Specialists dominate patient care. General practitioners (the family doctor) treats whatever he can treat. The GP sends his patient to a specialist after identifying a problem he cannot treat. Thats a good thing. Its comforting knowing that the specialist does nothing else but the thing you are seeing him for. Specializing in one type of surgery is doubly comforting. You gotta figure the guy knows what he is doing because he does nothing else. After listening to this audio: http://www.youtube.com/watch?feature=player_embedded&v=VNHWeTEvGU4 I sensed that death panels are moving towards specializing in different fields. It makes sense. The culture of death becomes too obvious when one death panel can deny treatment for every illness. Denying treatment should require as much special knowledge as is required to perform brain surgery, heart surgery, and so on. Should death panel members have to testify in court, or before Congress, they would have to prove their decision was based on special knowledge. Naturally, death panel members are not expected to combine knowledge and skill. Demanding both would be unfair. After all, nobody expects the millions of aficionados with knowledge of art to dash off a Mona Lisa in their spare time? NOTE: I have to admit that Democrats do care about the middle, if not the middle class. Democrats are determined to kill life at both ends abortion and old age. There is a bright spot in the war against the practitioners of the culture of death. Donald Berwick resigned because he knew Republicans were going to block his confirmation. Death panels aside, anybody who admires socialized medicine has to ignore the institutional indifference, brutality, and outright cruelty that is commonplace in the UKs model for socialized medicine. That is the system Berwick wants to import. The following article does a good job of defining Berwick: Berwick Resigns as Medicare Chief Ahead of End to Recess Appointment Published November 23, 2011 WASHINGTON Medicare chief Don Berwick, the point man for carrying out President Obama's health care law, announced Wednesday that he will step down on Dec. 2 in anticipation of not getting confirmation in the Senate to extend his term beyond a recess appointment. Berwick, a Harvard professor who aggravated many Republicans for his praise of Britain's government-run health care program, was appointed as head of the Center for Medicare and Medicaid Services by President Obama on July 7, 2010. Knowing that Berwick would not be confirmed to take a more permanent post, the recess appointment was temporary. It runs out at the end of this year. Forty-two GOP senators -- more than enough to derail Berwick's confirmation -- had announced their opposition to his nomination months ago. "Not only did he not win Republicans over he didn't win Democrats in the Senate over and Max Baucus, chairman of the Finance Committee, never even scheduled a hearing on the nomination," Sen. John Barrasso, R-Wyo., a physician told Fox News Radio on Wednesday. A pediatrician before becoming an educator, Berwick had sought a public-based system that he said would provide a better overall experience for individual patients, improve the health of groups of people such as seniors and African-Americans and lower costs through efficiency. But many of his prior statements dogged him in Washington, especially over the question of rationing. His praise for the British model also sent up flags. "You could have been spending 17 percent of your GDP to make healthcare unaffordable as a human right, instead of spending 9 percent and guaranteeing it as a human right," he said in a 2008 speech delivered in the United Kingdom. "You could have had a monstrous insurance industry of claims and rules and paper pushing instead of using your tax base to provide a single route of finance," he added. "Any healthcare funding plan that is just equitable civilized and humane must, must redistribute wealth from the richer among us to the poorer and less fortunate. Excellent health care is by definition redistributional. Britain you chose well." During hearings on the Hill, Berwick distinguished U.S. needs from the British model, saying "the American system needs its own solution." He also denied supporting rationing. "I abhor rationing. My entire life has been spent fighting rationing. There's no substance whatsoever to the substance of that," Berwick told the House Ways and Means Committee in February 2011. He also told a Biotechnology Healthcare, an industry publication, that some health care is "so expensive that our taxpayers have better use for those funds." "We make those decisions all the time. The decision is not whether or not we will ration care ... the decision is whether we will ration with our eyes open. And right now, we are doing it blindly," he is quoted saying. Defenders say Berwick's only problem was that he was a surrogate for the health care law "The reason why they decided not to go forward with Berwick was because Republicans were really determined to tear--Republicans were politically determined to tear him down and to tear down the law," said Igor Volsky, the health care policy editor for ThinkProgress.org at the Center for American Progress. To be sure, Berwick had become too controversial to win any converts. "As government continues to struggle to find a way to add 30 million people to the taxpayer-funded health care rolls thanks to Obamacare in the midst of a sovereign debt crisis, Senate Republicans are to be praised for blocking the confirmation of Berwick," Americans for Limited Government President Bill Wilson said Wednesday. Berwick's "doctrines were pure Marxism," Wilson added, warning that Senate Republicans "must be vigilant that whosoever Obama selects to replace Berwick is not just another radical extremist." Obama on Wednesday announced that he intends to nominate Berwick's principal deputy, Marilyn Tavenner, Virginia's secretary of health and human resources from 2006-2010, to be his replacement. Former Virginia Gov. Tim Kaine, for whom Tavenner served, said the nominee played "an instrumental role" in the state on several items, most notably by helping reduce "Medicaid costs in smart ways through program improvements, focus on preventive care and creative use of technology." For Republicans, they want to hear more. "I'm glad the White House opted against another end run around the Senate and instead has put forward a CMS nominee that the Senate must thoroughly examine. Republicans on the Finance Committee look forward to examining her record and gaining an understanding of her views of Medicare, Medicaid and the Presidents health law," said Sen. Orrin Hatch of Utah, ranking Republican member of the finance panel. For his part, Berwick, who turned 65 this year -- making him the first Medicare chief eligible to be enrolled in the program -- told The Associated Press that he was putting in his application, but that he intends to keep working to improve the nation's health care system. Fox News' Jim Angle and The Associated Press contributed to this report. http://www.foxnews.com/politics/201...ead-medicare-ahead-end-to-recess-appointment/
The health system in the USA wastes too much money on incapacited old people who only have a few months to live, or for whom prolonged survival would only mean more suffering. If an 80-year old person will never be able to get out of bed, and has been unable to communicate for over 5 months, the hospital should allow the patient to peacefully pass away.
My father was a devout Catholic, who died in a hospice. He insisted that palliative care meant that dying in agony and pain was unnecessary and that proper funding of the hospice system would obviate any possible justification for euthanasia, which he saw as murder. He was also a physician. He taught me the adage "Thou must not kill, But must not strive, Officiously, To Keep Alive". He would strongly disagree with you on cost grounds. But on medical grounds he would totally agree with you, as would I. Doctors everywhere always have and always will make decisions about life or death. The best we can hope for is that we establish strong medical ethics, independent of financial considerations, transparency over how these decisions evolve with medical technology, and the ability to cope with nuance - to navigate between polar extremes - in argument.
It is rather inconsistent to say that cost should completely not be a factor in life-or-death medical decissions while homeless people die on the streets. http://www.politicalforum.com/human-rights/216722-homeless-dropping-dead-like-flies.html
So you mean we should ask "which poor people should we kill?" The real death panels are those smug "I'm alright" morons who judge that because they are in a job with good health insurance (for now) the people who aren't should suffer so that a market which generates winners and losers in healthcare can incentivize people to work harder and harder.
To Anders Hoveland & Heroclitus: 1. Never give any government the authority to decide who lives and who dies. Never, never, not for any reason. The control freaks that go into government will always choose death over life. 2. Ending life is slowly evolving from doing nothing to prolong life into taking action that ends life. When someone is taken off life support a nurse, a doctor, a technician, SOMEBODY, must perform the deed; i.e., pull the plug; remove the feeding tube, etc. That person is guilty of premeditated murder. Societys failure to punish a murderer is the first step on the road to giving the government the authority to murder any group the government deems undesirable. 3. All medical decisions must remain in the individuals hands. In practical terms that means a patient decides what treatment and medication to accept or refuse. That Right to decide will not be allowed to stand when medical scare tactics fail. Once a substantial number of Americans begin deciding against this or that treatment or medication both the government and the medical profession will take away the Right to decide. Note that the government is now in the process of denying the individuals Right to control his body parts in life and after death: http://www.wnd.com/index.php?fa=PAGE.view&pageId=368257 Finally, Americans are being slowly pushed towards obeying doctors; i.e., obey the government à la Nazi Germany and communist dictatorships. The government began its march towards total control when it said that parental Rights stopped at the schoolhouse door. Infanticide soon followed. Once control freaks got away with those two important totalitarian dictates it was inevitable that they would quickly move towards actually killing people legally. The Affordable Care Act is the instrument of death the scum in government has long sought.
What an absurd concept here! Given that MOST old folks have Medicare, the GOVERNMENT is ALREADY in control! Further Obamcare does NOTHING to prohibit people from buying healthcare directly, or buying supplemental insurance, or in dependent insurance to supply whatever kind of health care they would like, or can afford! Just like NOW, except there will be about 30 million MORE people having the option of having decent health insurance, people who now have none or the screwed up mess of limited and hard to qualify for Medicaid plans, ER rooms, and charity.
Yes, I am all for democratizing healthcare, and involving people in their own medical decisions. But to pretend that somehow we are going from an era where everything is transparently done, with no "doctor knows best" and fully involved patients, to some sort of totalitarian nightmare, is utterly absurd. More and more doctors are having to involve patients in their own decisions. And that is a good thing. But the way that this is happening does not always get support from the Right, at least in America, and probably rightfully so, as it is due to litigious environments where openness is due to legal risk rather than good medical practice. Notwithstanding that, an increasingly educated public will demand increasing openness from their doctors and an increased participation in decisions about their treatment. This is also medical practice now, more and more. Talk of "death panels" is extremist nonsense that seems to have entered the very immature body politic of America. And at some level, doctors are not just there to follow the instructions of patients. Actually euthanasia is one such case where the propensity for "consent" to be given by elderly people who "don't want to be a burden" is absolutely no basis to justify or co-erce a doctor carrying out such a procedure. Equally, perpetuating a life by artificial means, beyond certain limits, is not an appropriate way for doctors to act. Ultimately, as any economist will tell you, in a free market the pricing mechanism is a method of rationing scarce resources. So all systems ration, whether in the US through excluding or threatening to bankrupt people who have fallen on hard times, or in socialized systems by having waiting times for non urgent operations. The argument even goes that by having rationing in this way, efficiency increases. This of course does not seem to be the case in the most inefficient healthcare market in the world, which is the USA. This is because the market is an oligopoly/monopoly which - even the classical economists agree - requires regulation. In universal healthcare systems like in France and Germany, where there is public/private partnership and the country makes a choice to make resources available, the rationing is actually very limited, the efficiency is very good, and the culture is just right to ensure that an increasingly less deferential public hold doctors to account for their decisions. This is why these nations spend less as a % of GDP on health than the USA and yet their health outcomes are rated as far superior.
To fiddlerdave & Heroclitus: Oh really! Things like the following were taking place before Hillarycare II became law. Socialist incrementalism will increase the government’s authority as it did in every other area of society. Here’s a video. Pleae read the article below the video: http://www.msnbc.msn.com/id/3082458.../t/teen-who-fled-chemo-may-be-heading-mexico/ Here’s what happened: Judge orders chemotherapy for teen Published: May 15, 2009 at 9:19 PM MINNEAPOLIS, May 15 (UPI) -- A 13-year-old Minnesota teen must undergo chemotherapy for cancer even though the treatment is against his family's beliefs, a judge ruled. The St. Paul (Minn.) Pioneer Press reported that Brown County District Court Judge John Rodenberg said there is overwhelming medical evidence that Daniel Hauser will most likely survive if he receives the treatment and die if he doesn't. In his 60-page ruling Friday, the judge said officials proved "a compelling state interest in the life and welfare of Daniel sufficient to override the fundamental constitutional rights of both the parents and Daniel to the free exercise of religion and the due process right of the parents to direct the religious and other upbringing of their child." Daniel and his parents have sought treatments for the boy's form of Hodgkin's lymphoma that included diet, vitamins and ionized water, stating that they belonged to the Nemenhah, a quasi-Native American spiritual group. The judge ordered that the Hausers select an oncologist before a May 19 review of the case. In his ruling, the judge noted that his finding might have been different if it involved someone who was older and had a greater understanding of his illness. "This matter ... involves a 13-year-old child who has only a rudimentary understanding at best of the risks and benefits of chemotherapy," the judge said. "He genuinely opposes the imposition of chemotherapy. However, he does not believe he is ill currently. The fact is that he is very ill currently." http://www.upi.com/Top_News/2009/05/15/Judge-orders-chemotherapy-for-teen/UPI-40061242436751/
Could NOT have said this better What use is there to subject a frail bedridden 96 year old to heart surgery, ICU wires, tubes, pumps when you KNOW that survival is a very low possibility?
Quality of life must be on the forefront, along with life expectancy, of course. Providers must be able to communicate prognosis effectively to people from ALL walks of life, and overcome myths and rumors. Education is key, on both sides, and must include how to begin a conversation, what needs to be discussed, how to cope and assist a terminal/dying patient and their family. You don't want some rude physician with no bedside manner tell you that you will die, and walk away. If one wishes to call it a death panel, so be it. But lets not forget, it exists in some form already, has for a while, needing improvement, of course. But, instead of seeing it as a death panel, why not embrace a group of highly dedicated people as those who are willing to tell you the truth, so that you and your loved ones can make an informed decision, and live your life out as comfortable, pain free, and with the utmost dignity?
Totally agree with the judge. The child is incompetent to make a decision. The parents are chid abusers. The State must intervene to protect the child. And this has nothing to do with "Obamacare" or socialized medicine. I'm sorry. I thought this was a serious debate.
Yep! these sorts of interventions are not uncommon - happen to children of Jehovah witnesses who need blood - parents are overruled and it happens to Christian Scientists who will not take their children to doctors
To Heroclitus: I see. It’s not serious because you disagree with the opposing view. Here’s more for you to disagree with: [ame="http://www.youtube.com/watch?v=gbaDRdG6nrE&feature=player_embedded"]Overruled: Government Invasion of your Parental Rights (Official Movie) - YouTube[/ame] The video comes from this article: Does your child belong to state? Cases reveal how government undermining rights of parents Posted: November 28, 2011 8:00 pm Eastern By Michael F. Haverluck http://www.wnd.com/index.php?fa=PAGE.view&pageId=372409
The best interests of the child's health overrules parental superstitions which cause them harm. What's difficult to understand about that? A child is not a possession, it has rights too. If parenting is inadequate or positively harmful, then the government has a duty to protect the child.
To Colonel K: Being from the UK there is probably a lot about the US Constitution that you do not understand. Americans can change it so judges have the constitutional authority to do what they want: Article V The Congress, whenever two thirds of both Houses shall deem it necessary, shall propose Amendments to this Constitution, or, on the Application of the Legislatures of two thirds of the several States, shall call a Convention for proposing Amendments, which, in either Case, shall be valid to all Intents and Purposes, as Part of this Constitution, when ratified by the Legislatures of three fourths of the several States, or by Conventions in three fourths thereof, as the one or the other Mode of Ratification may be proposed by the Congress; Provided that no Amendment which may be made prior to the Year One thousand eight hundred and eight shall in any Manner affect the first and fourth Clauses in the Ninth Section of the first Article; and that no State, without its Consent, shall be deprived of its equal Suffrage in the Senate. And if anyone wants judges to have the authority to force chemotherapy on innocent children how about amending this one: Article [VIII] Excessive bail shall not be required, nor excessive fines imposed, nor cruel and unusual punishments inflicted. Judges can then order castrations and lobotomies for convicted child molesters? I think youll find that that amendment will be ratified a lot faster then anything you and your American counterparts might propose.
My god father was a physician who believed in first do no harm.. He developed ALZ in his late 60s.. and by age 75 had one leg removed .. When the doctors wanted to remove his other leg because of gangrene in his toes.. the final decision was mine to make.. I said NO.. and NO antibiotics. .. per his expressed wishes to me years earlier. The docs were wrong.. The leg healed. He lived another year and died peacefully and in comfort in his sleep.
I have said this before .. My Grandmother suffered with Brain Cancer , she convulsed and suffered for almost a year , I would of shot an overdose into her IV if I had a chance . Why do we put down a sick animal out of respect and yet we let our loved ones suffer ?
So would most doctors.. they simply increase the morphine dosage sufficient to stop the pain... the outcome is predictable. Medicine is supposed to be compassionate and merciful.. its not vested in some policy wonk who is concerned about the terminally ill patient becoming "addicted".
What really gets me about threads like this is that as far as I can tell there are far more "death panels" in private health insurance than there ever is in public systems
Can a whole culture actually be raving mad? No - but your right wing are way off the cliff, ranting as they walk on air.
These so-called 'death panels' are actually advisory sessions set up to counsel the elderly on 'end of life' issues. Since those decisions are now privately held between the patient, the patient's family and the patient's doctor, setting up these advisory sessions by government mandate is foolish and dangerous.
While it is true that private health insurance entities categorize treatment, (similar to government healthcare) a person has the right to drop that insurance, unlike a mandatory government 'death panel.' I think your socialist roots are showing...LOL
