The level of treatment indicated under subparagraph (A)(ii) [subparagraph (A)(ii) reads: "(A) For purposes of this section, the term 'order regarding life sustaining treatment' means, with respect to an individual, an actionable medical order relating to the treatment of that individual that-- (ii) effectively communicates the individual's preferences regarding life sustaining treatment, including an indication of the treatment and care desired by the individual"] may range from an indication for full treatment to an indication to limit some or all or specified interventions.So, by my reading, it seems pretty darn clear that the bill requires that the individual patient's voluntarily-expressed preferences (as opposed to some bureaucratic "death panel's" mandate) be respected in the provision of particular medical care treatment, AND that such voluntarily-expressed preferences can include "full treatment" among other options.
End result: Sarah Palin is a shameless, bald-faced, demogogic, Chavez-esque, populist liar. But what's new about that?
Well ... let me reconsider ... it's either that or she's hitting the LSD much too hard.
If that's the case, Sarah Palin should get off the LSD and, to quote her own pathetic self, "quit making things up."
UPDATE: Thursday, August 13, 2009, 10:26PM: You know, I really do have an unseemly and obsessive disdain for Sarah Palin. Although I often wonder if it's the true reason, I really think this disdain stems from the cultivated ignorance and crass anti-intellectualism that she not only consciously projects, but actually seems to revel in. It truly disgusts me. But, who knows? Maybe I'm just a crass sexist and not even aware of it. Regardless, it is unseemly and I should try to do better just to let it go.
While I do think this is a liberty and freedom constraining part of the overall legislation, it isn't death panels. Palin should drop it, or at least better explain what she means. It appears they are in the process of stripping this from the Senate bill anyway.
ReplyDeleteBut yeah, a lot of people don't trust the government to get too involved in these types of decisions, because they fear it will turn into 'death panels' after the bill is passed and the pressure is on to reduce costs to show that the reform 'works'. There are some things the government could easily do after-the-fact, such as (Nudge, Nudge) setting the default option to a lower level of care, or even a 'DNR' if you fail to meet with your doctor every 5 years. A lot of people worry about things like that, and they should. Palin overstates those fears, but it is just as damaging to the public discussion when the Democrats try to paint everyone who expresses such concerns as a nutjub or part of an 'angry mob'.
The real fear for many people (and this seems to be gaining traction) is that this entire 'reform package' is just groundwork to slowly nudge us all into a single payer system. That's a hard one to prove or disprove, but removing the public option would certianly go a long way towards allaying those fears. That's where the Republicans should be focusing most of their energy.
Also, on this issue... we should not let the irony escape us that the same Obama who thinks doctors are needlessly taking out kids' tonsils for the paycheck wants to put those same doctors in charge of 'consulting' old people (who provide infinitely more paycheck opportunities) about their end-of-life care. Perhaps Sarah Palin isn't the only one engaging in hyperbole.
ReplyDeleteEric - I've read this section of the legislation very carefully. And I just don't see where you get that the government is involved in these types of decisions. Maybe that's a concern for other parts of the legislation, but not this part. The legislation really just incentivizes physicians to offer advance directive counseling to patients. It is simply a way to nudge patients and physicians into a dialogue that both probably would appreciate having, but are hesitant to do so because of the sensitive nature of discussing mortality so directly and frankly. The conversation would be between patient and physician, and either the patient or the physician could choose not to engage in the conversation, with not one the worse for wear. I know you agree with me that the "death panels" hyperbole is wrong, but I fail to see how this is a liberty and freedom constraining part of the legislation. All it does is encourage doctor and patient to have an informed conversation about the patient's advance care preferences and to ensure that such preferences are well-known and respected in the event such a person becomes incapacitated. How is turning over healthcare decisions about my own life to anyone else freedom and liberty constraining? Knowing more about my options and expressing my preferences ahead of time preserves my freedom and liberty over my own life.
ReplyDeleteTake another example: education. Imagine if the government were to encourage all public school counselors, by means of concrete incentives, to meet with parents of students and give them information on costs, test results, scholarship opportunities, curriculum emphases, extra-curricular opportunities, etc., of ALL schools in the area, including private and parochial schools, and then letting the parents decide what to do with that information, even if the counselor praises the public school at which he or she works. That's ultimately better for the parents and the students. It doesn't compromise their freedome and liberty at all, it enhances them. Moreover, if counselors will get paid for such sessions, it ensures that this information is much more likely to actually reach parents, some of whom might not be able to get such information otherwise, and makes it less likely that such information would be kept hidden from parents by school counselors. That's how I read this section of the healthcare legislation. There's just nothing sinister about it. Having a healthy suspicion of anything produced by the government is good; but throwing out the baby with the bathwater all the time is just irrational. The government can get some things right sometimes and enhance individual freedoms and liberties in ways that the market cannot or will not. Conservatives make this case all the time regarding defense spending and other national security programs.
And, Eric, on the whole question of Obama's comment regarding tonsillectomies and paychecks, come on. That's happening right now, without Obama! Example: I blew out my ACL in my left knee years ago. I discussed with my primary care physician whether I should have it surgically repaired. We talked about the options, one of which is just to let it be. I don't need an ACL to live a happy, productive life. If playing pick-up basketball games were necessary for my happiness, then I might have to consider surgery. But it's not necessary and I came to the conclusion that, at this stage of my life, I really don't need the surgery. Now my primary care physician also said that another option was for me to see an orthopedic surgeon specialist. But he told me that this specialist's advice would tend towards encouraging the surgery because that's how the specialist makes his living. And I can understand that. But let's not think that doctor's aren't already nudging people in the current health care environment towards certain kinds of treatments, based largely on what kind of payouts can be extracted from the insurance companies (or the state!) in the current, broken health care environment. I would have thought that Obama's attitude promoting a health care system that looks at the cost inefficiencies relative to the health benefits of unnecessary medical procedures is a rather "conservative" attitude. Is being conservative now, when it comes out of the mouth of Obama, subject to charges of hyperbole?
ReplyDeleteHuck, I don't deny that stuff like this happens, I just don't think it is prevalent enought that Obama should have been using it as an excuse for why there needs to be government overshight of what procedures are appropriate in what condidtions. And, as I mentioned, I find it ironic that he doesn't trust these doctors enough to let them make a responsible decision about when a kid should have a tonsillectomy, but he trusts them enough to speak to elerly patients about planning their end-of-life care.
ReplyDelete"Is being conservative now, when it comes out of the mouth of Obama, subject to charges of hyperbole?"
That depends on which side of his mouth it comes out of... he tends to use both!
That depends on which side of his mouth it comes out of... he tends to use both!
ReplyDeleteROTFLMAO! Now that was pure genius funny, Eric!
Wow, Huck's entire argument is that there's no "death panel" because Sec. 1233 doesn't use the words "death panel." I guess I shouldn't expect anything else from the intellectual wellspring that reasons we can end the war on terror by not calling it that anymore. And based on that, Palin is eather a liar, or a drug user. Tell me again about hyperbole?
ReplyDeleteAnd as for Eric's claim that claims that "this entire 'reform package' is just groundwork to slowly nudge us all into a single payer system." are "hard to prove or disprove" I suggest Eric open his eyes and watch this video:
http://www.theminorityreportblog.com/story/steve_foley/2009/08/19/proof_positive_the_public_option_will_lead_to_single_payer