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Rant

End of Life Counseling Part II

Posted 30 months ago|17 comments|733 views
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Out Of The Box
 Moderator
Earlier I asked the question if Mandatory End of Life Counseling would mean government influence on the decisions we will have to make concerning our continuing care into our golden years.

I received some advice that the mandatory counseling required by our government would only be used to determine our wishes and legally document those wishes, as in the case of Terry Shiavo, who was starved to death for humane reasons, having not made clear her wishes about how she wanted to be disposed of when she was no longer able to communicate, through a living will or other instrument.

I am still not convinced that the government, or at least those behind the MANDATORY counseling, (it would sit better if the counseling was made available, but optional) do not have the goal of reducing costs by flim-flamming our senior citizens into giving up their healthcare at the time in life when most of the care you receive over your lifetime is needed. It is also a time in life when you are most susceptible to being conned.

For me, the video at the left pretty much sums it up.

Is this going to become the new patriotism, literally giving your life for the good of the country?

PLEASE. Tell me what you think.
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30 months ago: Can you do me a favor and punch your number into the calculator for me? I trust you. If there are too many zeros in the answer. I'll sign over all of my assets to good ol' Uncle Sam. Who cares anyway?
30 months ago: What I think is that your bias against the attempt to provide quality health care for everyone is driving you to see dragons behind bushes!

He didn't say anything about giving up our lives for the good of the country.

What he DID say is that they want to ensure people know the benefits/risks of treatments which apply to the elderly so they can make good decisions.

That's all ANY of this discussion is about.
Out Of The Box
Out Of The Box
 Moderator
30 months ago: Pardon my differing opinion, but i haven't seen anything in any proposals about increasing the quality of health care per se. I have only seen an effort to provide heath care insurance, without any indication of the quality of said insurance.
Out Of The Box
Out Of The Box
 Moderator
30 months ago:
What I have seen Obama say over and over is that the quantity of health care has to be curtailed, in the hope that the quality would rise.
JAK Gladney
JAK Gladney
Saint Albans, WV
30 months ago: "Is this going to become the new patriotism, literally giving your life for the good of the country?"

I'm pretending you can still be convinced on this issue, and that you're not just an errand boy for the pro-life camp (though given the Terri Schiavo statement in your rant, that's a big suspension of disbelief).

Why is it that any time someone says "end-of-life care/counseling," people think "euthanasia"? I've seen this conflated with physician-assisted suicide, withholding life-saving treatments (like transplant surgery) to people over a certain age threshold (psst: doctors already make that decision when assessing surgery risk), putting grandma on an ice floe, etc.

Read the provision: Sec. 1233
(1) Subject to paragraphs (3) and (4), the term `advance care planning consultation' means a consultation between the individual and a practitioner described in paragraph (2) regarding advance care planning, if, subject to paragraph (3), the individual involved has not had such a consultation within the last 5 years.

Like the PSDA, in effect for almost 20 years, this affords you the OPPORTUNITY to execute your own advance directive, and to learn about other end-of-life plans of action. If you choose not to, bully and good luck to you. No one is going to force you to make your wishes clear--they can be as murky as you like. Your extended family can be involved in legal wrangles like Terri Schiavo's family for years; your non-responsive body can be used like a political football; you can be shuttled from long-term care facility to long-term care facility like a bad penny for decades. In short, no government official can prevent you from making catastrophic decisions.

More to follow...
JAK Gladney
JAK Gladney
Saint Albans, WV
30 months ago: III, iii: "A program for orders for life sustaining treatment for a States"

This is known as a POST form in some states--Physicians Order for Scope of Treatment. It's an itemized list of end-of-life interventions: you choose which you'd like (feeding tubes, CPR, antibiotics) and which you'd refuse, and discuss the specific scope of treatment with your doctor. If you'd like some but not others, great; if you'd like every single intervention, super; if you'd like no extraordinary intervention whatsoever, fine.

You're against anything resembling universal health care--understood. And like other like-minded people, you smell blood in the water on this issue: maybe one more distortion will effectively kill health care reform. So what's the game plan look like? (1) Mobilize the scattered remnants of the pro-life movement on an end-of-life issue (Terri Schiavo was really their Waterloo--the prospect of having these people by the bedside scared the hell out of most people); (2) Scare old people?

You remain unconvinced because you don't want to be convinced.
Out Of The Box
Out Of The Box
 Moderator
30 months ago: Awww, JAK, such a harsh statement. Why is it that you can not believe that someone with a differing opinion can hold a thought of their own in their little pea sized brains?
I realize it was uttered mainly for the gallery, with the secondary purpose of trying to put me on the defensive.
My brother, who I am quite fond of, is also an intellectual snob, and says things like "I won't insult your intelligence by assuming you aren't thinking what I am." Hee Hee! Are you a lacky for the socialist movement and the baby killers? I would never presume to put it that way, what did you call it?

Oh yeah, POLEMICS

And skipping over the rest for the time being, your statement about "mobilizing the scattered remnants of the Pro-life movement" you and I both know to be based on a false premise, as we just had the conversation recently concerning the recent superior numbers of pro-lifers over pro-choicers.
Out Of The Box
Out Of The Box
 Moderator
30 months ago: Now, I have read the provisions, in entirety, and posted excerpts from the bill in my first post on this topic.

You are the one not getting the gist of my question, and I feel that your reactions are flavored by a desire to socialize as much of the private sector as possible, as quickly as possible.

The question is, mainly, "Would it be possible for our government, through a socialized health care plan, to override the wishes of a citizen of United States of America, through obfuscatory (that word has been popping up a lot lately) language that might be interpreted one way or the other. Would economic factors influence the decisions goverment officials make in regard to a citizens care?"

Obama has clearly stated he wants to cut down on the amount of care we recieve. What if that doesn't work? He wants to go in both feet first, without testing the waters.
With the current amount of opposition to his plan, it will surely fail. In his response to Mrs. Sturm, he clearly indicated that in some cases it would be determined that the best thing would be to "take a painkiller".

I think JAK, that you are conflating your experience with the state version of Advance Care Directive Planning with the new proposed Federal version.

I see Terry Shiavo as our Alamo.

I remain unconvinced because I haven't seen ample evidence to the contrary.
JAK Gladney
JAK Gladney
Saint Albans, WV
30 months ago: West Virginia didn't write it's advance directive statutes in a vacuum, and the federal proposal, as currently written, reflects nationwide end-of-life trends--like the POST form (also known as MOST, MOLST, POLST, and PORT, initially developed by an Oregon task force).

This is a copy of North Carolina's form--almost identical to WV's, and representative of the type:

http://www.dhhs.state.nc.us/dhsr/EMS/pdf/ncmostform.pdf

This movement is 20 years old, and there's been talk, for the last few years, about organizing a national advance directive database.

More later...
30 months ago: NOWHERE have you seen (or heard) "Obama say the quality of health care must be curtailed." NOWHERE. If you can find that in a verified quote--I want to see it.

Let me quote from Obama: "Over the next month there is going to be an avalanche of misinformation and scare tactics from those seeking to perpetuate the status quo. But we know the cost of doing nothing is too high. Health care costs will double over the next decade, millions more will become uninsured, and state and local governments will go bankrupt.

(The following are the basic principles under which they're operating.)

No discrimination for pre-existing conditions
No exorbitant out-of-pocket expenses, deductibles or co-pays
No cost-sharing for preventive care
No dropping of coverage if you become seriously ill
No gender discrimination
No annual or lifetime caps on coverage
Extended coverage for young adults
Guaranteed insurance renewal so long as premiums are paid

So--show me where it says all old people will be taken from their homes and forced to die for the good of the country.

I'm waiting.
30 months ago: Oh--and like JAK, I'm beginning to think you are one of the anti-choice people who're so terrified that tax money might be used to pay for LEGAL pregnancy terminations of poor women that you'll do anything to stop the plan in its entirety.

I'm just saying.
30 months ago: "But others think caution about savings from efficiency gains is warranted. Eugene Steuerle, vice president of the Peter G. Peterson Foundation, an anti-deficit group, points out that every improvement in medical care, such as a cure that could extend life, could lead to more costs."

Gee...which major lobby in this country would object to better health insurance/higher costs?

Out Of The Box
Out Of The Box
 Moderator
30 months ago: The scare tactics are not coming only from the opposition, read your own Obama quote. If that isn't scare tactics, I don't know what is.
Lady, I never said that Obama said quality must be curtailed, he said quantity must be curtailed. He cites country after country that spend less per capita on healthcare than the U.S. I'm sure Zimbabwe spends way less than that. That in itself is not a good recommendation.

Now, believe it or not, the insurance industry is part of the capialist system, and subject to the laws of commerce, same as Walmart. Thay don't all get together once a month to go up on premiums and figure out how to further screw the consumer. If they can't hold the prices down on quality health care with the limits they have placed on policies, how can the government continue Quality health care with all those limits removed, without a drastic increase in insurance premiums? It makes no economic sense to say that they can increase the load by 20 per cent, remove the conditions and caps, and keep healthcare any more affordable than it is now.

Let's try to not get hysterical.

And to your final comment, although it has nothing to do with this topic, but it is so far skewed out into left field, that I must reply:

There are always choices. Adoption is a choice. Proper protection is a choice. Choosing to not make a baby that you don't want is a choice.
Stopping a beating human heart is a choice.

But that has nothing to do with my concerns over this part of the bill. I wanted to have a ratonal discussion, but as usual, when people disagree, they get nasty.
Out Of The Box
Out Of The Box
 Moderator
30 months ago: Let me add that the same considerations of abortion can be placed on the elderly.

1. Is a baby/the elderly going to inconvenience me?
2. Is a baby/the elderly going to cost me money?
3. I am not able to take care of a baby/the elderly.
4. I must think about the baby's/the elderly's quality of life.
Any reason you may think is just cause to have an abortion can also be applied to the way "enlightened" society will consider the care of the elderly, if their care is distributed by the government.
30 months ago: Sorry, OTB, I am guilty of reading without my glasses.

However, you DID just say "Let's try to not get hysterical." Your statements above are so skewed that I consider them just that.

There is considerable difference between a zygote and an adult, sentient human being. You frighten me when you're so willing and downright EAGER to believe the worst of our government and our society.

Well, Obama and his advisors are well aware of the hysteria and outright lies being perpetrated about the health-care issue and so are we.
JAK Gladney
JAK Gladney
Saint Albans, WV
30 months ago: You're circling the wagons, OOTB.

This is not MANDATORY counseling. It ensures that advance care planning will be covered if a patient requests it from a qualified care provider. They may have this consultation more than once every five years in the event of chronic illness or a change in health status. And let's not gloss over your "giving your life for the good of the country" comment, unless you meant this as hyperbole.

Obama, during a July 28th AARP health care forum:

"The intent here is to simply make sure that you've got more information, and that Medicare will pay for it. So if Medicare is saying you have the option of consulting with somebody about hospice care, and we will reimburse it, that's putting more power, more choice in the hands of the American people, and it strikes me that that's a sensible thing to do."

He has made this statement time and time again. AARP executive vice-president John Rother has added, "To suggest otherwise is a gross, and even cruel, distortion--especially for any family that has been forced to make the difficult decisions on care for loved ones approaching the end of their lives."

And now you've actually made the inevitable tie-in with abortion. Does a fetus have decision-making capacity?
Out Of The Box
Out Of The Box
 Moderator
30 months ago: OK, I concede for now that the consultations are not mandatory. I have read until my eyes swam (swum?)and referenced the changes to Section 1861 of the Medicare Act, and I can't find "mandatory" or any synonym thereof anywhere.

And actually, I didn't make the abortion tie-in, it was presented to me. But I thought I made a pretty point with the opportunity.

See rudistettners rant on euthanasia, he has researched it further than I.

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