Death Panels,
 

WE need death panels.

Well, maybe not death panels, exactly, but unless we start allocating health care resources more prudently — rationing, by its proper name — the exploding cost of Medicare will swamp the federal budget.

But in the pantheon of toxic issues — the famous “third rails” of American politics — none stands taller than overtly acknowledging that elderly Americans are not entitled to every conceivable medical procedure or pharmaceutical.

http://stevenrattner.com/


Previously, Mr. Rattner served as Counselor to the Secretary of the Treasury and led the Obama Administration’s successful effort to restructure the automobile industry, which he chronicled in his book, Overhaul: An Insider’s Account of the Obama Administration’s Emergency Rescue of the Auto Industry.

Recently I was in the hospital for a few days. I was assigned to the oncology ward ...a nurse explained that sometimes when they have an overflow in other wings, they stash a few non-cancer patients there.

Late one night, I was chatting with one of the nurses about his job and how tough it must be to take care of mostly critically ill people. He mentioned that one of the hardest parts was getting patients from nursing homes, people far advanced with dementia. Seems it's a revolving door ... they're sent to the hospital to get them through some medical crisis, then back to the nursing home, hospital, nursing home, etc.

I think there's probably a line somewhere, although it's above my pay grade to say where it should be drawn.

* * * * * * * * * * *
But if this so-called Obama(care) is implemented in its entirity, it will soon be evident
that someone will be hired (or perhaps volunteer to help keep costs down?) to make
the decision as to whether it's time for gramps or memaw to take the little red pill.

Pity those individuals when their own relatives paperwork crosses their desk and the
same decision is 'expected' by management. Pity them even more. . . when it's their
time to take that same little red pill. How we all would long for soylent green. . .

The death panels exist now and always have. Decisions are made every day by insurance companies to withhold or deny treatment. Doctors also decide what will be done and what will not be done.

Not entirely the same, however, the truth/reality now, is we ALL have the freedom to not listen to the death panels, and can choose to do something else....... BIG difference.

Dirty little secret: they stop the revolving door between the nursing home and hospital with hospice. That way non-terminal patients can be killed-off through denial of medical care, saving insurance companies a fortune. Just leave them in bed with an untreated bronchial infection, then let nature take it course.

That introduction sends chills down my spine -

Yes, the cost of care for the elderly is staggering. They are being overmedicated, over treated, and overcharged. There is no doubt about that.

They, however, do not make those decisions. It is made by people in the healthcare industry - who are supposed to know what they are doing - and who just happen to be making huge amounts of money off this. The only decision they can make on their own is NOT to have the treatment. They can't write their own prescriptions, admittance slips, or force anyone to do any procedure.

It is a crime the amount of medication some elderly are one. Once on these medications, though, sometimes they can never get off them, certainly not without hospitalization and maybe not then.

The government and media are doing a really good job of diverting that blame from where it belongs and convincing people the elderly are the culprit and not the victims. It's working really well it seems.

There has always been some resentment between groups in this country for one reason or the other, but lately the talk seems to be revving up. We somehow have a group a presidential candidate thinks is to be ignored, and now we use the term 'death panels' in connection with human beings?

Rather than actually looking under the cover and see who is truly at fault, who is making obscene money from this, we are venting our spleen on the victims.

The certain group are not worth considering, need death panels for the elderly -

Who's next???

The "who's next" is already here. The elderly aren't being singled out because they're elderly, they're being singled out because they are expensive to care for on a long-term basis. That makes anybody who becomes expensive on a long-tern basis at risk.

I don't care how old you are. You're only one traffic collision away from being eliminated through hospice.

Yes, a lot of money is being spent to, as I said, overmedicate, overtreat, and overcharge the elderly. Ask who is making the profit on this? Certainly, the elderly are not profiting. Many are having their quality of life destroyed by these actions.

We just read about a hospital that routinely did heart procedures on the elderly when they came in with chest pains - whether they truly needed it or not. That person is now a 'heart patient' and will need care, and medications for whatever time they have left. That patient isn't responsible for that horror - the corporations making money is.

We have two nursing homes in this town. There was a doctor here who would stop by the nursing homes, one every other day. He would walk down the hall and stick his head in the door of all his patients and say, 'Hello, Mary, how are you today?' He then went to his office and charged medicare or medicaid for visits to the nursing homes.

So - why vent the spleen at the elderly - why not put the blame where it belongs on corruption and fraud?


You may know, but I don't know if everyone realizes just how many elderly are getting home healthcare. Those healthcare workers are all over the place. It has mushroomed in the last few years. Do all of them really need that or is this the corporations 'contributing' to politicians?

Go to an estate sale, and almost all will have a wheelchair, potty chair, sling that helps put them in bed, electric go carts, lift chairs, etc., or some of this equipment. Some of these will be new, unused - yet they are practically worthless. This has got to be in the billions. If these were simply checked out to be returned, refurbished (if needed) and reissued, it would save a ton of money. People do buy the lift chairs and go carts sometimes.

Also, it's not just the elderly or the accident victim. When will they decide a chronically ill child, a severely handicapped child, a preemie baby is too expensive? This is a slippery slope.

Maybe even those 'non taxpayers' who aren't important?

The government keeps starting new programs and adding more and more people to the healthcare - allow the healthcare industry to get by with fraud and outright theft, by their contributors. They then have the gall to complain about the cost.

Again, who is next?

Nevada, you had an AWFUL experience with Hospice. COuld be because you weren't clear, or Alma wasn't clear, or SOMEONE wasn't clear as to what type of Hospice she had set up. Hospice is SUPPOSED to take care of any illness NOT RELATED to the terminal illness while allowing nature to "take its course" for the actual illness itself. ie. If you have cancer and break an arm, you WILL be treated for the broken arm. If you have cancer and are taking a turn for the worse because of the cancer, you will be given comfort measures and YES you can be transported to the hospital IF YOU REQUEST IT, and YOU WILL BE TREATED if you request it. Any inaction on the part of the hospital at that point is sheer negligence.

I am really sorry you had such an awful experience. Many MANY people use hospice daily and it rolls along smoothly, as it is supposed to. As a medic, I always transported anyone who requested it. If however they coded and had a DNR, I would respect that and not take any measures to revive them. Even DNR's are different...some say do NOTHING, others say Do EVERYTHING until a pulse is lost and then let it be. Hospice and DNR's and so forth are a tricky road if you aren't clear about your instructions.

Sorry :hijacked:.

In theory that's the way it's supposed to work, and in the case of an injury they will take care of it. Where they find an opening is when the hospice patient gets an infection, say a bronchial infection. In that case you can see a doctor and take antibiotics, but if it gets worse the hospice patient will not be going to the hospital. Even if it develops into pneumonia, the hospice patient still stays home.

If course requiring home care in serious illnesses is going to result in death sooner or later for the elderly. Hospice will say that the patient was being treated and that they did everything they could to save her, but the objective was always to allow the patient to die inexpensively.

Don't kid yourself. Most hospice services are now for-profit companies. Their job is to save insurance companies money. If they don't, the insurance company will send their patients someplace else.

It's even trickier when they don't tell the truth. The hospice rep who got me to sign Alma into hospice even pretended to be offended that I said hospice was end-of-life care. A week later when there was a problem I reminded them of that, but they told me that the rep should have been up-front about hospice being end-of-life care. Clearly, the rep was willing to say ANYTHING to get me to agree to hospice.

The thing that people need to understand is that signing a patient into hospice is not just an agreement between the patient and the hospice service. Agreeing to hospice changes your status with both medicare and hospitals. If you don't understand that, you are being deceived.

I'm so worried about my in-laws. My MIL is 80 and has a heart condition. My FIL is 81 and has just been diagnosed with bladder cancer. They live in one of those retirement villages where you start out living pretty independently and move up to different levels of assisted living as needed. When Obamacare kicks in fully, I am so concerned about them being denied care.

These people worked hard their whole lives and owned two different businesses. They raised 4 great kids and have 6 grandchildren. FIL served during the Korean War. They've volunteered many hours at all of the churches they've attended. My MIL still knits hats for Samaritan's Purse. They deserve better than to be told "sorry, but you are too expensive to maintain since you are no longer useful to the state".

I don't know that I really think care is going to be denied. I'm afraid I think it will just continue to grow, and much of this is just rhetoric and pitting one group against another.

Truly, when you realize the elderly are not in charge of this program - not even their own healthcare, to a point. The corporations?government are. I don't see them giving up one dime of this income - unless something else is given them.

I think the government will continue adding more and more people to the programs, adding more and more programs, all the while making everyone think it's the elderly.
Then they can actually put in place total government paid healthcare and rather than the government and the corporate pals getting the blame, they will blame it on the elderly.

Your best bet is to have them at home, but I know that's not always possible. No matter how good their facility might be, they all play ball with doctors and insurance companies.

Avoid private hospitals. I found the best care for my elderly friend at a public hospital here in Las Vegas. Every private hospital in town has insurance companies as investors. I learned that the hard way.

If they can afford it, stay with standard Medicare with no supplemental insurance. Even a private supplemental insurance carrier can influence access to care.

Above all, don't talk to a hospice provider unless your loved one is terminal and wants to die.

I would like to know what the difference is between refusing an elderly patient what they need to live, and simply deciding to kill them off. Death panels do not eliminate the problem: theyeliminate the person.

I don't see any difference.

We don't need death panels - we need our government to stop letting the corporations have free run here. It shouldn't be that hard to catch some of the fraud and I'm thinking if they prosecute those responsible. The few times they do catch them, they simply announce a big fine, then privately make a deal for a lesser amount and the people doing the theft gets away with it.

They do not need to deny people necessary treatment. You can put a stop to the unnecessary medications and procedures and the elderly will have a better life and the taxpayers will save money. The corporations won't make as much and in turn, politicians won't get quite as many 'contributions'.

You are right, it doesn't fix the problem, it just 'fixes' the person.

The practice was institutionalized with hospice. A classic case of taking a good thing and abusing it for profit.

I believe that admitting a non-terminal patient into hospice is attempted murder, and keeping a non-terminal patient away from the hospital during a life-threatening medical emergency is straight-out murder.

We need to care for our elderly...they gave us values, and taught us responsibilities for life and living it. It's not perfect, and needs some sense put into it.

Medi-caid chaps my rear big time! Welfare moms take their kids to the doc every time they have a snotty nose, and think they're entitled to it! They think it's a free govmt program to take care of them and their kids. WHy not? they can squirt them out and be on the govmt payroll for everyone they hatch! Why not sterilize both the mother and father if they can't take care of their kids?

Pretty harsh, eh? Or is it better to teach them that what they're doing is good? It abounds here in very rural america! They need a subsistence plan for them, instead of nice housing, full benifits, and whatever choice of food and snacks they choose. Oh yeah, we don't want to forget smart phones, big screens, and toys! Yet, they're allowed to vote?

Not here. Hospice will not take you without a doctor verified diagnosis of a terminal illness with a time of 6 months or less until your death. They will not take dementia as a reason. I know people who have tried. Also, if you live one day beyond the six months, they are required to drop you from the program. I know because they made the rules clear before my dad died of cancer. He only had them for pain control about the last month of his life.

Hospice was excellent here to my dear MIL. She was in hospice care IN the hospital. She never got out after her cancer diagnosis. There were there every step of the way during treatments for infections/pneumonia/bronchitis. She was treated with iv antibiotics and given pain control for the cancer too.

Im sorry that you had such a bad experience Nevada. But you are painting with a pretty broad brush about the whole program. It was not like that at all in my experience. I have been in healthcare for over 17 years mostly with terminal patients and not once were they deprived of treatment. All they needed to do was have family or themselves say they wanted treatment. It was as simple as that.

Oh...this was in the last 5 months also...not that long ago.

It requires two doctors. Normally that's a hospitalist and the hospice director. They don't have to have a diagnosis of a terminal illness. They only need to say the patient isn't expected to live for more than 6 months. If the patient does not die in 6 months they can get an extension.

In Alma's case, they brought her into hospice for a mild stroke. She never had another stroke, and she did not die within 6 months. But she did have a pulmonary embolism after she was signed into hospice, and they were furious that I called an ambulance for her. They told me flat out that I was supposed to give her morphine & ativan, then let her die.

Alma's story was written up in Kiplinger's Magazine. It's only a couple of paragraphs, starting with the last paragraph in the left column on the second page.

https://dl.dropbox.com/u/22059150/hospice.pdf

Note that in the following paragraphs that hospice workers agreed that insisting that I not call an ambulance was standard for hospice.

I think that any suggestion that they didn't want Alma to die inexpensively is nonsense. Their objective was clear; they thought Alma was going to become expensive (she did), so they wanted her dead.

Does anyone truly believe that it will get better with Obamacare? do you really believe that the government will say "I don't care what it costs, do everything possible!"??? If so, then you are delusional.

Well they said that with the banks. Why not with the medical corporations. They will just create an extra trillion or so. Heck probably won't know the difference. A trillion here a trillion there. Long as we keep voting them back in.

So . . . Sarah Palin might actually have been correct, that her son, Trigg, might be denied care because there is very little chance taht he will become a fully contribution member of society?

American hospices are rank amateurs. To really get a good look at what's coming, see the Liverpool Care Pathway. Please not that after being placed on a LCP, the patient receives only pain medications.. No nutrition, no hydration, no antibiotics, no heart, cholesterol, or anti-seizure or anti-psychotic medication at all. As anyone who has experience with those kinds of medication knows, stopping them abruptly is a very bad thing.

Yet somehow we know when it's time to put our ailing pets to sleep and I've never heard anyone called a monster for doing so. In fact, someone who insisted on keeping alive an elderly, incontinent, blind, senile dog crippled from hip dysplasia, despite its obvious suffering, probably would be considered CRUEL for doing so...

No, I'm not seriously suggesting that we euthanize Grandma. :)

But there seems to be a real disconnect here in our thinking ...

It depends on your circumstance. My significant other has no insurance at all, but in 2004 she will get free coverage. She will be a lot better off.

I know that I'm looking forward to Obamacare for myself too. I'll be better off. In fact when I turn 65 I'll be forced off of Obamacare and into Medicare, which will be more expensive. for me.

It's not about contribution to society, it's about cost. If Palin's son was inexpensive to care for then they wouldn't care how long he lives, but any patient who becomes expensive on a long-term basis has a problem.

These two are contradictory, Nevada. You're entering the time of your life when you will cost the most money, right as Obamacare is kicking in.

It's going to cost more money than they expected the first year (and the second, and the third, and every year thereafter.) Before year three (2017), they will start making drastic cuts.

Realistically, I cannot see them making cuts to the care of the young and working without making parallel cuts the the care of the elderly, except they will (again) take money from Medicare to fund Obamacare, and thus hurt Medicare more than Obamacare.

Face it, Nevada, you're on the chopping block, or will be soon, because Medicare's simply not worth it. It's going to come down to Medicare being folded into Obamacare, so all the funds are in one pot, then it will be subtly defunded, with less and less spent on the elderly because ther simply isn't enough money to go around.

You saw what Alma went through, Nevada. Well, worse is on the way, because the only way socialized medicine will work is if we implement something like the Liverpool Car Pathway. Alma actually had it good. If we'd had the LCP in place, she'd have been given pain meds and nothing else -- not even IV fluids.

That's where we're heading, Nevada, and here you stand, cheering it on.

Forward!

EXACTLY....only the insurance companies use death panels who are looking at profits and not people.

Yet when Obamacare was first brought up everyone on the left denied that there would be death panels. Looks like the right was right on this one.

OK, I'll say it... some of it is in fear of lawsuits from the Family and some of it IS the family. It's hard to say goodbye to Grandma or Mom or that special friend... how many families though INSIST on ANY AND ALL extreme measures be taken even when the patient has signed a DNR?

Are we really being humane when a 87 year old is kept alive who will never get out that bed and never interact with those same relatives? What kind of quality of life is that for the patient?

The elderly and the young. Those who can not benefit society. Sounds hauntingly familiar to me.

Mark my words, it's coming whether you think it is or not. This is just how it started in Nazi Germany. At first they mocked anyone who even suggested that they would use death panels. Now you have elected officials calling for them.

Big difference between Rover and Grandma. Anyone that can't see that is beyond hope.

It reached that point with Alma, but I kept life fun for her. Less than 2 weeks before she died I took her to Circus Circus hotel for a few nights. She watched circus acts, watched the kids play games & go on rides, and enjoyed a few buffets. She deserved that.

Her only serious problem was recurrent urinary tract infections, and that's what she died of. She could have been treated a lot more aggressively. She never even met a urologist. She wasn't going to live forever, and I knew that, but she could certainly have lived to be 90.

The reason hospice is becoming more powerful is because of statements like yours. It's always assumed that old, expensive patients would be a lot happier dead. That really should be up to the patients though, don't you think?

If she could have lived to be 90 then why was she on hospice? I'm not trying to be mean, I know she meant a lot to you. But you have a HUGE chip on your shoulder. Not ALL hospices are the same. My sister's was wonderful. She even made a last trip to Tx about 2 weeks before she passed and they were there for her in Tx also.

I'm sorry that you and Alma had such a bed experience.

I didn't say that "ALL" hospice services are the same. There are honest ones, and if someone is truly in his last days any hospice service will treat a patient well.

Yes, I have a chip in my shoulder. They tried to kill my friend, and nobody (including you) denies that. And they would have succeeded if I hadn't intervened. There is a hospice advocate that I have talked to on the phone several times who tells me that this is going on all over the country.

Suggesting to me that I'm being unfair for wanting to regulate hospice after they tried to kill my friend because they might also do good work doesn't make sense. I'm not trying to shot hospice down. I'm only trying to stop them from killing non-terminal patients.

Why is that a problem for you?

Then I'm not exactly sure why you are for Obama care. There will be less money to treat more people, which will necessarily mean more denial of care, and more hospices.

You say you are against hospices or hospitals being run like sanitary death camps -- then why pick a course of action that will undeniably lead to more of them?

I don't believe it has to be that way.

There is a difference between the "quality of life" I was referring to and that of your friend. I'm referring to those that can't get out of bed and have lost mental acuity.

Unfortunately, Hospice has become the answer when the patients no longer needs a hospital but still needs some sort of "supportive care". I think the types of patients you are refering to need better nursing home care (and for alot, the ability to pay for a nursing home).