Surprise! End-of-life advisory incentives return — through regulation
posted at 12:00 pm on December 26, 2010 by Ed Morrissey
Better get used to this process, because it’s how President Obama will be pushing his agenda on all fronts. The New York Times reports today that the White House will create incentives for doctors to discuss “options” for end of life care through regulation, after Congress removed the incentives from ObamaCare:
Under the new policy, outlined in a Medicare regulation, the government will pay doctors who advise patients on options for end-of-life care, which may include advance directives to forgo aggressive life-sustaining treatment.
Congressional supporters of the new policy, though pleased, have kept quiet. They fear provoking another furor like the one in 2009 when Republicans seized on the idea of end-of-life counseling to argue that the Democrats’ bill would allow the government to cut off care for the critically ill.
The final version of the health care legislation, signed into law by President Obama in March, authorized Medicare coverage of yearly physical examinations, or wellness visits. The new rule says Medicare will cover “voluntary advance care planning,” to discuss end-of-life treatment, as part of the annual visit.
Under the rule, doctors can provide information to patients on how to prepare an “advance directive,” stating how aggressively they wish to be treated if they are so sick that they cannot make health care decisions for themselves.
While the new law does not mention advance care planning, the Obama administration has been able to achieve its policy goal through the regulation-writing process, a strategy that could become more prevalent in the next two years as the president deals with a strengthened Republican opposition in Congress.
There is nothing wrong with patients planning for contingencies through advance directives. There is also nothing wrong with doctors discussing those options with patients ahead of those decisions. As the spouse of a patient who has faced life-threatening circumstances on more than one occasion, I certainly understand why these conversations need to take place before the pressures of acute circumstances come into play. This new regulatory effort at least puts the conversation where it belongs, in routine wellness visits, rather than as a five-year set conversation. It also appears to make this a voluntary conversation (at least for now), one the patient can decline without any repercussions.
There is, however, something at least vaguely disturbing about a government incentivizing doctors to do so as part of an expansive regulatory program that has, as one of its primary goals, cost reduction. The process used by Obama and Kathleen Sebelius to get this into ObamaCare is more disturbing, and in a very specific way. Congress made it clear that it didn’t want this incentive as part of the new law. However, thanks to the miles and miles of ambiguity in the final version of ObamaCare, with its repetitive the Secretary shall determine language, Congress has more or less passed a blank check for regulatory growth to Obama and Sebelius.
This is just the opening gambit of a strategy Obama will use throughout the coming year in order to achieve through regulation what a Democrat-run Congress could not deliver through legislation. The new Republican House will have to use its power of the purse to stop this autocratic imposition of regulation, and remain vigilant in doing so on all fronts. Let’s hope the GOP gets used to fighting this process over the next two years.
Blowback
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That is the GOAL of the Left – to remove the fruit of your life from your hands by regulation and to do so completely.
And it won’t be just over $100K: it will be everything down to the last red cent from billionaire to beggar down to the last piece of clothing, the last piece of furniture, anything you own becomes the property of the State. And you will be told this is a good thing. Then they will have control over everything, cradle to grave, to hand out favors as they see fit and to make everyone poor, save for the bureaucrats who will be rich. Aristocracies have to be formed on the backs of someone, and it is the majority upon which they ride.
And yet you were born free.
And have a republic if you can keep it…
ajacksonian on December 26, 2010 at 5:21 PM
Tell that to the thousands of old people lying in UK hospices, doped up on pain killers waiting to die because the NHS ruled that they were not “worth” treating, or the woman whose premature baby came a few days before an arbitrary cutoff date and the NHS refused to treat it.
No, that type of panel is not in Øbamacare. That type of panel is never in a socialized medicine law when it first passes. It comes later, when the cost curve fails to get bent downward as promised. Palin was talking about what was to be.
Kafir on December 26, 2010 at 5:26 PM
Anyone have an answer to the rising cost of healthcare and aging population ……………. and, the increasing new healthcare technology that is expensive to implement? What is the cost of medical care going to be when everyone expects a lifespan of 100 years? I am sad to say that I have a beloved 93 old aunt who has had to move into a in a nursing home. Her short term memory is just no long functioning. It breaks my heart.
SC.Charlie on December 26, 2010 at 5:27 PM
For now. Remember how Social Security and Medicare started out as small programs and ballooned? Øbamacare is designed to ultimately put all health care insurers out of business so the government can take over (just ask Jan Schakowsky). When that occurs, there will be no way to fund any procedures the government does not allow, unless you have the means to travel to another country where they do not have socialized medicine.
Kafir on December 26, 2010 at 5:32 PM
All we have to go on is what has happened in nations that have adopted such measures that people like Berwick think are the cure for what’s wrong with America’s situation.
Since you say “literally a thousand,” I don’t suppose you would like to propose maybe one that your Obamassiah has suggested (rather than trying to sneak extralegislative language into the regulations like a weasel)?
L.N. Smithee on December 26, 2010 at 5:32 PM
Before you answer my last question, BlueSite, go here: Dr. Jacob Hacker: “It’s not a trojan horse. It’s just right there. I’m telling you! We’re going to get there…”
L.N. Smithee on December 26, 2010 at 5:39 PM
‘The govt isn’t going to decide you need to die and take away care.’
Oh, yes they will. Have you ever heard of the UK NHS’ Liverpool Care Pathway’(LCP)?
That’s exactly what they do. A team of doctors and other healthcare workers decide, on their own without appeal or oversight, that someone is ‘terminal’. Once this determination is made, all fluids and nutrition are suspended and the patient is medicated into insensibility.
When the patient actually does die, the staff all pat themselves on the back for being right.
Under the LCP, an otherwise healthy patient who presents with a broken rib and later develops severe pneumonia could hypothetically find themselves literally sentenced to death without appeal in as little as 24 hours.
NHS officials admit to themselves that the LCP ‘may’ be causing unnecessary deaths. Family members who have disregarded LCP rules and continued feeding the patient themselves have reported dramatic recoveries.
Tailgunner on December 26, 2010 at 5:42 PM
Phase One – Fed Govt provides incentives for doctors to talk about end-of-life alternatives that save money
Phase Two – Fed Govt decides non-physicians can provide advice on end-of-life alternatives that save money
Phase three – Fed Govt decides bureaucrats are in a better position to select end-of-life alternative to save a lot of money
Phase four – Death Panels make unilateral decisions on how to kill expensive patients
David in ATL on December 26, 2010 at 5:49 PM
Let us hope we do not make it to those four phases!..:)
Dire Straits on December 26, 2010 at 5:54 PM
the striking thing is that the Lefty/Dems have stuck together for decades to get this. Nixon had a plan…it was blocked, Carter had a plan, Kennedy blocked it.
Hillarycare was so radical that it outlawed cash transactions between Drs and patients. Hardly any nation has that radical of a plan
but, the left/Dems hang tough…single payer, central control, is an article of faith. we have our Hayek, etc. they have command and control.
r keller on December 26, 2010 at 6:19 PM
Death panels are indignant.
Schadenfreude on December 26, 2010 at 6:33 PM
Ed, it is more than “something at least vaguely disturbing about a government incentivizing doctors to do so [end of life planning] as part of an expansive regulatory program that has, as one of its primary goals, cost reduction.” What has been referred to as “death panels” are being introduced by regulation. Obama and today’s Democrats are really creepy radical socialists.
Phil Byler on December 26, 2010 at 6:39 PM
I’m glad you finally figured out what the rest of us have long known.
bw222 on December 26, 2010 at 6:42 PM
It has nothing to do with Palin, idiot.
My doc has stopped taking Medicare. I work for a regional healthcare alliance – dozens of hospitals, tens of clinics, 9000 employees…we are rationing care as well. It is happening, idiot, and it will only get worse in the future.
Yes, you ARE the idiot. Go on, kiss Obaka’s ass…see where it ultimately gets you. Death. You are as expendable as anyone else.
Idiot.
ladyingray on December 26, 2010 at 6:42 PM
Honey, death panel claims weren’t your problem. Incompetence is the liberal hallmark. You all managed to pass something by shoving it down our throats. No one, especially YOU, knows what is in that horrible piece of incompetent and freedom stealing legislation.
I tell you what though- if you will man up and show where you were willing to pay for someone else’s medical bills and Palin’s defense fund, I will take back the things I think about you.
Other that that, hypocrisy and incompetence to blame yourself for your own disaster is your hallmark. It is ALL you liberals fault, and yet with the super majority you had, you couldn’t get it passed with out dirty, rotten, stinking tricks and ignorance, nor could you get the American people to LIKE this **it sandwich you forced them to eat. INCOMPETENT.
Noelie on December 26, 2010 at 6:56 PM
First I am on Tricare, retired Military Health Insurance and qualify for V A Health care as well. Having said that. Those who chose to have the Government fund their Health care, should expect the Government to act in it’s own interest, not the people who are getting the Health Care.
While we do use Tricare and the VA, my wife I are very selective and “Health Tourist” a lot in Asia for more serious stuff and second, third etc opinions. The point being, retired military, veteran and Senior Citizen or not, I am in charge of my Health Care.
Linh_My on December 26, 2010 at 7:22 PM
I just had to log on. I am in flyover country. I believe America is still great and has helped millions all over the world.
I cannot believe anyone still thinks Bambi is educated, intelligent, or a great orator. He is not well educated in any area, cannot construct an intelligent sentence, and cannot speak well without a teleprompter. I hate his evil practices in every area. No one who hates America should have been elected to any office.
I do not understand why anyone thinks Sarah has no experience, education or training, or brains. I have liked her since she spoke at the last presidential convention. I took a democrat friend to see her speak last year; this friend had waited 3 hours to see her hero Bambi. My friend knew little about Sarah before the meeting. She said she was very impressed by Sarah and would vote for her. Hah!
I voted for Sarah and will again. I will NOT vote for lousy RINOs. God save us all from these evil politicians and their czars.
MoGal on December 26, 2010 at 7:28 PM
I’ve said it so many times that if I had talent I’d set it to music or embroider it into a sampler or something–here it comes again. All these troubles started the day Barack Obama walked into the WH. Imagine how nice the last two years could have been had we never heard of this demagogue. I’ll console myself by deciding that he was sent to us to underline the error of our ways and give us a lesson we won’t soon forget.
jeanie on December 26, 2010 at 7:36 PM
darwin-t on December 26, 2010 at 7:37 PM
Free yourself from Palin Derangement Syndrome. As long as you do she will own your head.
itsspideyman on December 26, 2010 at 7:44 PM
Failed Governor? HI! HI! HI!
She’s locked up by erroneous AK Ethics Law! She got rid of that silly law (now repealed by Parnell) to do what? To get revenge to the tacticians…. DEMOCRATIC PARTY!
Now, no one can’t contain or control her. Too much damage to Obama’s image, right?
HI! HI! HI!
Death Panels …. be ‘fraid. Blue Site.
I know, you still know what that “Bluish” color really means. DEAD!
TheAlamos on December 26, 2010 at 7:59 PM
Hey, no problem, just do what the pre-world war II German people did when the Nazis tried this on their own ‘inconvenent” people. After the doctors became seen by the common man as “the enemy trying to kill you” they refused to get those death causing medical innoculations ,endangering the entire populace.(they went on strike you might say) The nazies were forced to switch to killing off their own undesirables with no-fat (saurkraut) diets (3 or 4 months usually did the job. So when the Obama-messiah machine begins to order saurkraut for the medicare program…well….
Don L on December 26, 2010 at 8:18 PM
He’s not the DOTUS anymore……
……now he’s the DAOTUS
Death Angel of the United States….a fitting followup to his Illinois Senate work to make sure the unborn don’t survive botched abortions.
Nice work DAOTUS!!
PappyD61 on December 26, 2010 at 8:40 PM
“If they would rather die, they had better do it, and decrease the surplus population.” – Mr. Ebeneezer Scrooge, Democrat
Django on December 26, 2010 at 9:35 PM
Government by decree…or should that be by edict?
Gohawgs on December 26, 2010 at 10:15 PM
I love “the secretary shall determine” default
a czar is a czar
you could throw out the 1999 pages of legislature snd leave one page to
“the secretary shall determine” and you would have the same law without the camoflage
Sonosam on December 26, 2010 at 10:50 PM
Hey, here’s an interesting little find. I didn’t have to look very hard either. Found it on Bing.
German National Socialist Party (that means, .. shhh… nazi party.. shhh ) propaganda poster from the 40′s.
Shows a fine young health German standing behind some derelict with the words
“This person suffering from hereditary defects
costs the community 60,000 Reichsmark during his lifetime.
Fellow German, that is your money, too.”
How weird is that? Go figure!
http://www.bing.com/images/search?q=nazi+propaganda&view=detail&id=75A88FBFCCE3BC70D31354CC3679B598FF528DA0&first=31&FORM=IDFRIR&qpvt=
JellyToast on December 26, 2010 at 10:55 PM
I have no quarrel with letting people who WANT to die doing so, and the life-at-all-costs fanatics can take a hike.
But letting the Feds become a super-company that cuts costs by refusing treatments is abhorrent. We already have more than enough of that in the private sector, God help us if it becomes national!
Dark-Star on December 26, 2010 at 10:58 PM
Well, thank God Jesus wasn’t pro-death panel. Strange how He was always going around healing sick people instead of telling them it was time to die.
Heck, looks like he’s even healing people today. Wonder what he thinks of ObamaCare?
http://www.cbn.com/cbnnews/us/2010/October/Alabama-Revival-Sparks-Miracles-Healings/
JellyToast on December 26, 2010 at 11:04 PM
End-of-life discussions have a place in the doctor-patient relationship.
But what place does government have paying doctors to make sure they have the conversation? All that’s required for this to go awry is for doctors to believe that the government wants them to emphasize reduced treatment options.
But I’m sure the government will never talk about how fiscally strapped Medicare is, right?
hawksruleva on December 26, 2010 at 11:24 PM
So death panels are in FACT a likely prospect? Hmmm who woulda thunk it?
Not to mention the FDA’s decertification of Avastin, the cancer drug, so when will Glenn Beck get the credit he deserves for predicting a year and a half ago that Congress will become irrelevant? Just sayin’.
MsUnderestimated on December 26, 2010 at 11:29 PM
May it please the Court, Death panels are back. Anyone’s pants on fire whom previously denied it?
Mason on December 26, 2010 at 11:30 PM
This is why it had to be passed before we found out what was in it. Nice trick.
Cindy Munford on December 26, 2010 at 11:38 PM
It doesn’t matter what’s in it now since,
“the secretary shall determine ” in the rare case when obabacare contradicts itself or the economic model isn’t matching reality, right.
That gives them unlimited authority
funny how that caveat makes this law living in a sense
and ultimately meaningless
Sonosam on December 26, 2010 at 11:51 PM
Hey I am all for Democrats killing off their own! Whether it be abortions, death panels or short changing their elderly… I say go for it. One less Greedy Lib Democrat screaming about their medicare or social security. We cannot convince them these things are wrong, so let them have at it.
We will simply take care of our own and when we take over via the vote, we banish them to the Phantom Zone Forevahhhhhhhhhhh!!!!!!!!!!!
Africanus on December 27, 2010 at 12:41 AM
diktat
besser tot als rot on December 27, 2010 at 1:11 AM
Ed, I have been wondering how the First Mate is doing. I remember reading your “HospiBlogging” way back when. Please update the oldtimers here on her if you are comfortable with it.
leftnomore on December 27, 2010 at 3:36 AM
And yet you’re still pulling for the dems who want this implemented.
Sucker.
Squiggy on December 27, 2010 at 6:42 AM
Abandon hope all ye who enter here.
Not only a blank check, but entirely usurping the bank and the entire economy in due process of making it up as you go autonomous authoritarians with salivating, blood thirsty enforcement of authoritarianism IRS hounds.
And given the entrenched “reformed by GWB” compassionate Republican Party (that gifted America the DHS and executive ordered the Sec./Treasury complete autonomy) featured in the Washingtonian bipartisan show in Congress, pray for the New Year. If we are to pray for those who abuse us, then pray that they stop and that they lose opportunity and potency to destroy Constitutional Governance.
May Divine Providence strengthen Tea Party newly elected legislators and citizenry, for protection from the Washingtonian establishment that eats fresh meat for laughs, for unity to govern our Constitutional Republic against all odds, to cut the spending, to cut tax funding in order to apply the tourniquet and amputate socialist bureaucracies from governance, and to preserve our Bill of Rights even as Americans strive ourselves to build the economy without a Big Brother or Nanny Mandate, certainly without eugenics.
maverick muse on December 27, 2010 at 7:52 AM
This is just the shape of things to come.
kingsjester on December 27, 2010 at 8:58 AM
One leading critic of the initial end-of-life language said Sunday she wasn’t bothered by the new Medicare rule.
“Medicare should reimburse physicians for counseling patients on the medical decisions they may face,” said Betsy McCaughey, a former New York lieutenant governor, in an interview. “But government should never prescribe what is discussed between doctor and patient, or pressure doctors financially to push their patients into living wills and advanced directives.”
Ms. McCaughey said the previous guidelines from the George W. Bush administration and other administrations had left it up to patients and doctors to decide how they would discuss end-of-life matters.
http://online.wsj.com/article/SB10001424052970203568004576043970989095748.html?mod=WSJ_WSJ_US_News_5
Can anyone explain how this is different than what was previously done? Looks like Medicare would have paid for this anyways.
Jimbo3 on December 27, 2010 at 9:56 AM
This is my list of what needs to privatized in the Federal government.
Social Security
Medicare
Fannie Mae Freddie Mac
FHA Program
And reduce Defense Spending, but not at the cost of US security. We don’t need to protest Europe.
Oil Can on December 27, 2010 at 10:09 AM
I hate to break this to all of you, but the Medicare Part B Improvements bill passed by the GOP in 2003 and signed by Bush also provided for these same services in hospice settings:
SEC. 512. COVERAGE OF HOSPICE CONSULTATION SERVICES.
(a) COVERAGE OF HOSPICE CONSULTATION SERVICES- Section 1812(a) (42 U.S.C. 1395d(a)) is amended–
(1) by striking `and’ at the end of paragraph (3);
(2) by striking the period at the end of paragraph (4) and inserting `; and’; and
(3) by inserting after paragraph (4) the following new paragraph:
`(5) for individuals who are terminally ill, have not made an election under subsection (d)(1), and have not previously received services under this paragraph, services that are furnished by a physician (as defined in section 1861(r)(1)) who is either the medical director or an employee of a hospice program and that–
`(A) consist of–
`(i) an evaluation of the individual’s need for pain and symptom management, including the individual’s need for hospice care; and
`(ii) counseling the individual with respect to hospice care and other care options; and
`(B) may include advising the individual regarding advanced care planning.’.(b) PAYMENT- Section 1814(i) (42 U.S.C. 1395f(i)) is amended by adding at the end the following new paragraph:
`(4) The amount paid to a hospice program with respect to the services under section 1812(a)(5) for which payment may be made under this part shall be equal to an amount established for an office or other outpatient visit for evaluation and management associated with presenting problems of moderate severity and requiring medical decisionmaking of low complexity under the fee schedule established under section 1848(b), other than the portion of such amount attributable to the practice expense component.’.
(c) CONFORMING AMENDMENT- Section 1861(dd)(2)(A)(i) (42 U.S.C. 1395x(dd)(2)(A)(i)) is amended by inserting before the comma at the end the following: `and services described in section 1812(a)(5)’.
(d) EFFECTIVE DATE- The amendments made by this section shall apply to services provided by a hospice program on or after January 1, 2005.
http://thomas.loc.gov/cgi-bin/query/D?c108:5:./temp/~c108G5a4qz:e743627:
Jimbo3 on December 27, 2010 at 10:10 AM
I believe the argument is that it us not unusual for a Dr/ Patient relationship to cover “end of life ” subjects in the case of the terminally ill
it’s the concern that government bodies will lead in that regard which isn’t the case now
GWB has nothing to do with the takeover and perversion of our healthcare system jimmy
Sonosam on December 27, 2010 at 10:24 AM
Jimbo –
The is a HUGE difference between
`(B) may include advising the individual regarding advanced care planning.
and the government paying doctors to advise patients on options for end-of-life care,during their annual Medicare physical, which may include advance directives to forgo aggressive life-sustaining treatment.
kingsjester on December 27, 2010 at 10:36 AM
End of life counseling = Death panels. The deceptions of this administration to brand Palin as a nutcase for suggesting what was really put in place was a reflection of the ignorance of the American electorate. If the American people even consider believing what was an obvious lie from Obama, they shall be the ones to suffer the consequences. The ignorance of the American people is being exploited as never before in our history.
volsense on December 27, 2010 at 10:41 AM
What are you being dishonest about today jimbo?
Inanemergencydial on December 27, 2010 at 10:46 AM
Silly Sarah Palin! It’s not a “death panel!” It’s an “end of life counseling.”
morganfrost on December 27, 2010 at 11:05 AM
Jimbo doesn’t seem to understand there is a difference between hospice care and healthcare.
ladyingray on December 27, 2010 at 11:09 AM
With a leftist like jimbo, why assign ignorance when malice is more likely his intent.
Inanemergencydial on December 27, 2010 at 11:14 AM
You mean a worthless lying scum like yourself?
Jimbo3 on December 27, 2010 at 12:02 PM
Aah, Kingjester, Medicare is paying for the advance care planning under the Prescription Drug Bill.
So why don’t you explain why it’s coersive when the counseling is done during annual physicals and not coersive when it’s done when someone is at the end of their life?
Jimbo3 on December 27, 2010 at 12:04 PM
End of life discussions SHOULD be a part of routine medical care for everyone. But becaise Medicare has ratcheted down reimbursements so much over the years, the few doctors who still accept Medicare do their routine physicals as quickly as possible because they lose money on them. They will not take the time to discuss any end-of-life planning or advanced-care directives with a Medicare patient unless they get paid to do it, or the patient insists on it. The government is hoping that more doctors will initiate the discussions if it doesn’t cost them anything to do it.
It sounds sinister, and I don’t trust this Administration as far as I could throw any of them, but this doesn’t bother me too much as a policy issue – what bothers me is the willful “FU” by the Administration in issuing this regulation knowing that it was expressly removed from the legislation.
rockmom on December 27, 2010 at 12:07 PM
at least we don’t have to worry about congress passing laws…Obama and his merry band of fascists will rule by decree.
right4life on December 27, 2010 at 12:16 PM
Now we are talking!
Long live the motherland!
Inanemergencydial on December 27, 2010 at 12:16 PM
Makes me livid. These people will do whatever it takes to cram their controls down our throats. Being rejected by Congress, by the courts, or at the polls just makes them more devious and more defiant.
Mark, on Rush’s show, is on a rant about this now. I hope talk radio beats this like a drum.
petefrt on December 27, 2010 at 12:17 PM
and we need to eliminate the FDA the FCC, EPA, department of agriculture, education, energy, transportation, and labor.
right4life on December 27, 2010 at 12:18 PM
Add the Bureau of Indian Affairs to your list R4L.
Inanemergencydial on December 27, 2010 at 12:20 PM
What makes me livid is how big a bunch of unethical f*cking liars some of the GOP types are on this board. Some of you are total scum.
Jimbo3 on December 27, 2010 at 12:20 PM
Hear! Hear!
petefrt on December 27, 2010 at 12:20 PM
Let it out jimbo, feel the hate coursing thru your veins.
Go full Stalin, I know you want to.
Inanemergencydial on December 27, 2010 at 12:22 PM
very true…their medical system is the model for obamacare…kill off the useless eaters…
right4life on December 27, 2010 at 12:26 PM
don’t post here…go to stormfront where you will more at home.
right4life on December 27, 2010 at 12:26 PM
Jimbo, do you not understand the difference between someone being in an end-of-life Hospice setting, and a Seasoned Citizen, receiving their annual physical from their physician?
kingsjester on December 27, 2010 at 12:29 PM
Here’s a random sampling of your comments via Google. Do you ever make any positive contributions to these discussions, or do you just insult people?
Proud Rino on July 25, 2010 at 1:27 PM
Silly twaggot, don’t you know wikipedia isn’t a reliable source?
Inanemergencydial on July 25, 2010 at 1:30 PM
Poor leftist activist…
Inanemergencydial on July 25, 2010 at 1:54 PM
I hope he is the first against the wall.
Inanemergencydial on July 29, 2010 at 10:56 AM
Jimbo3 on December 27, 2010 at 12:29 PM
I understand there is a difference. But when is that counsiling likely to be more coersive? When someone is in a hospice or when someone is more healthy in connection with their annual physical?
Jimbo3 on December 27, 2010 at 12:31 PM
Just so it doesn’t get buried in the thread:
This is the kind of lawless defiance we’re up against. Heads need to roll.
petefrt on December 27, 2010 at 12:32 PM
FIFY
When Medicare pays specifically for this “chat” it becomes coercive. Currently, all patients have the ability to discuss this with their physicians, and they should. Coercing the physician into the conversation via reimbursement is nothing short of the government telling a physician what to say, and what type of treatment to provide.
It isn’t the government’s business!
ladyingray on December 27, 2010 at 12:40 PM
So you are calling me a neo-Nazi and a white supremacist?
Jimbo3 on December 27, 2010 at 12:41 PM
Hey jumbo the stalinist copy-paste warrior.
Can you cut out proud rino’s moniker in those comments and replace it with your own?
Inanemergencydial on December 27, 2010 at 12:42 PM
I guess reading comprehension isn’t your strong point. Medicare is already paying for this in a hospice setting under the Prescription Drug Improvement plan passed by the GOP and signed by Bush.
Jimbo3 on December 27, 2010 at 12:43 PM
I guess common sense isn’t your strong point. There is a difference between hospice and healthcare.
ladyingray on December 27, 2010 at 12:45 PM
well if the jack-boot fits..you’ve already said you want to get rid of ‘uesless eaters’ like terri shiavo…
right4life on December 27, 2010 at 1:06 PM
Why don’t you point out where I used the term “useless eaters”.
Jimbo3 on December 27, 2010 at 1:09 PM
Looks like you’ve intentionally avoided answering my question….
Jimbo3 on December 27, 2010 at 1:11 PM
A few things…
1. Saying “Bush did it too” is not a valid argument. In case you’ve forgotten, he wasn’t all that liked when he finally left office, and it wasn’t just the liberals who didn’t like him.
2. I fail to understand why those in hospice shouldn’t receive end of life counseling. These are dying people who need to make those kinds of decisions.
Also, I don’t see where you’re arguing that these talks are considered part of money saving tools for a government program.
Esthier on December 27, 2010 at 1:11 PM
Why are wasting your time?
Esthier on December 27, 2010 at 1:12 PM
I see your Lie-O-Matic is fully functional.
Dark-Star on December 27, 2010 at 1:16 PM
Maybe because he (somehow) expects an iota of intelligence and honesty from you?
Dark-Star on December 27, 2010 at 1:17 PM
so you didn’t want terri schiavo starved to death huh?
you know what they say, a rose by any other name..
right4life on December 27, 2010 at 1:19 PM
Reading fail.
Esthier on December 27, 2010 at 1:24 PM
Let’s not dump on Esthier. I respect Esthier and her views. right4life and inanemergency…well, let’s just say that inanemergency seems to be incapable of doing anything other than insulting people and right4life seems to primarily twist things.
Jimbo3 on December 27, 2010 at 1:25 PM
My point was that Medicare already pays for this in an end-of-life situation under a bill passed by the GOP and signed by Bush. People in those situations are likely to be the most vulnerable and most easily coersed. Yet it apparently was fine for the GOP to pass that bill in 2003 when it wasn’t politically convenient to call that “death squads” and “death counseling”.
I think it’s even more appropriate for people on Medicare to make those decisions when they are in a better frame of mind and healthy, so I’m fine with the nre rules.
Jimbo3 on December 27, 2010 at 1:30 PM
Will do. (or rather, will not do)
Thanks for the clarification.
Dark-Star on December 27, 2010 at 1:31 PM
Eh, I don’t bother with Dark either, especially when he can’t even be bothered to look ahead and see who that question was directed at.
right will direct those same comments at anyone, making them completely meaningless. It’s not even personal.
Esthier on December 27, 2010 at 1:31 PM
I’ll have turkey on rye, with dijon and relish. Thanks!
DarkCurrent on December 27, 2010 at 1:32 PM
I haven’t called you that…you’re just dishonest, delusional and idiotic.
right4life on December 27, 2010 at 1:34 PM
I think you mean Dork, not Dark. I’m Dark.
DarkCurrent on December 27, 2010 at 1:34 PM
twist things? after reading your absolute joy in the death of terri shiavo? right.
right4life on December 27, 2010 at 1:35 PM
Looks like you’ve intentionally avoided responding to my point regarding the difference between hospice care and healthcare. Kingjester pointed out the same fact.
Since my comment was first, I’ll answer your question after you respond to my comment.
I have no problem with those in hospice care having these conversations with their physicians, but it should be between the patient and the physician. The federal government has no place in coercing this discussion by rewarding the physician specifically for having this conversation.
This discussion has no place in a routine healthcare exam, unless broached by the patient.
ladyingray on December 27, 2010 at 1:35 PM
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