Impeding changes to our Health Care system

[TheMercenary]

Why did you leave out the rest of it? Maybe you aren't familar with the term "actionable medical order".

`(2) A practitioner described in this paragraph is--

`(A) a physician (as defined in subsection (r)(1)); and

`(B) a nurse practitioner or physician's assistant who has the authority under State law to sign orders for life sustaining treatments.

`(3)(A) An initial preventive physical examination under subsection (WW), including any related discussion during such examination, shall not be considered an advance care planning consultation for purposes of applying the 5-year limitation under paragraph (1).

`(B) An advance care planning consultation with respect to an individual may be conducted more frequently than provided under paragraph (1) if there is a significant change in the health condition of the individual, including diagnosis of a chronic, progressive, life-limiting disease, a life-threatening or terminal diagnosis or life-threatening injury, or upon admission to a skilled nursing facility, a long-term care facility (as defined by the Secretary), or a hospice program.

`(4) A consultation under this subsection may include the formulation of an order regarding life sustaining treatment or a similar order.

`(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.

`(B) The level of treatment indicated under subparagraph (A)(ii) may range from an indication for full treatment to an indication to limit some or all or specified interventions. Such indicated levels of treatment may include indications respecting, among other items--

`(i) the intensity of medical intervention if the patient is pulse less, apneic, or has serious cardiac or pulmonary problems;

`(ii) the individual's desire regarding transfer to a hospital or remaining at the current care setting;

`(iii) the use of antibiotics; and

`(iv) the use of artificially administered nutrition and hydration.'.

(2) PAYMENT- Section 1848(j)(3) of such Act (42 U.S.C. 1395w-4(j)(3)) is amended by inserting `(2)(FF),' after `(2)(EE),'.

(3) FREQUENCY LIMITATION- Section 1862(a) of such Act (42 U.S.C. 1395y(a)) is amended--

(A) in paragraph (1)--

(i) in subparagraph (N), by striking `and' at the end;

(ii) in subparagraph (O) by striking the semicolon at the end and inserting `, and'; and

(iii) by adding at the end the following new subparagraph:

`(P) in the case of advance care planning consultations (as defined in section 1861(hhh)(1)), which are performed more frequently than is covered under such section;'; and

(B) in paragraph (7), by striking `or (K)' and inserting `(K), or (P)'.

(4) EFFECTIVE DATE- The amendments made by this subsection shall apply to consultations furnished on or after January 1, 2011.

I really doubt that the government would ever get any provision passed that would begin to have a documented trail of withholding care, it will be done more quitely through rationing.

Originally Posted by TheMercenary

Why did you leave out the rest of it? Maybe you aren't familar with the term "actionable medical order".

What part of:

`(ii) effectively communicates the individual's preferences regarding life sustaining treatment, including an indication of the treatment and care desired by the individual;

dont you understand?

[TheMercenary]

Like I said, really doubt that the government would ever get any provision passed that would begin to have a documented trail of withholding care, it will be done more quitely through rationing.

[TheMercenary]

Maybe you can defend the two consecutive CBO reports that state no money will be saved over the 10 year projection to make and save money.

How about the estimates that we still will not have covered the uninsured.

In fact, the CBO staff also stated that their analysis excluded estimates of potential savings.

I have some problems with several of the proposals..but I dont judge a book after reading only one chapter and I dont make final judgments on draft legislation that is far from final.

And I certainly dont base my opinion on mischaracterizations by partisan editorials.

[TheMercenary]

Originally Posted by Redux

In fact, the CBO staff also stated that their analysis excluded estimates of potential savings.

I have some problems with several of the proposals..but I dont judge a book after reading only one chapter and I dont make final judgments on draft legislation that is far from final.

And I certainly dont base my opinion on mischaracterizations by partisan editorials.

I never really considered the CBO to be a partisan editorial, but if that is how you see them, what ever.

The evidence is that there is as much of a possibility that we will go bankrupt under the proposal as there is that they don't know? What kind of forcast is that? So you are willing to take that chance with our economy in the shape it is in? You are willing to take a chance with our childrens future? I am not.

We are not reading one chapter, we are reading the elements that need effective change. Not a the typical Demoncratic Rahm Rod and Pelosi push without adequate public comment and opportunity to have input and effective change in the Bill.

Originally Posted by TheMercenary

I never really considered the CBO to be a partisan editorial, but if that is how you see them, what ever.

Neither do I, but I also consider what they said that they did not include in their analysis...the potential savings.

Ahh...the 'whatever" defense again.

I guess that means we're done with this go round.

I'll just wait for your next string of "snips and posts" to find out about the deals.

You're guys in the media seem to have all the facts.

[TheMercenary]

Originally Posted by Redux

I'll just wait for your next string of "snips and posts" to find out about the deals.

You're guys in the media seem to have all the facts.

"You're" Guys?

We will never know about any deals unless Obamy and his Demoncratic cronies tell us. Will we?

[TheMercenary]

Originally Posted by Redux

I'll just wait for your next string of "snips and posts" to find out about the deals.

You're guys in the media seem to have all the facts.

So you can't defend the estimates? You are ok with them bankrupting us? Ok.

Looking forward to the "snips of the day" that tell me the government is planning to take over my life.

[TheMercenary]

Originally Posted by Redux

Looking forward to the "snips of the day" that tell me the government is planning to take over my life.

You can let them take over your life if you want. You have free choice in that much.

[TheMercenary]

Should Public, Private Health Plans Compete?

http://www.ncpa.org/pdfs/ComJCGHeartland070109.pdf

[TheMercenary]

More ideas about care for the elderly. I am not sure that I completely disagree with some of it. It is the only way that the system as proposed may survive. This actually refers to an earlier post I made on the issue.

NCPA: White House (advisor) Has Ideas On How To Ration Health Care
July 22, 2009

Presidential Health Advisor's Writings Support Less Care for the Elderly

DALLAS, TX (July 22, 2009) - On the cusp of President Obama's news conference tonight, the National Center for Policy Analysis points to evidence that the President's health care reform plan may result in denying care to a significant number of Americans, especially the elderly.

"Clearly the Administration does not consider doctors the best judges of the type of health care people need," said NCPA President John C. Goodman. "The obvious end game: Washington will tell doctors how to practice medicine and dictate what kind of health care patients receive." Goodman's full statement appears in an entry he posted today on this subject at his health policy blog.

The NCPA cites two scholarly articles in which the President's health advisor Ezekiel Emanuel outlined how health care rationing could be carried out. Emanuel, special advisor for health policy to the director for the White House Office of Management and Budget, says young adults should be given preference over seniors because younger people have more years of life ahead of them. He also says that young adults should be given preferential care over very young children because society already has made an investment in their education.

In the medical journal The Lancet, Emanuel writes that if health care has to be rationed, he prefers the "complete lives system," which "discriminates against older people....Unlike allocation by sex or race, allocation by age is not invidious discrimination; every person lives through different life stages rather than being a single age. Even if 25-year-olds receive priority over 65-year-olds, everyone who is 65 years now was previously 25 years."

In a different article written more than 10 years ago for the Hastings Center Report, Emanuel said health services should not be guaranteed to "individuals who are irreversibly prevented from being or becoming participating citizens." Emanuel wrote, "An obvious example is not guaranteeing health services to patients with dementia."

As a part of a better solution to health reform, the NCPA is taking an active role in promoting consumer-driven health care options by supporting a national petition drive to educate citizens.

The "Free Our Health Care Now" petition has already been signed by over 620,000 people opposed to a government nationalization of our health care system: http://freeourhealthcarenow.com/

http://www.ncpa.org/media/ncpa-white...on-health-care

Merc...I ask this in all sincerity

Why do you think other members would be inclined to engage you on the issue when for the most part, all you do is snip and post, and mostly from partisan editorials and sites (the ncpa being the latest)...day after day...hour after hour?

To others...is it just me? Am I missing a reason to continue to discuss the issue with Merc, given they style of discussion (?) that is presented.

Is it worth responding to every snip and post when all you get in response is dodging and weaving?