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Wednesday, January 5, 2011 - 8:51amSanction this postReply
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Reason.com has an article about this here.

It includes the following:
Editor’s Note: In an unexpected reversal, the Obama administration has announced that it will not implement the end-of-life planning regulations discussed in this article.


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Post 1

Wednesday, January 5, 2011 - 4:09pmSanction this postReply
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Editor’s Note: In an unexpected reversal, the Obama administration has announced that it will not implement the end-of-life planning regulations discussed in this article.
They're like cockroaches running from the daylight.




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Wednesday, January 5, 2011 - 4:38pmSanction this postReply
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I'm disappointed with many of the discussions of "death panels." Too many people don't get it. Counseling on end of life alternatives is NOT the original "death panel." The physician writing that article makes a point that a younger patient may elect to choose a directive that in the future would result in medical savings, but that still isn't a "death panel" even if a patient chose a "do not resuscitate" policy that resulted in an earlier death.

Sarah Palin coined the phrase and it referred to a panel that rations medical care to conserve funds even if it runs counter to medical advice, the wishes of the patient, and counter to any free market mechanism and occasionally results in the death of the patient.

Sarah Palin wrote, "...reading that section of the bill, it became so evident that there would be a panel of bureaucrats who would decide on levels of health care, decide on those who are worthy or not worthy of receiving some government-controlled coverage ... Since health care would have to be rationed if it were promised to everyone, it would therefore lead to harm for many individuals not able to receive the government care. That leads, of course, to death."

This goes back to the "Life Scores" concept written about by Obama's science czar (the guy that advocated forced sterilization), and is approved of by the Obama-appointed administrator of Obama-Care and that is currently in use in Britain's National Health Care System. It is applied by a panel that sets rules saying if you're above a certain age, (or whatever criteria is of importance at the time) you lose x number of points, and when your final score is less than y, then you don't get expensive treatments. You die.



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Wednesday, January 5, 2011 - 5:04pmSanction this postReply
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Steve W. wrote:
I'm disappointed with many of the discussions of "death panels." Too many people don't get it. Counseling on end of life alternatives is NOT the original "death panel."
 I'm puzzled by this. You quoted Sarah Palin saying "... that section of the bill ...". That section of the bill was Section 1233, about reimbursement for end-of-life counseling.
When asked exactly what part of the proposed legislation mandated death panels, Palin's spokesperson pointed to H.R. 3200, section 1233 Advance Care Planning Consultation. The provision would have allowed physicians to receive payment from Medicare for voluntary counseling with patients regarding end-of-life issues so that personal preferences for care when the time comes would be known so that doctors and relatives would not have to make decisions about care on their behalf. The counseling would cover topics such as making living wills, enabling a close relative or a trusted friend to make health care decisions, hospice as an option for the terminally ill, and information about pain medications for chronic discomfort. (source)


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Wednesday, January 5, 2011 - 5:33pmSanction this postReply
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Merlin,

Maybe Palin's spokesperson became confused. Maybe Palin wasn't fully consistent in her statements. I don't know.

I just know that when government moves towards control of the health care system they MUST end up rationing. When they do that, people will die because of the decisions made - decisions that were taken out of the market place and out of the hands of the patient.

I believe that this ugly aspect of government health care is being over-looked because 'death panels' (bureaucratic rationing) are being conflated with end-of-life counseling which is not a problem. When the government uses tax dollars to pay doctors to talk to me about end-of-life options, it isn't as good as the same thing being done under free enterprise, but I'm still making the choice of which options to select. But when a panel says that anyone over a certain age will not be given an expensive drug even if it means they die without the drug, that is a problem of greater magnitude.

Do you see why I get disappointed when people don't see the real death panel issue, and instead get it mixed up with the end-of-life counseling?

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Wednesday, January 5, 2011 - 5:55pmSanction this postReply
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Steve wrote:
Do you see why I get disappointed when people don't see the real death panel issue, and instead get it mixed up with the end-of-life counseling?
At least partly. Is Sarah Palin one of those who disappoint you?
But when a panel says that anyone over a certain age will not be given an expensive drug even if it means they die without the drug, that is a problem of greater magnitude.
Agreed. There is also a related issue. Does Palin believe patients (or their appointees) have the right to choose (with their doctors) any treatment whatever, regardless of cost or effectiveness, and have Medicare, i.e. taxpayers, pick up the tab?

(Edited by Merlin Jetton on 1/05, 6:03pm)


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Wednesday, January 5, 2011 - 6:59pmSanction this postReply
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Merlin,

I'm not a spokesperson for Gov. Palin and don't know what her opinions are on all things. There are a great many things about her that I like and others that I don't like. As far as I know she is strongly pro-Capitalism which would include moving away from Medicare to private systems. A quick Google indicates that she has advocated dismantling Medicare. I believe she suggested something like a voucher system to transition the current generation away and ending it for younger generations. But like I said, keeping track of her positions isn't my job.

She disappoints me less than most of the politicians out there - mostly because of character, honesty, guts, and small government stance. But needless to say, I'm very unhappy with her religiosity and believe that she doesn't have the intellectual strengths or gravitas to hold down the presidency. (But I'd vote for her in a heart-beat over Huckleby/Romney/?)

You put your finger on the problem that arises when you don't have a free-market medical system - patients can't be deprived of the right to health care needed to stay alive, yet no one has the right to spend other peoples' money on their medical care. There is no logical or just answer once the government inserts itself - health care needs to be totally free market.



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Thursday, January 6, 2011 - 3:32amSanction this postReply
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Steve wrote:
A quick Google indicates that she [Sarah Palin] has advocated dismantling Medicare. I believe she suggested something like a voucher system to transition the current generation away and ending it for younger generations.
You are correct. I found a WSJ op-ed she wrote here. Thanks. I wasn't aware of that.
You put your finger on the problem that arises when you don't have a free-market medical system - patients can't be deprived of the right to health care needed to stay alive, yet no one has the right to spend other peoples' money on their medical care.
I think the problem still exists in a free-market system, as long as insurance is part of it. It wouldn't be somebody in government making decisions about some treatment being too expensive or ineffective. It would be somebody who works for an insurer. Of course, it might be done via policy limits, with these likely having a significant effect on the size of the premium.

(Edited by Merlin Jetton on 1/06, 5:44am)


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Thursday, January 6, 2011 - 4:56amSanction this postReply
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Merlin observed:

I think the problem still exists in a free-market system, as long as insurance is part of it. It wouldn't be somebody in government making decisions about some treatment being too expensive or ineffective. It would be somebody who works for an insurer. Of course, it might be done via policy limits.

People seem not to accept that no human being in this universe has an infinite financial value to the market. That implies that every human being has a finite value and that different human beings have different values to the market. Moreover, their market value depreciates as their future earnings potentials decline in old age. This depreciation applies to people as well as to automobiles. This is why sensible car ownership includes knowing when to repair and when to discard a given automobile.

I know this sounds harsh but it is true regardless of whether the market is "free" or "dictatorially controlled." Obviously more options can proliferate in the former than in the latter which can ultimately create greater total value. More importantly, the former respects the individual's right to make his own choices whereas the latter does not. But in the end, much of this consternation comes down to people trying to legislate away the harsh reality of finite personal worth.

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Thursday, January 6, 2011 - 11:56amSanction this postReply
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Merlin,

With government run health care individuals may have no choice at all. And that means that under certain circumstances they will die, when under a free market health care system they might have lived.

Insurance creates a messy environment - particularly when it is is a third-party payer system (the party who pays the provider isn't the one receiving the service). But under free enterprise the person purchasing the insurance gets to choose the policy from those being offered and, in addition, as long as they can find the funds, they can make health care purchases that aren't covered by their policy. This last option is usually made illegal by governments (or regulated in a fashion that ends up driving out of business any independently provided services) as it moves towards single-payer status.

My current insurance company rules many things out (they won't pay for them) because they are "experimental" or "not in their formulary" or not "accepted medical practice," etc. Fortunately, I don't need any of those things at this time, and I hope I never will, but if I do, I can still pay out of my pocket (using cash or credit). But with government provided health care of the kind Obama-Care would soon have become, that would not be possible and that is where a panel responsible for ruling this or that out would become a death panel.

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Thursday, January 6, 2011 - 12:10pmSanction this postReply
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Luke,

Insurance companies just monetize risk. The older you are, all things considered, the greater your health risks, so the more you pay them. The more things you want them to cover you for, the higher the price.

When we make the choice to sell a car instead of continuing to own it and make repairs, that is a not the same as the government taking away the right of the individual to choose to continue seeking to get himself 'repaired' - in other words, the car doesn't have a right to continue on, but we do. The car isn't an agent, but we are. That makes the car analogy inapplicable in this area.

An employer should have the right to continue to employ a person as they get older, or to let them go (in the absence of a contract to the contrary). There is some market value of a person of a given age to fill a given job role. And for some roles, that value declines with age. The employee has no right to force the employer to keep him on, but he is free to attempt to negotiate a lower salary or to seek employment elsewhere. But the government death panels don't allow for some negotiation that would change their rulings, and the regulations kill the opportunity to purchase the needed health services outside of the government system.

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Friday, January 7, 2011 - 2:01pmSanction this postReply
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Luke:

But in the end, much of this consternation comes down to people trying to legislate away the harsh reality of finite personal worth.

Well said. It's about shedding unavoidable risk. I'm always drawn to the comparison, "How did our grandparents handle this existential boundary condition, and why do we think we are entitled to attempt an impossible solution?"

We all have finite duration here. Our processes, our borrowed star dust and our finite motes of heat and light and animation get 'spent.' It's an amazing, remarkable ride. In the end, we should be prepared to say 'thank-you, it was the most amazing thing' -- even if just to that universe -- and hand back our merely borrowed star dust to the universe from which we borrowed it.

The mission we seem to be on now ... stave off the inevitable end of the ride using every heroic effort known or imaginable to mankind with no questions asked, succeeds only in throwing patched up bodies onto a tidal wave that is still going to crash on the beach no matter what we do.

In our grandparents era, they would take the bad news, "Ride's almost over, order you affairs." They wouldn't say, "I can't afford it, but isn't there some way we can tax all of not only our children into oblivion to try and get me another 12 weeks here via some technological heroics?"

And, there wasn't a politician selling them that message using the lives of others on the way to political power.

My sister and I witnessed in horror what 'Medicare' permitted to be done to our elderly 90 year old mother, dieing of multiple diseases of old age: cancer, kidney failure. We finally had to wrestle her from the system and take her home to simply let her die in peace. For as long as Medicare would pay, her slow, drawn out death was being used as bait to fish for billables, torturing this woman far from the comfort of her home, in some hospital facility, simply so that A could bill B for trying to keep elderly dieing patient C living forever... Meanwhile, no 'cure' for old age was ever within sight. That was not compassion, that was systematic insanity, and that insanity is breaking the nation's back.

More hospice, less heroics. Patients should make their own choices, and it is not 'cruel' when those patients consider their own economic conditions, when considering, 'do I want to exhaust not only my entire estate but the resources of my children just to cling to this bed for another six months? Life is precious, but is the difference between 90.5 and 90 really worth all this, considering that the 'extra' 0.5 is during the most miserable phase of my entire existence on earth, and is largely just extending medical torture, in a futile try to avert the inevitable?

Individuals should have that choice, just like their parents and grandparents did.

We've attempted to make a utopic tribal assertion, that individuals will not make that choice, that the tribe will exert the maximum heroics possible for everyone at the end of their natural lives with no considerations at all to cost, futility, and choice.

It is tribal insanity, not compassion.





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