, for the most part, are not objective. Some I work with want to keep the pt alive as long as possible because it means a paying customer. End of life is when most of the health care dollars are spent, and that's where MDs and hospitals make the most money.
Death panel? Call it what you want, but our society is sorely lacking in honest accepting discourse about death.
Some people want to live forever and will submit themselves to any test, drug or procedure for that end. I respect that decision.
Some people want to live as long as possible, with quality of life determining how much intervention they want.
Shouldn't these people be given hard, basic information to guide them in these decisions?
The number of health-care professionals posting on this thread that show a complete lack of understanding of how health-care is structured, funded, and what exactly advanced directives are and who needs them is frightening.
First off, as many others have said, this is just a Medicare visit that allows providers to bill for discussing end of life care. We know what providers can and cannot bill for affects the provision of care. It doesn't say you have to pull the plug on grandma when she turns 85. I know that in my very short career I have already cared for patients who I wish had advance directives so I knew what THEY want.
Second of all, advance directives can say anything you want. It can tell your loved ones and care providers that you want absolutely EVERYTHING done in order to save your life no matter what your prognosis and condition.
Thirdly, this law/regulation was actually already in existence. The initial rule related to the one physical that individuals received when they started Medicare that the provider could bill for talking about end of life care. Now that individuals in Medicare receive annual physicals they had to update the law to include the ability to bill for end of life care conversations.
Finally, all these people who say they don't want the government involved in this discussion. Who do you think is going to be involved in determining end of life care if someone doesn't talk about advanced directives, health-care power of attorneys and living wills with their clients? Hopefully their loved ones will already know their wishes, but if they don't and they disagree then it's going to be the government. If Todd and Sarah Palin get into a car wreck tomorrow and Todd is killed instantly and Sarah is in a persistent vegetative state, who decides? Let's say Bristol thinks that mom wouldn't like to be kept alive laying in bed with machines, but Willow and Track (or whatever their names are) think that mom supported life and what to do whatever necessary to keep her alive. Then they get lawyers and they fight in out in a court of law and the judge decides, who does the judge work for? Oh, that's right the judiciary branch of the dreaded GOVERNMENT.
Okay, I'm going to take my publicly funded socialist bus on my tax payer paid for roads to go sit in my publicly funded schools and go get edumacated. Yay government!
Just curious - where do you live? Because in California, you do not have to get a physical before getting your driver's license.
steph
I live in Pennsylvania. Here you have to have a "Medical Qualification Certificate" (pretty much a physical a Dr or NP has to do) filled out to take the written test to get the innital drivers permit. Thought it was like that everywhere.
For the posters who simply call anyone associated with Fox liars/misinformed, one can say the same of those that are just as "misinformed" by the (dying) MSM.
Death Panels. They are a reality in Europe. A UK man needed a liver transplant. He had destroyed his liver via ETOH. He was in his 20s. He was sober....but it had NOT been a year yet and he would not survive to the 1 yr point w/o a liver transplant. He did not qualify as eligible. He died. He COULD have had a much longer life. Due to the UKs "death panel" group's regulations, liver transplants are wasted on alkies. But at what point are you no longer an alkie? They chose one year. A fixed criterion. He did not pass.
NO. We don't have this....YET! As a previous poster stated, it isn't the END-OF-LIFE discussion or the advanced directives that scares the "right", it is the slippery slope it is putting us on....that one day, due to limited fiscal resources, that we will have regulations determining at what point you can deny "life-saving" care. Just the sheer number of baby boomers entering Medicare DAILY will blow that budget very soon and these issues WILL be brought up. It scares folks to contemplate to what extent this will be carried out. (And I could cite so many things ie: a first trimester abortion is inexpensive. Fetus shows condition that is ultimately fatal. Abortion will be paid for...payment for any other treatment will be denied.)
I know so many of you want to jump and say that I am putting the cart before the horse and that one doesn't lead to the other. So I am going to give you a wacky (OT) statement......telling a new wife that you prefer women without makeup is a prelude to a spousally applied broken arm (domestic violence)! It is just as wacky to imply that EOL talks lead to death panels, right?
Well, this man says he likes women without makeup and he tells his beautiful bride that she is beautiful without makeup so to please her man, she stops wearing makeup. Then he tells his beautiful bride that he thinks this style dress is prettier than that suit. (Any abused woman can tell you how 'innocent' the slippery slope to abuse was when it started.) Later on, she is no longer feeling "attractive" or looks in the glass in a store window and sees someone else looking back at her. She decides to do her hair, her nails, her makeup and wear a suit to work. She has a great day! She feels like herself again! Then she gets home and get her first beating. See, HIS logic is that she is trying to attract someone else because she KNOWS that HE doesn't like her dressed like that.
SHE never saw it evolving. She never saw it coming......but many of her friends and family did. After all, his orginal statements weren't abusive, were they? Could you have convinced her that he was "controlling" her? Nope.
There are those of us that honestly believe that we are taking the first step (seemingly innocent, harmless, good for us..) on a slippery slope (start with OPTIONAL, becomes REQUIRED, becomes predetermined DNRs) to death panels and euthanasia. We may NOT be able to convince others who are not so inclined to have the same beliefs or the same deductions. It doesn't make us stupid, liars, purveyors of "misinformation" and *NO*! we wll not gloat years later when it all takes shape just like we said it would.
Consider this: Obama ran as a president who would be moderate. He had NO experience for us to evaluate what kind of President he would be. He used hype to get elected. (Define "Hope", define "Change"....He never did get into specifics and he did that intentionally.) Once in office, he and Nancy Pelosi went on a 2 year binge that would please less than 20% of the population. The majority of the population was against much of his agenda. They were told that the people didn't want this or that law passed and they passed it ANYWAY because in their god given elitist, ivy league education, they knew what was best for the populace even if we didn't know what was good for us.... :grn:.....so let me ask you this: What makes you think another Speaker + President (of either party) won't do this in the future "because it is necessary for the country's survival" or any other reason?
You don't have to agree with me, but don't attack me for my beliefs. The MSM will tell you what they want you to hear....this morning's example: "The GOP is ignoring the fact that the CBO said that the deficit would increase $230B in the next 10 years if HCR is repealed." FOX told you: "The CBO sent a letter to Speaker Boehner that repeal of HCR will increase the deficit $230B in the next ten years." Rep Xxxx® replied, "Yes. That is the estimate that was sent to the speaker because of the limitations in what the CBO is allowed to consider. The BUDGET COMMITTEE determined that the failure to repeal HCR will cost $704B."
The MSM would like a more "progressive" America and that is what they will emphasize. Fox would like a more "conservative" America and that is what they will emphasize. Just because some posters here disagree with Fox/conservatives, does not make their positions correct or Fox's positions maliciously incorrect.
I apologize for the long winded post, but I was offended by the attacks earlier in the thread.
Isn't the governor in Arizona who has restructured Medicaid/Medicare allowing transplant receipients to die - Republican? Isn't this a one-man (or in this case, woman) death squad?
Death Panels. They are a reality in Europe. A UK man needed a liver transplant. He had destroyed his liver via ETOH. He was in his 20s. He was sober....but it had NOT been a year yet and he would not survive to the 1 yr point w/o a liver transplant. He did not qualify as eligible. He died. He COULD have had a much longer life. Due to the UKs "death panel" group's regulations, liver transplants are wasted on alkies. But at what point are you no longer an alkie? They chose one year. A fixed criterion. He did not pass. NO. We don't have this....YET!
In what world do you live? There are committees who decide the criteria and candidates for all transplants in this country. It's not a simple matter of getting on the list. You have to be deemed a viable candidate. Who do you think makes these decisions? And further, here are two very recent cases, believed to be caused by Arizona's health care budget cuts, BY the GOP governor and state legislature, by the way. Apparently it's only a 'death panel' if Obama's name is attached:
For your reading pleasure!
I'm not even sure what to say about your abused wife analogy.. other than.. are you serious?
If we jump on the slippery slope bandwagon every time we try to create change, we'd get absolutely nowhere. We have to progress as a nation. As a civilization.
You defend Fox news? You contribute to the problem. They throw out lies designed to strike fear in the hearts of the uninformed which spreads like wildfire. "OMG- the sky is falling- take cover". It's ridiculous.
Politicians have been in bed with private health insurance agencies for decades. These agencies have been denying life saving care to patients all across the board from day one. They decide who gets coverage. They decide when too much has been spent on a patient. They decide not to cover someone with preexisting conditions.
Death Panels? That should be a term saved for the private health insurance companies that have been in control all along.
Politicians have been in bed with private health insurance agencies for decades. These agencies have been denying life saving care to patients all across the board from day one. They decide who gets coverage. They decide when too much has been spent on a patient. They decide not to cover someone with preexisting conditions.
Death Panels? That should be a term saved for the private health insurance companies that have been in control all along.
You defend Fox news? You contribute to the problem. They throw out lies designed to strike fear in the hearts of the uninformed which spreads like wildfire. "OMG- the sky is falling- take cover". It's ridiculous.
And they call this a personal attack. Is your belief simply the "progressive" belief because YOU believe it (along with only 20% of this country)?
More than 40% of the country calls themselves conservative. Fox is watched my more than the MSM's combined. You are in a minority belief system. The MSM mocked the TEA partiers as fabricated. That didn't make it so and it was a major force in this past election.
Here is a man who damaged his liver to the point of cirrhosis at the ripe old age of 22. He admitted to be an alcoholic from age 13. He was sober less than a year.
For the sake of argument- lets say there is another patient on the list in the same hospital and one liver becomes available. The other patient's profile is like this:
A 43 year old health care worker with a liver destroyed by Hep C which she contracted several years before after being stuck by a patients IV needle. No other health issues and no history of alcohol or drug abuse.
Who gets the liver? The young man who deserves a second chance at life or the middle aged health care worker who had no say in the matter, became ill as a consequence of the job.
These decisions are made every day in the US.
Yes, it is horribly sad that a 22 year old man had to die. But what exactly entitled him to a liver over someone else on the list?
Organs are not a first come first served kind of treatment.
i posted this 2010 monthly analysis of fox news' misinformation previously in another area and it's a very detailed, sourced, and linked report. the greatest hits of december are quoted below.
as the year comes to a close, media matters offers a month-by-month look back at fox news' most outrageous and factually challenged moments of 2010.
fox washington managing editor bill sammon caught slanting news reporting.media matters released emails showing washington managing editor bill sammon directing staff not to use the phrase "public option" when discussing health care reform legislation. the emails, which were sent during the height of the health care debate, echoed republican pollster frank luntz's appearance on hannity in which he encouraged host sean hannity not to say "public option," but instead use the term "government option," because "if you call it the 'government option,' the public is overwhelmingly against it."
media matters also obtained emails from sammon in which he instructed news staff to "refrain from asserting that the planet has warmed (or cooled) in any given period without immediately pointing out that such theories are based upon data that critics have called into question." this directive was issued less than 15 minutes after fox correspondent wendell goler accurately reported on-air that the united nations' world meteorological organization announced that 2000-2009 was "on track to be the warmest [decade] on record." sammon's email was sent as the network heavily promoted the fabricated "climategate" scandal.
RadBSN
86 Posts
The number of health-care professionals posting on this thread that show a complete lack of understanding of how health-care is structured, funded, and what exactly advanced directives are and who needs them is frightening.
First off, as many others have said, this is just a Medicare visit that allows providers to bill for discussing end of life care. We know what providers can and cannot bill for affects the provision of care. It doesn't say you have to pull the plug on grandma when she turns 85. I know that in my very short career I have already cared for patients who I wish had advance directives so I knew what THEY want.
Second of all, advance directives can say anything you want. It can tell your loved ones and care providers that you want absolutely EVERYTHING done in order to save your life no matter what your prognosis and condition.
Thirdly, this law/regulation was actually already in existence. The initial rule related to the one physical that individuals received when they started Medicare that the provider could bill for talking about end of life care. Now that individuals in Medicare receive annual physicals they had to update the law to include the ability to bill for end of life care conversations.
Finally, all these people who say they don't want the government involved in this discussion. Who do you think is going to be involved in determining end of life care if someone doesn't talk about advanced directives, health-care power of attorneys and living wills with their clients? Hopefully their loved ones will already know their wishes, but if they don't and they disagree then it's going to be the government. If Todd and Sarah Palin get into a car wreck tomorrow and Todd is killed instantly and Sarah is in a persistent vegetative state, who decides? Let's say Bristol thinks that mom wouldn't like to be kept alive laying in bed with machines, but Willow and Track (or whatever their names are) think that mom supported life and what to do whatever necessary to keep her alive. Then they get lawyers and they fight in out in a court of law and the judge decides, who does the judge work for? Oh, that's right the judiciary branch of the dreaded GOVERNMENT.
Okay, I'm going to take my publicly funded socialist bus on my tax payer paid for roads to go sit in my publicly funded schools and go get edumacated. Yay government!