"Real liberty is neither found in despotism or the extremes of democracy, but in moderate governments.
Alexander Hamilton

Wednesday, July 15, 2015

No Death Panels and Also No Death Chats

 I read this editorial in the Union Leader entitled "No death panels here: Just paid death 'chats' instead. " 
( The brief editorial follows below). 
Invoking the " death panel" misnomer  is so misleading and so far from the truth. It wasn't true when Sarah Palin said it in 2008, and it is not true now. Calling them " death conversations" is almost as misguided.
Advanced care discussions have been happening for many years and is increasingly important as people are living longer and more conditions have viable interventions. And it isn't just for the elderly or seriously ill.  Health care is after all a birth to death continuum. Often times the discussion is about treatment options and what type of interventions are available. Do you want to be kept alive with artificial breathing machines and a feeding tube for example? Many times the treatment options are worse than the disease and without benefit of Advanced Directives, providers are obligated to provide a barrage of treatments, surgeries and the most advanced level of care available.
 According to the National Hospice and Palliative Care Organization the results of a recent survey  showed only 26.3 percent of respondents  had an advance directive. Talking with patients about their goals and preferences is not a "death chat" or a "death panel", it is a necessary part of the health care process. Editorials such as this one in the Union Leader does a disservice to its readers, as it may lead to some not having this important advanced care discussion with their provider and thus not having their true wishes for care legally documented. 
The " tripe" is not the proposed payments, it is the content of the editorial. An irresponsible distortion of the facts that benefits no one. 

"It is not exactly the “death panels” that critics of Obamacare warned could be set up to ration care to the old and sick. But the Obama administration proposed “rule” that 
came out last week is just as Orwellian.
The government wants to pay health-care providers to talk with Medicare recipients about end-of-life care. This would “encourage” doctors and other providers to begin these chats. This will save costs and improve patient care, so goes the theory.
What a bunch of tripe.
Doctors worth their oath have never needed encouragement to have meaningful conversations with their patients. But today’s factory-like atmosphere, brought on in part by the government, gives little time for the traditional doctor-patient relationship. Paying doctors to talk death is more likely to increase still more the cost of health care, the presumed savings from pulling the plug notwithstanding.
Shame on the American Medical Association for having at the ready two billing codes intended to be used for these paid death conversations.
We would say shame, too, on the Obama administration for this. But it has no shame. When the Affordable Care Act passed, it was after a provision to pay for these chats was deleted from the bill. Now, in typical Obama fashion, the law is to be ignored in favor of a “rule.”

Sort of the overall story of this bunch. "


Where's the Beef? said...

Is some else writing the blog? Why has there been a sift from local Moultonborough news to regional and national? I don't read the blog for regional and national news I read it to learn what's happening in Moultonborough and my community. I read the Laconia Sun, Citizen and Union Leader. Watch local and National news on TV and hear it on the radio. Blogger how about some NEWS about what's going on in our own town?

Joe Cormier/jcormier2@myfairpoint.net said...

Sitting here in Laconia, Irwin Motors, for a recall.

I've got "Directives" done ... I'm worried they may get triggered here, if I've got to wait much longer for the recall to be fixed!


Disappointed said...

I disagree with the blogger wholeheartedly. But then I didn't vote for Obama either time. This administration has one premise: if you can't legislate... regulate. This is the same president that begged us to believe cash for clunkers will work... is working... did work. When the numbers only proved that a whole section of affordable used cars were eliminated. The same one that caused a national sensation over a local deal in Cambridge MA calling the local PD stupid when they did their job of securing a possible crime scene. That all led to a beer summit. Whoopee. He jumped down about 5 levels of responsibility to start his racially divisive legacy. Fast forward to earlier this week. Same guy would have us believe the nuclear deal with Iran is good for the US and the world. Blogger I have an oceanfront property to sell you... in Wyoming.
Let's leave the national news to those who do it best and keep us up to date with Moultonborough and related issues.

Anonymous said...

Disappointed. I think a number of world powers agreed with him. Too bad Dick Cheney wasn't elected in his place. We would have six or seven wars going on. Did you learn about the British Empire in school? If so, don't you know two major wars brought it down. We haven't even paid for Iraq and Afghanistan. Did you sell your oceanfront property in Wyoming to Dick for that is where he lives?

Anonymous said...

Disappointed is out of touch with reality. What happens in DC effects all of us. You are Fox News to the tee. Forget the real issue, just bash Obama. You missed the point entirely. No wonder our country is so ^&^&^ up.

Anonymous said...

Please stick to the local issues.

Anonymous said...

"You are Fox News to the tee ..." What does that mean, by the way?

Thank you Chris Mathews!

"Forget the real issue,..."

Typical liberal mentality. Can,'t debate issues ... have to make personal attacks.

Moultonboro Blogger said...

The so called " paid death chats" are not part of the Affordable Care Act. The proposed rule is for a new payment schedule that is being proposed by CMS, the Centers for Medicare and Medicaid Services in compliance with the Medicare Access and CHIP Reauthorization Act of 2015 which was sponsored by a Texas Congressman and was a truly bipartisan bill. It repealed the Medicare Sustainable Growth Rate Formula, which had been used to control Medicare spending on physicians, amd was signed into law by President Obama in April 2015.

Florence Nightengale said...

"But today’s factory-like atmosphere. . . "

Come on now. This all happened long before the election of President Obama.
Most hospital used to be not-for-profit. Now most hospital are owned by large for profit corporations.
The first time I went into hospital as an adult and stayed 3 days I got two bills. One from the hospital and one from the doctor.
Last time I went into hospital for one night I got 18 bills.
Yes, I went to billing to obtain a copy of my hospital bill.
Everything is contracted out now. Even the billing was a private contractor.
18 companies have to make a profit on a single overnight stay at hospital.
This last time I started in the Emergency Room. Blood tests, X-Ray/MRI etc.
Then admitted. And a nurse comes in with empty vials for routine blood tests. I stated that I just had extensive blood tests in the Emergency Room downstairs. Well it's procedure I was advised for new blood tests.
I demanded that the obtain the results of the blood tests from the Emergency Room first - then come back to me and see if I need more blood tests.
AMAZING. No more blood tests were needed.
And you question why health care costs have risen. Hmmmm.
It's not Obamacare.
It's the greedy 18 private for profit health care companies that are sucking all of us dry AND causing health insurance costs to rise.