End-of-life care eats up a huge slice of spending, but the proposals do little to address this directly. And the clause in the House bill about providing Medicare reimbursements to doctors for counsel on end-of-life questions originated in an earlier proposal backed by Republican senators.By the way... Many people have made fun of HR3200's thousand-page length. But those pages display large type and much white space. (PDF here.) For a slightly less daunting look at the bill, go here. The thing comes to roughly 166,000 words, which is shorter than any two novels starring Sookie Vampirefucker.
Saturday, August 15, 2009
End of life
Here's irony for you. Maybe you already knew this, but I didn't...
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7 comments:
Counseling someone on Care subjects such as POA's, Living Wills etc. are being done now. That isn't the problem. The problem is with rationing health care. Who gets it first since there is only so many doctors, nurses, meds, etc. to go around. This is especially noted with Dr. Ezekial Emanuel being one of Obama's advisors. He is all about comparative effectiveness treatment and his Complete Lifes curve where "When implemented, the complete life system produces a curve on which individuals aged between foughly 15 and 40 years get the most substantial chance, whereas the youngest and oldest get chances that are attenuated(rationed). Some folks say that is just another term for "triage" but it's more than that...it is also an ideology. The choosing is already seen in play in face of the so-called coming swine-flu "pandemic" where certain people have been chosen to get the shots first. Obviously, when the supply is gone then those left will not get a shot. At least with health insurance the "rationing" is strictly based on monetary considerations....those with more money can pay for more care. I think this bill stinks for poor people. With Medicare being, supposedly, revamped to weed out the waste and fraud to pay for the Health Care subsidies, my question is why hasn't that been done already and then we would have a truer idea of what kind of money is being talked about instead of some wishful thinking....and an increase in taxes for the wealthy...another "spread the wealth around" scheme. I'm so far from rich it's pathetic but even I don't think that is fair.
I think folks should make visits to nursing homes subsidized by Medicare....get some reality going on.
Lonni
The obvious arguments apply, Loni. If you pay for private insurance you can get good treatment. No-one's getting rid of that option. Every medical system in every country makes life or death decisions about the allocation of scarce resources and (ho hum) they give low priority to old, dying people. Get over it. Nowhere do you recognize the political legitimacy or benefits of a public health system option. Do the HW. It's cheaper and better than universal private health care. And yes, tax the rich. Only in America could these ridiculous ideas hold sway.
Yes, HR 3200 is "only" 166,000 words long (1016 pages). Before we see something come out conference committee, you can expect it to be twice that long and even the insurance and pharmaceutical company lobbyists who wrote it won't understand it anymore. On the other hand, HR 676 (the Conyers single-payer bill) is a mere 3948 words.
I guess brevity really *is* the soul of wit, after all.
I can't find any source for the Emanuel quote and I can find no reference to rationing in HR3200.
There have been numerous studies done on this - the crux being, caring for people who are near death is very expensive. Under a profit-based health care system, this can only lead to one conclusion.Here's a particularly odious study.
There are also studies which indicate end-of-life counseling reduces health care costs. Reuters summarized a few of the studies.
Joseph the poster above is referring to an article in the Lancet by Persad, Wertheimer and Emanuel:
Principles for allocation of scarce medical interventions. 2009.
http://www.ncpa.org/pdfs/PIIS0140673609601379.pdf
Ana
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