By JIM TOWEY
If President Obama wants to better understand why America's discomfort with end-of-life discussions threatens to derail his health-care reform, he might begin with his own Department of Veterans Affairs (VA). He will quickly discover how government bureaucrats are greasing the slippery slope that can start with cost containment but quickly become a systematic denial of care.
Last year, bureaucrats at the VA's National Center for Ethics in Health Care advocated a 52-page end-of-life planning document, "Your Life, Your Choices." It was first published in 1997 and later promoted as the VA's preferred living will throughout its vast network of hospitals and nursing homes. After the Bush White House took a look at how this document was treating complex health and moral issues, the VA suspended its use. Unfortunately, under President Obama, the VA has now resuscitated "Your Life, Your Choices."
Who is the primary author of this workbook? Dr. Robert Pearlman, chief of ethics evaluation for the center, a man who in 1996 advocated for physician-assisted suicide in Vacco v. Quill before the U.S. Supreme Court and is known for his support of health-care rationing.
"Your Life, Your Choices" presents end-of-life choices in a way aimed at steering users toward predetermined conclusions, much like a political "push poll." For example, a worksheet on page 21 lists various scenarios and asks users to then decide whether their own life would be "not worth living."
The circumstances listed include ones common among the elderly and disabled: living in a nursing home, being in a wheelchair and not being able to "shake the blues." There is a section which provocatively asks, "Have you ever heard anyone say, 'If I'm a vegetable, pull the plug'?" There also are guilt-inducing scenarios such as "I can no longer contribute to my family's well being," "I am a severe financial burden on my family" and that the vet's situation "causes severe emotional burden for my family."
When the government can steer vulnerable individuals to conclude for themselves that life is not worth living, who needs a death panel?
One can only imagine a soldier surviving the war in Iraq and returning without all of his limbs only to encounter a veteran's health-care system that seems intent on his surrender.
I was not surprised to learn that the VA panel of experts that sought to update "Your Life, Your Choices" between 2007-2008 did not include any representatives of faith groups or disability rights advocates. And as you might guess, only one organization was listed in the new version as a resource on advance directives: the Hemlock Society (now euphemistically known as "Compassion and Choices").
This hurry-up-and-die message is clear and unconscionable. Worse, a July 2009 VA directive instructs its primary care physicians to raise advance care planning with all VA patients and to refer them to "Your Life, Your Choices." Not just those of advanced age and debilitated condition—all patients. America's 24 million veterans deserve better.
Many years ago I created an advance care planning document called "Five Wishes" that is today the most widely used living will in America, with 13 million copies in national circulation. Unlike the VA's document, this one does not contain the standard bias to withdraw or withhold medical care. It meets the legal requirements of at least 43 states, and it runs exactly 12 pages.
After a decade of observing end-of-life discussions, I can attest to the great fear that many patients have, particularly those with few family members and financial resources. I lived and worked in an AIDS home in the mid-1980s and saw first-hand how the dying wanted more than health care—they wanted someone to care.
If President Obama is sincere in stating that he is not trying to cut costs by pressuring the disabled to forgo critical care, one good way to show that commitment is to walk two blocks from the Oval Office and pull the plug on "Your Life, Your Choices." He should make sure in the future that VA decisions are guided by values that treat the lives of our veterans as gifts, not burdens.
Mr. Towey, president of Saint Vincent College, was director of the White House Office of Faith-Based Initiatives (2002-2006) and founder of the nonprofit Aging with Dignity.
Thursday, August 20, 2009
Monday, August 17, 2009
I divorce you
Dear American liberals, leftists, social progressives, socialists, Marxists, Obama supporters, et al:
We have stuck together since the late 1950's, but the whole of this latest election process has made me realize that I want a divorce. I know we tolerated each other for many years for the sake of future generations, but sadly, this relationship has run its course. Our two ideological sides of America cannot and will not ever agree on what is right so let's just end it on friendly terms. We can smile and chalk it up to irreconcilable differences and go our own way.
Here is a model separation agreement:
Our two groups can equitably divide up the country by landmass each taking a portion. That will be the difficult part, but I am sure our two sides can come to a friendly agreement. After that, it should be relatively easy! Our respective representatives can effortlessly divide other assets since both sides have such distinct and disparate tastes.
We don't like redistributive taxes so you can keep them. You are welcome to the liberal judges and the ACLU, and abortion clinics Since you hate guns and war, we'll take our firearms, the cops, the NRA and the military. You can keep Oprah, Michael Moore and Rosie O'Donnell...
We'll keep the capitalism, greedy corporations, pharmaceutical companies, Wal-Mart and Wall Street. You can have your beloved homeless, homeboys, hippies and illegal aliens. We'll keep the hot Alaskan hockey moms and rednecks. We'll keep the Bibles and give you NBC and Hollywood .
You can make nice with Iran and Palestine and we'll retain the right to invade and hammer places that threaten us. You can have the peaceniks, and war protesters. When our allies or our way of life are under assault, we'll help provide them security.
We'll keep our Judeo-Christian values. You are welcome to Islam, Scientology, Humanism and Shirley Maclaine. You can also have the U.N., but we will no longer be paying the bill.
We'll keep the SUVs, pickup trucks and oversized luxury cars. You can take every Subaru station wagon you can find.
You can give everyone healthcare if you can find any practicing doctors. We'll continue to believe healthcare is a luxury and not a right. We'll keep The Battle Hymn of the Republic and the National Anthem. I'm sure you'll be happy to substitute I'd Like to Teach the World to Sing, Kum Ba Ya or We Are the World.
We'll practice trickle down economics and you can give trickle up poverty your best shot. Since it often so offends you, we'll keep our history, our name and our flag.
Would you agree to this? If so, please pass it along to other like minded liberal and conservative patriots and if you do not agree, just hit delete. In the spirit of friendly parting, I'll bet you ANWAR which one of us will need whose help in 15 years.
Sincerely,
John J. Wall
Law Student and an American
P.S. Also, please take Barbara Streisand and Jane Fonda with you
GOD BLESS AMERICA!
We have stuck together since the late 1950's, but the whole of this latest election process has made me realize that I want a divorce. I know we tolerated each other for many years for the sake of future generations, but sadly, this relationship has run its course. Our two ideological sides of America cannot and will not ever agree on what is right so let's just end it on friendly terms. We can smile and chalk it up to irreconcilable differences and go our own way.
Here is a model separation agreement:
Our two groups can equitably divide up the country by landmass each taking a portion. That will be the difficult part, but I am sure our two sides can come to a friendly agreement. After that, it should be relatively easy! Our respective representatives can effortlessly divide other assets since both sides have such distinct and disparate tastes.
We don't like redistributive taxes so you can keep them. You are welcome to the liberal judges and the ACLU, and abortion clinics Since you hate guns and war, we'll take our firearms, the cops, the NRA and the military. You can keep Oprah, Michael Moore and Rosie O'Donnell...
We'll keep the capitalism, greedy corporations, pharmaceutical companies, Wal-Mart and Wall Street. You can have your beloved homeless, homeboys, hippies and illegal aliens. We'll keep the hot Alaskan hockey moms and rednecks. We'll keep the Bibles and give you NBC and Hollywood .
You can make nice with Iran and Palestine and we'll retain the right to invade and hammer places that threaten us. You can have the peaceniks, and war protesters. When our allies or our way of life are under assault, we'll help provide them security.
We'll keep our Judeo-Christian values. You are welcome to Islam, Scientology, Humanism and Shirley Maclaine. You can also have the U.N., but we will no longer be paying the bill.
We'll keep the SUVs, pickup trucks and oversized luxury cars. You can take every Subaru station wagon you can find.
You can give everyone healthcare if you can find any practicing doctors. We'll continue to believe healthcare is a luxury and not a right. We'll keep The Battle Hymn of the Republic and the National Anthem. I'm sure you'll be happy to substitute I'd Like to Teach the World to Sing, Kum Ba Ya or We Are the World.
We'll practice trickle down economics and you can give trickle up poverty your best shot. Since it often so offends you, we'll keep our history, our name and our flag.
Would you agree to this? If so, please pass it along to other like minded liberal and conservative patriots and if you do not agree, just hit delete. In the spirit of friendly parting, I'll bet you ANWAR which one of us will need whose help in 15 years.
Sincerely,
John J. Wall
Law Student and an American
P.S. Also, please take Barbara Streisand and Jane Fonda with you
GOD BLESS AMERICA!
Friday, August 14, 2009
More from Sarah
Another posting from Sarah Palin on her Facebook page regarding healthcare.
quote
I join millions of Americans in expressing appreciation for the Senate Finance Committee’s decision to remove the provision in the pending health care bill that authorizes end-of-life consultations (Section 1233 of HR 3200). It’s gratifying that the voice of the people is getting through to Congress; however, that provision was not the only disturbing detail in this legislation; it was just one of the more obvious ones.
As I noted in my statement last week, nationalized health care inevitably leads to rationing. There is simply no way to cover everyone and hold down the costs at the same time. The rationing system proposed by one of President Obama’s key health care advisors is particularly disturbing. I’m speaking of the “Complete Lives System” advocated by Dr. Ezekiel Emanuel, the brother of the president’s chief of staff. President Obama has not yet stated any opposition to the “Complete Lives System,” a system which, if enacted, would refuse to allocate medical resources to the elderly, the infirm, and the disabled who have less economic potential. [1] Why the silence from the president on this aspect of his nationalization of health care? Does he agree with the “Complete Lives System”? If not, then why is Dr. Emanuel his policy advisor? What is he advising the president on? I just learned that Dr. Emanuel is now distancing himself from his own work and claiming that his “thinking has evolved” on the question of rationing care to benefit the strong and deny the weak. [2] How convenient that he disavowed his own work only after the nature of his scholarship was revealed to the public at large.
The president is busy assuring us that we can keep our private insurance plans, but common sense (and basic economics) tells us otherwise. The public option in the Democratic health care plan will crowd out private insurers, and that’s what it’s intended to do. A single payer health care plan has been President Obama’s agenda all along, though he is now claiming otherwise. Don’t take my word for it. Here’s what he said back in 2003:
“I happen to be a proponent of a single payer universal health care plan.... A single payer health care plan – universal health care plan – that’s what I would like to see.” [3]
A single-payer health care plan might be what Obama would like to see, but is it what the rest of us would like to see? What does a single payer health care plan look like? We need look no further than other countries who have adopted such a plan. The picture isn’t pretty. [4] The only way they can control costs is to ration care. As I noted in my earlier statement quoting Thomas Sowell, government run health care won’t reduce the price of medical care; it will simply refuse to pay the price. The expensive innovative procedures that people from all over the world come to the United States for will not be available under a government plan that seeks to cover everyone by capping costs.
Our senior citizens are right to be wary of this health care bill. Medical care at the end of life accounts for 80 percent of all health care. When care is rationed, that is naturally where the cuts will be felt first. The “end-of-life” consultations authorized in Section 1233 of HR 3200 were an obvious and heavy handed attempt at pressuring people to reduce the financial burden on the system by minimizing their own care. Worst still, it actually provided a financial incentive to doctors to initiate these consultations. People are right to point out that such a provision doesn’t sound “purely voluntary.”
In an article I noted yesterday, Charles Lane wrote:
“Ideally, the delicate decisions about how to manage life’s end would be made in a setting that is neutral in both appearance and fact. Yes, it’s good to have a doctor’s perspective. But Section 1233 goes beyond facilitating doctor input to preferring it. Indeed, the measure would have an interested party -- the government -- recruit doctors to sell the elderly on living wills, hospice care and their associated providers, professions and organizations. You don’t have to be a right-wing wacko to question that approach.” [5]
I agree. Last year, I issued a proclamation for “Healthcare Decisions Day.” [6] The proclamation sought to increase the public’s knowledge about creating living wills and establishing powers of attorney. There was no incentive to choose one option over another. There was certainly no financial incentive for physicians to push anything. In fact, the proclamation explicitly called on medical professionals and lawyers “to volunteer their time and efforts” to provide information to the public.
Comparing the “Healthcare Decisions Day” proclamation to Section 1233 of HR 3200 is ridiculous. The two are like apples and oranges. The attempt to link the two shows how desperate the proponents of nationalized health care are to shift the debate away from the disturbing details of their bill.
There is one aspect of this bill which I have not addressed yet, but it’s a very obvious one. It’s the simple fact that we can’t afford it. But don’t take my word for it. Take the word of Doug Elmendorf, the director of the nonpartisan Congressional Budget Office. He told the Senate Budget Committee last month:
“In the legislation that has been reported we do not see the sort of fundamental changes that would be necessary to reduce the trajectory of federal health spending by a significant amount. And on the contrary, the legislation significantly expands the federal responsibility for health care costs.” [7]
Dr. Elmendorf went on to note that this health care legislation would increase spending at an unsustainable rate.
Our nation is already $11.5 trillion in debt. Where will the money come from? Taxes, of course. And will a burdensome new tax help our economy recover? Of course not. The best way to encourage more health care coverage is to foster a strong economy where people can afford to purchase their own coverage if they choose to do so. The current administration’s economic policies have done nothing to help in this regard.
Health care is without a doubt a complex and contentious issue, but health care reform should be a market oriented solution. There are many ways we can reform the system and lower costs without nationalizing it.
The economist Arthur Laffer has taken the lead in pushing for a patient-center health care reform policy. He noted in a Wall Street Journal article earlier this month:
“A patient-centered health-care reform begins with individual ownership of insurance policies and leverages Health Savings Accounts, a low-premium, high-deductible alternative to traditional insurance that includes a tax-advantaged savings account. It allows people to purchase insurance policies across state lines and reduces the number of mandated benefits insurers are required to cover. It reallocates the majority of Medicaid spending into a simple voucher for low-income individuals to purchase their own insurance. And it reduces the cost of medical procedures by reforming tort liability laws.” [8]
Those are real reforms that we can live with and afford. Once again, I warn my fellow Americans that if we go down the path of nationalized health care, there will be no turning back. We must stop and think or we may find ourselves losing even more of our freedoms.
- Sarah Palin
[1] See http://www.scribd.com/doc/18280675/Principles-for-Allocation-of-Scarce-Medical-Interventions
[2] See http://washingtontimes.com/news/2009/aug/14/white-house-adviser-backs-off-rationing/
[3]See http://www.youtube.com/watch?v=-hsqzSKuC44
[4] See http://article.nationalreview.com/?q=N2M0ODk0OTNkZjkwNGM4OGMyYTEwYWY3ODUzMzFiOTc=
[5] See http://www.washingtonpost.com/wp-dyn/content/article/2009/08/07/AR2009080703043.html
[6] See http://www.gov.state.ak.us/archive.php?id=1094&type=6
[7] See http://blogs.abcnews.com/thenote/2009/07/cbo-sees-no-federal-cost-savings-in-dem-health-plans.html
[8] See http://online.wsj.com/article/SB10001424052970204619004574324361508092006.html
unquote
quote
I join millions of Americans in expressing appreciation for the Senate Finance Committee’s decision to remove the provision in the pending health care bill that authorizes end-of-life consultations (Section 1233 of HR 3200). It’s gratifying that the voice of the people is getting through to Congress; however, that provision was not the only disturbing detail in this legislation; it was just one of the more obvious ones.
As I noted in my statement last week, nationalized health care inevitably leads to rationing. There is simply no way to cover everyone and hold down the costs at the same time. The rationing system proposed by one of President Obama’s key health care advisors is particularly disturbing. I’m speaking of the “Complete Lives System” advocated by Dr. Ezekiel Emanuel, the brother of the president’s chief of staff. President Obama has not yet stated any opposition to the “Complete Lives System,” a system which, if enacted, would refuse to allocate medical resources to the elderly, the infirm, and the disabled who have less economic potential. [1] Why the silence from the president on this aspect of his nationalization of health care? Does he agree with the “Complete Lives System”? If not, then why is Dr. Emanuel his policy advisor? What is he advising the president on? I just learned that Dr. Emanuel is now distancing himself from his own work and claiming that his “thinking has evolved” on the question of rationing care to benefit the strong and deny the weak. [2] How convenient that he disavowed his own work only after the nature of his scholarship was revealed to the public at large.
The president is busy assuring us that we can keep our private insurance plans, but common sense (and basic economics) tells us otherwise. The public option in the Democratic health care plan will crowd out private insurers, and that’s what it’s intended to do. A single payer health care plan has been President Obama’s agenda all along, though he is now claiming otherwise. Don’t take my word for it. Here’s what he said back in 2003:
“I happen to be a proponent of a single payer universal health care plan.... A single payer health care plan – universal health care plan – that’s what I would like to see.” [3]
A single-payer health care plan might be what Obama would like to see, but is it what the rest of us would like to see? What does a single payer health care plan look like? We need look no further than other countries who have adopted such a plan. The picture isn’t pretty. [4] The only way they can control costs is to ration care. As I noted in my earlier statement quoting Thomas Sowell, government run health care won’t reduce the price of medical care; it will simply refuse to pay the price. The expensive innovative procedures that people from all over the world come to the United States for will not be available under a government plan that seeks to cover everyone by capping costs.
Our senior citizens are right to be wary of this health care bill. Medical care at the end of life accounts for 80 percent of all health care. When care is rationed, that is naturally where the cuts will be felt first. The “end-of-life” consultations authorized in Section 1233 of HR 3200 were an obvious and heavy handed attempt at pressuring people to reduce the financial burden on the system by minimizing their own care. Worst still, it actually provided a financial incentive to doctors to initiate these consultations. People are right to point out that such a provision doesn’t sound “purely voluntary.”
In an article I noted yesterday, Charles Lane wrote:
“Ideally, the delicate decisions about how to manage life’s end would be made in a setting that is neutral in both appearance and fact. Yes, it’s good to have a doctor’s perspective. But Section 1233 goes beyond facilitating doctor input to preferring it. Indeed, the measure would have an interested party -- the government -- recruit doctors to sell the elderly on living wills, hospice care and their associated providers, professions and organizations. You don’t have to be a right-wing wacko to question that approach.” [5]
I agree. Last year, I issued a proclamation for “Healthcare Decisions Day.” [6] The proclamation sought to increase the public’s knowledge about creating living wills and establishing powers of attorney. There was no incentive to choose one option over another. There was certainly no financial incentive for physicians to push anything. In fact, the proclamation explicitly called on medical professionals and lawyers “to volunteer their time and efforts” to provide information to the public.
Comparing the “Healthcare Decisions Day” proclamation to Section 1233 of HR 3200 is ridiculous. The two are like apples and oranges. The attempt to link the two shows how desperate the proponents of nationalized health care are to shift the debate away from the disturbing details of their bill.
There is one aspect of this bill which I have not addressed yet, but it’s a very obvious one. It’s the simple fact that we can’t afford it. But don’t take my word for it. Take the word of Doug Elmendorf, the director of the nonpartisan Congressional Budget Office. He told the Senate Budget Committee last month:
“In the legislation that has been reported we do not see the sort of fundamental changes that would be necessary to reduce the trajectory of federal health spending by a significant amount. And on the contrary, the legislation significantly expands the federal responsibility for health care costs.” [7]
Dr. Elmendorf went on to note that this health care legislation would increase spending at an unsustainable rate.
Our nation is already $11.5 trillion in debt. Where will the money come from? Taxes, of course. And will a burdensome new tax help our economy recover? Of course not. The best way to encourage more health care coverage is to foster a strong economy where people can afford to purchase their own coverage if they choose to do so. The current administration’s economic policies have done nothing to help in this regard.
Health care is without a doubt a complex and contentious issue, but health care reform should be a market oriented solution. There are many ways we can reform the system and lower costs without nationalizing it.
The economist Arthur Laffer has taken the lead in pushing for a patient-center health care reform policy. He noted in a Wall Street Journal article earlier this month:
“A patient-centered health-care reform begins with individual ownership of insurance policies and leverages Health Savings Accounts, a low-premium, high-deductible alternative to traditional insurance that includes a tax-advantaged savings account. It allows people to purchase insurance policies across state lines and reduces the number of mandated benefits insurers are required to cover. It reallocates the majority of Medicaid spending into a simple voucher for low-income individuals to purchase their own insurance. And it reduces the cost of medical procedures by reforming tort liability laws.” [8]
Those are real reforms that we can live with and afford. Once again, I warn my fellow Americans that if we go down the path of nationalized health care, there will be no turning back. We must stop and think or we may find ourselves losing even more of our freedoms.
- Sarah Palin
[1] See http://www.scribd.com/doc/18280675/Principles-for-Allocation-of-Scarce-Medical-Interventions
[2] See http://washingtontimes.com/news/2009/aug/14/white-house-adviser-backs-off-rationing/
[3]See http://www.youtube.com/watch?v=-hsqzSKuC44
[4] See http://article.nationalreview.com/?q=N2M0ODk0OTNkZjkwNGM4OGMyYTEwYWY3ODUzMzFiOTc=
[5] See http://www.washingtonpost.com/wp-dyn/content/article/2009/08/07/AR2009080703043.html
[6] See http://www.gov.state.ak.us/archive.php?id=1094&type=6
[7] See http://blogs.abcnews.com/thenote/2009/07/cbo-sees-no-federal-cost-savings-in-dem-health-plans.html
[8] See http://online.wsj.com/article/SB10001424052970204619004574324361508092006.html
unquote
Concerning the "Death Panels"
I admit I am not paying as much attention to the health care proposals as I should be. Too much going on in my life to read the bills. I do admit with most of the country that we need to do something about our health care system. But, as I heard mentioned on the radio this morning, mostly with the costs involved.
As a STRONGLY Libertarian oriented person I find it odious at the least that our government is trying to become even more involved in health care than they are. Frankly the less our governmetn does the better I'd like it. GIve me more money to pay for my own health care.
One of the raging controversies is that of "Care Rationing" and the "Death Panels." President Obama has gone on record (multiple times but that's another issue) to say that the right wing has it wrong. Well here is a response from Sarah Palin. What I like about this is she actually sites the bill in her description. Something you almost NEVER hear a democrat do.
Copied from her Facebook notes - Sarah Palins' response to the President:
quote
Yesterday President Obama responded to my statement that Democratic health care proposals would lead to rationed care; that the sick, the elderly, and the disabled would suffer the most under such rationing; and that under such a system these “unproductive” members of society could face the prospect of government bureaucrats determining whether they deserve health care.
The President made light of these concerns. He said:
“Let me just be specific about some things that I’ve been hearing lately that we just need to dispose of here. The rumor that’s been circulating a lot lately is this idea that somehow the House of Representatives voted for death panels that will basically pull the plug on grandma because we’ve decided that we don’t, it’s too expensive to let her live anymore....It turns out that I guess this arose out of a provision in one of the House bills that allowed Medicare to reimburse people for consultations about end-of-life care, setting up living wills, the availability of hospice, etc. So the intention of the members of Congress was to give people more information so that they could handle issues of end-of-life care when they’re ready on their own terms. It wasn’t forcing anybody to do anything.” [1]
The provision that President Obama refers to is Section 1233 of HR 3200, entitled “Advance Care Planning Consultation.” [2] With all due respect, it’s misleading for the President to describe this section as an entirely voluntary provision that simply increases the information offered to Medicare recipients. The issue is the context in which that information is provided and the coercive effect these consultations will have in that context.
Section 1233 authorizes advanced care planning consultations for senior citizens on Medicare every five years, and more often “if there is a significant change in the health condition of the individual ... or upon admission to a skilled nursing facility, a long-term care facility... or a hospice program." [3] During those consultations, practitioners must explain “the continuum of end-of-life services and supports available, including palliative care and hospice,” and the government benefits available to pay for such services. [4]
Now put this in context. These consultations are authorized whenever a Medicare recipient’s health changes significantly or when they enter a nursing home, and they are part of a bill whose stated purpose is “to reduce the growth in health care spending.” [5] Is it any wonder that senior citizens might view such consultations as attempts to convince them to help reduce health care costs by accepting minimal end-of-life care? As Charles Lane notes in the Washington Post, Section 1233 “addresses compassionate goals in disconcerting proximity to fiscal ones.... If it’s all about obviating suffering, emotional or physical, what’s it doing in a measure to “bend the curve” on health-care costs?” [6]
As Lane also points out:
Though not mandatory, as some on the right have claimed, the consultations envisioned in Section 1233 aren’t quite “purely voluntary,” as Rep. Sander M. Levin (D-Mich.) asserts. To me, “purely voluntary” means “not unless the patient requests one.” Section 1233, however, lets doctors initiate the chat and gives them an incentive -- money -- to do so. Indeed, that’s an incentive to insist.
Patients may refuse without penalty, but many will bow to white-coated authority. Once they’re in the meeting, the bill does permit “formulation” of a plug-pulling order right then and there. So when Rep. Earl Blumenauer (D-Ore.) denies that Section 1233 would “place senior citizens in situations where they feel pressured to sign end-of-life directives that they would not otherwise sign,” I don’t think he’s being realistic. [7]
Even columnist Eugene Robinson, a self-described “true believer” who “will almost certainly support” “whatever reform package finally emerges”, agrees that “If the government says it has to control health-care costs and then offers to pay doctors to give advice about hospice care, citizens are not delusional to conclude that the goal is to reduce end-of-life spending.” [8]
So are these usually friendly pundits wrong? Is this all just a “rumor” to be “disposed of”, as President Obama says? Not according to Democratic New York State Senator Ruben Diaz, Chairman of the New York State Senate Aging Committee, who writes:
Section 1233 of House Resolution 3200 puts our senior citizens on a slippery slope and may diminish respect for the inherent dignity of each of their lives.... It is egregious to consider that any senior citizen ... should be placed in a situation where he or she would feel pressured to save the government money by dying a little sooner than he or she otherwise would, be required to be counseled about the supposed benefits of killing oneself, or be encouraged to sign any end of life directives that they would not otherwise sign. [9]
Of course, it’s not just this one provision that presents a problem. My original comments concerned statements made by Dr. Ezekiel Emanuel, a health policy advisor to President Obama and the brother of the President’s chief of staff. Dr. Emanuel has written that some medical services should not be guaranteed to those “who are irreversibly prevented from being or becoming participating citizens....An obvious example is not guaranteeing health services to patients with dementia.” [10] Dr. Emanuel has also advocated basing medical decisions on a system which “produces a priority curve on which individuals aged between roughly 15 and 40 years get the most chance, whereas the youngest and oldest people get chances that are attenuated.” [11]
President Obama can try to gloss over the effects of government authorized end-of-life consultations, but the views of one of his top health care advisors are clear enough. It’s all just more evidence that the Democratic legislative proposals will lead to health care rationing, and more evidence that the top-down plans of government bureaucrats will never result in real health care reform.
- Sarah Palin
[1] See http://blogs.abcnews.com/politicalpunch/2009/08/president-obama-addresses-sarah-palin-death-panels-wild-representations.html.
[2] See http://edlabor.house.gov/documents/111/pdf/publications/AAHCA-BillText-071409.pdf
[3] See HR 3200 sec. 1233 (hhh)(1); Sec. 1233 (hhh)(3)(B)(1), above.
[4] See HR 3200 sec. 1233 (hhh)(1)(E), above.
[5] See http://edlabor.house.gov/documents/111/pdf/publications/AAHCA-BillText-071409.pdf
[6] See http://www.washingtonpost.com/wp-dyn/content/article/2009/08/07/AR2009080703043.html].
[7] Id.
[8] See http://www.washingtonpost.com/wp-dyn/content/article/2009/08/10/AR2009081002455.html].
[9] See http://www.nysenate.gov/press-release/letter-congressman-henry-waxman-re-section-1233-hr-3200.
[10] See http://www.ncpa.org/pdfs/Where_Civic_Republicanism_and_Deliberative_Democracy_Meet.pdf
[11] See http://www.scribd.com/doc/18280675/Principles-for-Allocation-of-Scarce-Medical-Interventions.
unquote
As a STRONGLY Libertarian oriented person I find it odious at the least that our government is trying to become even more involved in health care than they are. Frankly the less our governmetn does the better I'd like it. GIve me more money to pay for my own health care.
One of the raging controversies is that of "Care Rationing" and the "Death Panels." President Obama has gone on record (multiple times but that's another issue) to say that the right wing has it wrong. Well here is a response from Sarah Palin. What I like about this is she actually sites the bill in her description. Something you almost NEVER hear a democrat do.
Copied from her Facebook notes - Sarah Palins' response to the President:
quote
Yesterday President Obama responded to my statement that Democratic health care proposals would lead to rationed care; that the sick, the elderly, and the disabled would suffer the most under such rationing; and that under such a system these “unproductive” members of society could face the prospect of government bureaucrats determining whether they deserve health care.
The President made light of these concerns. He said:
“Let me just be specific about some things that I’ve been hearing lately that we just need to dispose of here. The rumor that’s been circulating a lot lately is this idea that somehow the House of Representatives voted for death panels that will basically pull the plug on grandma because we’ve decided that we don’t, it’s too expensive to let her live anymore....It turns out that I guess this arose out of a provision in one of the House bills that allowed Medicare to reimburse people for consultations about end-of-life care, setting up living wills, the availability of hospice, etc. So the intention of the members of Congress was to give people more information so that they could handle issues of end-of-life care when they’re ready on their own terms. It wasn’t forcing anybody to do anything.” [1]
The provision that President Obama refers to is Section 1233 of HR 3200, entitled “Advance Care Planning Consultation.” [2] With all due respect, it’s misleading for the President to describe this section as an entirely voluntary provision that simply increases the information offered to Medicare recipients. The issue is the context in which that information is provided and the coercive effect these consultations will have in that context.
Section 1233 authorizes advanced care planning consultations for senior citizens on Medicare every five years, and more often “if there is a significant change in the health condition of the individual ... or upon admission to a skilled nursing facility, a long-term care facility... or a hospice program." [3] During those consultations, practitioners must explain “the continuum of end-of-life services and supports available, including palliative care and hospice,” and the government benefits available to pay for such services. [4]
Now put this in context. These consultations are authorized whenever a Medicare recipient’s health changes significantly or when they enter a nursing home, and they are part of a bill whose stated purpose is “to reduce the growth in health care spending.” [5] Is it any wonder that senior citizens might view such consultations as attempts to convince them to help reduce health care costs by accepting minimal end-of-life care? As Charles Lane notes in the Washington Post, Section 1233 “addresses compassionate goals in disconcerting proximity to fiscal ones.... If it’s all about obviating suffering, emotional or physical, what’s it doing in a measure to “bend the curve” on health-care costs?” [6]
As Lane also points out:
Though not mandatory, as some on the right have claimed, the consultations envisioned in Section 1233 aren’t quite “purely voluntary,” as Rep. Sander M. Levin (D-Mich.) asserts. To me, “purely voluntary” means “not unless the patient requests one.” Section 1233, however, lets doctors initiate the chat and gives them an incentive -- money -- to do so. Indeed, that’s an incentive to insist.
Patients may refuse without penalty, but many will bow to white-coated authority. Once they’re in the meeting, the bill does permit “formulation” of a plug-pulling order right then and there. So when Rep. Earl Blumenauer (D-Ore.) denies that Section 1233 would “place senior citizens in situations where they feel pressured to sign end-of-life directives that they would not otherwise sign,” I don’t think he’s being realistic. [7]
Even columnist Eugene Robinson, a self-described “true believer” who “will almost certainly support” “whatever reform package finally emerges”, agrees that “If the government says it has to control health-care costs and then offers to pay doctors to give advice about hospice care, citizens are not delusional to conclude that the goal is to reduce end-of-life spending.” [8]
So are these usually friendly pundits wrong? Is this all just a “rumor” to be “disposed of”, as President Obama says? Not according to Democratic New York State Senator Ruben Diaz, Chairman of the New York State Senate Aging Committee, who writes:
Section 1233 of House Resolution 3200 puts our senior citizens on a slippery slope and may diminish respect for the inherent dignity of each of their lives.... It is egregious to consider that any senior citizen ... should be placed in a situation where he or she would feel pressured to save the government money by dying a little sooner than he or she otherwise would, be required to be counseled about the supposed benefits of killing oneself, or be encouraged to sign any end of life directives that they would not otherwise sign. [9]
Of course, it’s not just this one provision that presents a problem. My original comments concerned statements made by Dr. Ezekiel Emanuel, a health policy advisor to President Obama and the brother of the President’s chief of staff. Dr. Emanuel has written that some medical services should not be guaranteed to those “who are irreversibly prevented from being or becoming participating citizens....An obvious example is not guaranteeing health services to patients with dementia.” [10] Dr. Emanuel has also advocated basing medical decisions on a system which “produces a priority curve on which individuals aged between roughly 15 and 40 years get the most chance, whereas the youngest and oldest people get chances that are attenuated.” [11]
President Obama can try to gloss over the effects of government authorized end-of-life consultations, but the views of one of his top health care advisors are clear enough. It’s all just more evidence that the Democratic legislative proposals will lead to health care rationing, and more evidence that the top-down plans of government bureaucrats will never result in real health care reform.
- Sarah Palin
[1] See http://blogs.abcnews.com/politicalpunch/2009/08/president-obama-addresses-sarah-palin-death-panels-wild-representations.html.
[2] See http://edlabor.house.gov/documents/111/pdf/publications/AAHCA-BillText-071409.pdf
[3] See HR 3200 sec. 1233 (hhh)(1); Sec. 1233 (hhh)(3)(B)(1), above.
[4] See HR 3200 sec. 1233 (hhh)(1)(E), above.
[5] See http://edlabor.house.gov/documents/111/pdf/publications/AAHCA-BillText-071409.pdf
[6] See http://www.washingtonpost.com/wp-dyn/content/article/2009/08/07/AR2009080703043.html].
[7] Id.
[8] See http://www.washingtonpost.com/wp-dyn/content/article/2009/08/10/AR2009081002455.html].
[9] See http://www.nysenate.gov/press-release/letter-congressman-henry-waxman-re-section-1233-hr-3200.
[10] See http://www.ncpa.org/pdfs/Where_Civic_Republicanism_and_Deliberative_Democracy_Meet.pdf
[11] See http://www.scribd.com/doc/18280675/Principles-for-Allocation-of-Scarce-Medical-Interventions.
unquote
Monday, August 10, 2009
Combative? Aren't they elected by US?
There are multiple sources in the media for the complaint by the White House that the discourse and difficulty arising at town hall meetings and other venues where our elected leaders are appearing over the Obama Healthcare Plan is driven by a "organization" seeking to discredit the White House's legislation plan. In fact the White House has gone to the level that I personally do not remember of publishing a "tattle" site where anyone can report instances of "misinformation" to the White House. Obama has even upped the ante by threatening "double the effort" to support any candidate for office that votes for his legislation when someone brings up Health Care as an "attack" on their record.
Well excuse me - but is this not America. Do the people of this country NOT have the Constitutional RIGHT to organize to voice their opinion? And who cares who is "behind it." Do we question who is behind the Union organizers? Oh wait, that must be OK because its obvious that the Union is a necessary social instrument and since it is a social instrument it must know more than the common man.
And now this. The Washington Times is reporting that a Congressman, after opening the floor for questions, is ranting at a man for having the gall to question the healthcare program. Howe dare this man intrude on his time to ask a question about healthcare.
It is time that everyone take the time to mail a postcard to their Congressman and voice their opinion - CLEARLY. This Congressman said that there was no appointment. Well go to your legislators local office and register your voice. Tell them you are a constituent and you are NOT going to take this abusive response lying down.
If you do NOT fight for our rights and our country NOW, will you be willing to do it over the trenches?
Well excuse me - but is this not America. Do the people of this country NOT have the Constitutional RIGHT to organize to voice their opinion? And who cares who is "behind it." Do we question who is behind the Union organizers? Oh wait, that must be OK because its obvious that the Union is a necessary social instrument and since it is a social instrument it must know more than the common man.
And now this. The Washington Times is reporting that a Congressman, after opening the floor for questions, is ranting at a man for having the gall to question the healthcare program. Howe dare this man intrude on his time to ask a question about healthcare.
It is time that everyone take the time to mail a postcard to their Congressman and voice their opinion - CLEARLY. This Congressman said that there was no appointment. Well go to your legislators local office and register your voice. Tell them you are a constituent and you are NOT going to take this abusive response lying down.
If you do NOT fight for our rights and our country NOW, will you be willing to do it over the trenches?
Saturday, August 8, 2009
Thomas Jefferson knew
Here are some thoughts taken from another forum
The founding fathers of this country, knew first hand the kind of tyranny would tear this nation apart, so they created the Bill Rights so WE THE PEOPLE could have control. WE THE PEOPLE have become blind and deaf to the events that are slowing enslaving us.
Please read these wonderful quotes by my hero Thomas Jefferson:
1)A Bill of Rights is what the people are entitled to against every government, and what no just government should refuse, or rest on inference.
2)A wise and frugal government, which shall leave men free to regulate their own pursuits of industry and improvement, and shall not take from the mouth of labor the bread it has earned - this is the sum of good government.
3)All tyranny needs to gain a foothold is for people of good conscience to remain silent
4)Educate and inform the whole mass of the people... They are the only sure reliance for the preservation of our liberty.
5)Every government degenerates when trusted to the rulers of the people alone. The people themselves are its only safe depositories
6)I predict future happiness for Americans if they can prevent the government from wasting the labors of the people under the pretense of taking care of them.
7)My reading of history convinces me that most bad government results from too much government.
8)Our country is now taking so steady a course as to show by what road it will pass to destruction, to wit: by consolidation of power first, and then corruption, its necessary consequence.
9)The tree of liberty must be refreshed from time to time with the blood of patriots and tyrants.
10)A government big enough to supply you with everything you need, is a government big enough to take away everything that you have.
The founding fathers of this country, knew first hand the kind of tyranny would tear this nation apart, so they created the Bill Rights so WE THE PEOPLE could have control. WE THE PEOPLE have become blind and deaf to the events that are slowing enslaving us.
Please read these wonderful quotes by my hero Thomas Jefferson:
1)A Bill of Rights is what the people are entitled to against every government, and what no just government should refuse, or rest on inference.
2)A wise and frugal government, which shall leave men free to regulate their own pursuits of industry and improvement, and shall not take from the mouth of labor the bread it has earned - this is the sum of good government.
3)All tyranny needs to gain a foothold is for people of good conscience to remain silent
4)Educate and inform the whole mass of the people... They are the only sure reliance for the preservation of our liberty.
5)Every government degenerates when trusted to the rulers of the people alone. The people themselves are its only safe depositories
6)I predict future happiness for Americans if they can prevent the government from wasting the labors of the people under the pretense of taking care of them.
7)My reading of history convinces me that most bad government results from too much government.
8)Our country is now taking so steady a course as to show by what road it will pass to destruction, to wit: by consolidation of power first, and then corruption, its necessary consequence.
9)The tree of liberty must be refreshed from time to time with the blood of patriots and tyrants.
10)A government big enough to supply you with everything you need, is a government big enough to take away everything that you have.
Friday, August 7, 2009
HUZZAH! A strike for freedom of speech in California
I won't repeat the history but a blow for common sense and freedom has been struck in California. The same court, which issued an injunction allowing the authorities to confiscate a particular club's colors or items with their name, has issued a new injunction overturning the previous one. This injunction prohibits the government authorities from confiscating a club's colors and items with their name attached.
Read the original story which denotes the goverment's use of this unconstitutional tactic here and the latest update at.
It will be noted that the same Judge who granted the previous injunction issued the latest. She realized the government had hoodwinked her into not fully disclosing the broad anti-constitutional grounds she was giving them. Note, in the last few paragraphs, how she states that our patches are protected under the First Amendment's Freedom of Speech provision of the Constitution, . . despite how despicable some may see us as being.
My respects to the Motorcycle 101 forum at Delphi for the orignal source of this information.
Read the original story which denotes the goverment's use of this unconstitutional tactic here and the latest update at.
It will be noted that the same Judge who granted the previous injunction issued the latest. She realized the government had hoodwinked her into not fully disclosing the broad anti-constitutional grounds she was giving them. Note, in the last few paragraphs, how she states that our patches are protected under the First Amendment's Freedom of Speech provision of the Constitution, . . despite how despicable some may see us as being.
My respects to the Motorcycle 101 forum at Delphi for the orignal source of this information.
Healthcare
Like all political issues there are two sides of any political discussion. In nearly every one of these conversations there seem to be two diametrically opposed sides with no middle ground. I completed a diverstity class for my BS recently. My professor responded to me when I said the problem was that there is no middle ground that the problem was no one wanted to "discuss any possible middle ground." As I thought about it I didn't really understand what he meant.
My previous post illustrates this concept so very distinctly for me. As I read the e-mail that I had received I was struck by the relevance to the discussion currently ongoing about Healthcare. In fact I was initially worried that this e-mail might in fact be a taunt for that discussion. You can take the core subject of this e-mail in either light depending upon your outlook on politics. For me I take it from both views - the middle ground if you will.
The Insurance companies need to be held accountable for the concept that profit is more important than people. But I also do NOT want my government in the business of providing (in ANY measure) health care. Personally I do NOT see that as a dichotomy of thoughts. This country needs some help; and we do need to reign in some of the social injustice But we do NOT need our tax dollars and our elected officials put into a position of making life and death decisions over the populace.
That is NOT a function of government. I challenge anyone, anywhere to show me where in the Constitution it says the government is responsible for the social welfare of the populace? They are responsible for interstate commerce, international trade and soverign protection. ANY function outside that concept is unconstitutional.
Now the argument for insurance company regulation falls into the interstate commerce. But when you read the constitution - it is the REGULATION of interstate commerce - not the participation in it.
For me the concept of PARTICIPATION is what is getting scary.
My previous post illustrates this concept so very distinctly for me. As I read the e-mail that I had received I was struck by the relevance to the discussion currently ongoing about Healthcare. In fact I was initially worried that this e-mail might in fact be a taunt for that discussion. You can take the core subject of this e-mail in either light depending upon your outlook on politics. For me I take it from both views - the middle ground if you will.
The Insurance companies need to be held accountable for the concept that profit is more important than people. But I also do NOT want my government in the business of providing (in ANY measure) health care. Personally I do NOT see that as a dichotomy of thoughts. This country needs some help; and we do need to reign in some of the social injustice But we do NOT need our tax dollars and our elected officials put into a position of making life and death decisions over the populace.
That is NOT a function of government. I challenge anyone, anywhere to show me where in the Constitution it says the government is responsible for the social welfare of the populace? They are responsible for interstate commerce, international trade and soverign protection. ANY function outside that concept is unconstitutional.
Now the argument for insurance company regulation falls into the interstate commerce. But when you read the constitution - it is the REGULATION of interstate commerce - not the participation in it.
For me the concept of PARTICIPATION is what is getting scary.
A very important issue
This came by my e-mail and I am NOT going to frame this in the light of politics. Simply put this is a crying shame and I hope that it never happens to anyone I care about. This is the text of the e-mail:
From a nurse:
I'll never forget the look in my patients' eyes when I had to tell them they had to go home with the drains, new exercises and no breast. I remember begging the Doctors to keep these women in the hospital longer, only to hear that they would, but their hands were tied by the insurance companies. So there I sat with my patients, giving them the instructions they needed to take care of themselves, knowing full well they didn't grasp half of what I was saying, because the glazed, hopeless, frightened look spoke louder than the quiet 'Thank You' they muttered. A mastectomy is when a woman's breast is removed in order to remove cancerous breast cells/tissue. If you know anyone who has had a Mastectomy, you may know that there is a lot of discomfort and pain afterwards..
Insurance companies are trying to make mastectomies an outpatient procedure. Let's give women the chance to recover properly in the hospital for 2 days after surgery.
The balance of the e-mail continues with a plea to complete an online petition. I do not know how effective these on-line petitions are, but at the very least register your support for the concept. Perhaps the vision of pure numbers may help.
http://www.lifetimetv.com/breastcancer/petition/signpetition.php
From a nurse:
I'll never forget the look in my patients' eyes when I had to tell them they had to go home with the drains, new exercises and no breast. I remember begging the Doctors to keep these women in the hospital longer, only to hear that they would, but their hands were tied by the insurance companies. So there I sat with my patients, giving them the instructions they needed to take care of themselves, knowing full well they didn't grasp half of what I was saying, because the glazed, hopeless, frightened look spoke louder than the quiet 'Thank You' they muttered. A mastectomy is when a woman's breast is removed in order to remove cancerous breast cells/tissue. If you know anyone who has had a Mastectomy, you may know that there is a lot of discomfort and pain afterwards..
Insurance companies are trying to make mastectomies an outpatient procedure. Let's give women the chance to recover properly in the hospital for 2 days after surgery.
The balance of the e-mail continues with a plea to complete an online petition. I do not know how effective these on-line petitions are, but at the very least register your support for the concept. Perhaps the vision of pure numbers may help.
http://www.lifetimetv.com/breastcancer/petition/signpetition.php
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