Friday, December 31, 2010

No Death Panels?

Remember that section 1233 that was removed from the Obama Health Care Plan because of the furor it raised? Here is a summary:

"A provision in the House bill written by Rep. Earl Blumenauer ( D-Ore.) would allow Medicare to pay doctors for voluntary counseling sessions that address end-of-life issues. The conversations between doctor and patient would include living wills, making a close relative or a trusted friend your health care proxy, learning about hospice as an option for the terminally ill, and information about pain medications for people suffering chronic discomfort.

The sessions would be covered every five years, more frequently if someone is gravely ill."

That, of course, was removed from the bill because of the furor over "death panels", a team of "experts" in Washington who would oversee treatment options. Section 1233 is back-a result of an executive fiat.
(New York Times)

Of course, as is their custom, the Democrats don't want to publicize what they are doing here.

We, of course, know why Obama made a recess appointment to Dr Donald Berwick at Medicare. His love of the British system toward the sick and elderly was well-known-and previously reported here. Now, just this month, that provision about the government paying doctors to give end of life counseling to elderly patients has been put back into the health care bill by fiat. It may seem innocuous to some, but the government has now inserted itself into the issue that belongs between a patient, doctor, spiritual advisor and family. It is all in the name of saving money. I have a sneaking suspicion, having gone through this myself with my Mom, that this is what patients, families and doctors are doing everyday. Why does the government need to become involved? Of course, this part does not talk about death panels, but I still have visions of that team of experts back in DC deciding whether to give me a pacemaker in about 20 years.

Holland, here we come. It may take us a while, but we'll get there.


Kirsti said...

You make some of the most insane logical back flips to go from "voluntary counseling sessions that address end-of-life issues" to "I still have visions of that team of experts back in DC deciding whether to give me a pacemaker in about 20 years".

You take 2 + 2 and come up with 15.

Gary Fouse said...


You are on your wife's sign on again.

You miss the point. Why should the govt intrude on this issue? What interest does the govt have in this?

If you add 1233 to that mini-commission, agency or board or panel or whatever you want to call it, it smells like 4 to me.

Lance Christian Johnson said...

Gary, this is what happens when start with the conclusion. Read the words of you quoted. Doctors will get paid for "voluntary counseling sessions". How does that logically lead to your assertion that "the government has now inserted itself into the issue that belongs between a patient, doctor, spiritual advisor and family"?

The only role the government is taking is that the doctors will get paid for something that you say that they should be taking part in anyway!

Seriously, Gary, I'm trying to wrap my head around what your point is, and I'm getting a headache. What you're saying makes absolutely NO sense unless you do what I'm accusing you of doing - starting with a conclusion.

Gary Fouse said...

Pls explain to me why the govt should be involved in paying doctors for this in the first place. This end of life discussion can be held anytime the sick and elderly patient sees a doctor. I( have experienced it, so I know what I am talking about. This is what Eliz Edwards just went through. Just the fact that the govt is implementing this shows me they have avested interest in limiting expensive treatments for the elderly. Read the stuff that concerned this bureaucracy they intended to set up in Washington to review medical procedures. Add this and it makes sense.

It is true that people are nearing end of life and their families need to consider the wisddom of treatments and operations or just let nature take its course. The govt should have no role in this.

Siarlys Jenkins said...

Let me try to say, in slightly different words, what Lance attempted to bring to your attention:

1) When you are not being thoughtful and insightful, you deteriorate into pathetic knee-jerk bleeding heart faux "conservatism."

2) What is the problem with doctors being able to talk to their patients about "end of life" issues?

My parents have left very specific written instructions, and have let me know practically all my life that they do NOT want to be kept on ventilators ad infinitum. I feel the same way. Naturally, if I had a doctor, I would want my doctor to know.

The ONLY government intrusion is that doctors generally only work when they are paid to work, like most human beings. Many of us also volunteer, but not for our employers. The law in question, if adopted, would authorize payment to doctors for taking the time when patients request the counselling. Doctors might even offer. It is not mandatory.

(Elizabeth Edwards most likely had substantial private insurance coverage. Millions of Americans don't).

Now you might go from here to arguing that government shouldn't be paying for medical care at all, because then government decides what will or will not be funded. That's a logically consistent, principled argument, although I think it raises more problems than it solves.

To the extent that government is involved at all, this should be funded, so patients have the option. (I recall Senator James Buckley explaining his vote for a child care bill, saying he had doubts government should be funding child care, but since it is, he favors a bill making sure it is good quality care, and that mothers have choices.)

Picking about whether doctors will be paid to discuss end of life issues is absurd.

Lance Christian Johnson said...

So, you're saying that doctors should get no money from the government then? Does this mean that you want to abolish Medicaid then? This is the only way your argument could make any sense at all. (I would still disagree, but at lest you'd make some sense.)

If not, then why should these doctors stop doing what you think that they should be doing under normal circumstances?

Seriously, this is some loopy circular logic you're running with here.

Gary Fouse said...

Yee Gads! There is nothing wrong with a doctor discussing end of life issues with a patient, and no, it isn't for free. That all occurs during the office visit or in the hospital during the normal course of his or her work.

What is it that you are missing? I don't want the govt in it. What are you suggesting-that as soon as end of life subject comes up, the covered part of a visit or hospital stay ends?

Lance Christian Johnson said...

What are you suggesting-that as soon as end of life subject comes up, the covered part of a visit or hospital stay ends?

That's what YOU'RE suggesting, Gary! Geez, you're so busy chasing your own tail that you don't even see that you're running in circles. Circular reasoning works because circular reasoning works, huh?

Look at Siarlys' response - completely independent of me he identifies the exact same problem with your argument. We didn't collaborate on our responses, I swear.

Gary Fouse said...


The problem is that I am speaking japanese and you and Siarlys are speaking Korean.

Lance Christian Johnson said...

No, the problem is you're not making a damn bit of sense and we've called you out on it. Instead of acknowledging the cognitive dissonance in your argument, you rely on your usual tactic when you've been defeated - the lame wise crack.

Gary Fouse said...


What exactly is the point you are "refuting"? That the govt should have no say in end of life decisions? That there was a plan to engage in health care rationing with a govt board making decisions on treatment? Do you even know what you are talking about?

I swear you and Siarlys are on a different planet.

Lance Christian Johnson said...

Gary, if you can't see the point that's been refuted by now, then it doesn't matter how much I explain it. It's like your whole "Hey! Global Warming is fake 'cuz it's a cold in Sweden!" argument. You have it clearly spelled out to you ad nauseum where your reasoning is faulty, but you just can't admit when you're wrong.

I've never heard of this but their point is as loopy as yours. The Youtube link that they provided doesn't even match the point that's being made in the article! Krugman was talking about getting rid of expensive treatments that have been proven to not be effective. But who the hell cares what he has to say on this in the first place? It has nothing to do with the fact that the point you make in your original post makes NO SENSE.

This has gone so far off the rails though and you're obfuscating because you can't see the obvious contradiction that you're making in your point.

Siarlys Jenkins said...

Gary, nothing you have presented in this post refers to a government board making decisions about end of life treatment. Everything you have presented refers to a provision allowing the government to pay doctors for discussing end of life issues with their patients.

When you have significant evidence that a proposal is being made to have a government board determine end of life treatment, then come back and tell us about it.

In the meantime, you are insinuating we must be in Korea because we haven't seen what isn't there. That does make for a difficult discussion - but neither of us has added anything to your own presentation. Your fears are not sustained by the data you yourself have cited. Holland? Are you reporting from Holland? We're in America, not in Holland...

Siarlys Jenkins said...

Late breaking news:

Here are the REAL death panels.

They are all being run by Republicans, not to kill old folks, but children and people in the prime of life.

That will wake up Americans who thought the Republicans were offering an honest presentation of fundamental values...