Obama Health Care - Beware the fine print
 

My wife said she read where Tom Daschle, Obama's flawed and rejected choice for implementing his national health care system, advocated a program that would put the elderly at the back of the bus for health care with a formula that would treat younger patients first and base treatment on a formula that calculated life expectancy and potential productive years.

Wow....that's callous and cruel in so many ways.

Could this be a harbinger of Obama's change?

This is what Daschele said and I have included the source and Stimulus reference in the link provided so Tony doesn't put me in jail.

Elderly Hardest Hit

"Daschle says health-care reform “will not be pain free.” Seniors should be more accepting of the conditions that come with age instead of treating them. That means the elderly will bear the brunt.

Medicare now pays for treatments deemed safe and effective. The stimulus bill would change that and apply a cost- effectiveness standard set by the Federal Council (464). "

"The Federal Council is modeled after a U.K. board discussed in Daschle’s book. This board approves or rejects treatments using a formula that divides the cost of the treatment by the number of years the patient is likely to benefit. Treatments for younger patients are more often approved than treatments for diseases that affect the elderly, such as osteoporosis"


http://www.bloomberg.com/apps/news?p...d=aLzfDxfbwhzs

So....we old folk should just accept, disease, debilitation and let death take its course without a fight or treatment so others defined by Obama and his cohorts can get treatment. I wonder who would be at the top of his socially or should I say politically engineered list......pause for reflection. Is it just me at 68 that is offended?

Hmmmm......I would have liked to put more thought into this post but, I have a 9:30 tee time. Please excuse typos, I'm running late. I would be interested in your thoughts after the 19th hole.

What gripes me is that people like Daschle will not ever be affected by programs and decisions they make regarding others. They just buy whatever care they need, or go to the front of the line at Bethesda Naval Hospital and receive special care.

But none of this is a surprise. When government feels the most vulnerable at the front end of human chronology are disposable, it's no great leap to apply the same 'disposable' label to those at the back end of the time line.

Isn't this the change everyone wanted?

Personally I'm scared to death what this man is going to do to us. Me being 50, that will put me right about the perfect timeline to have the government decide what treatments I can have or not have.

ARE YOU PEOPLE READING THIS!!!

Hi Cabo...

Well even though I am in the healthcare industry I am in favor of some type of subsidized standard healthcare insurance. Business needs it to be competitive, all the other industrialized nations have it, with the rest of the world. The people whose employers don't offer healthcare and we need them to have it cause we are playing anyway.

I am taking a wait and see attitude.....

Extremely poor timing. It adds to the perception that is scaring most of us, especially Wall Street to death.... that the POTUS is unfocused and in some kind of frenzy of "let's do it all in the first 100 days. We'll throw everything I promised against the wall right now and see what sticks." He appears out of control and reckless. Healthcare reform announcement---> another 300pt drop in the DOW.

Good post.

Yesterday on one of the financial stations they alluded to the "scattershot" 6 weeks of this Presidency !

Perhaps it is poor timing. The flip side is a lot of these things have been languishing for years with no one willing to approach volatile issues that are way past needing change but a political and PR mindfield. Change is tough and probably the most difficult thing in life for human beings.
Business as usual has not worked in some of the issues, especially healthcare. Whoever decided to address these things was in for a rough ride and condemation from opponents. With massive failures of multiple arms of our system it is time to make some adjustmants and no one is immune from some of the pain (except perhaps members of congress)as we as a people have deal with the the missteps and mistakes of the past that we all tolerated as long as the financial picture was holding up. There is no way everyone will be happy because the old way of doing things has to change, and we will all end up sacraficing to some degree to right the ship.

I agree with most of your comment, except the "we will all end up sacrificing..." line. The "we" is going to be the one/third who actually pay taxes, and the remaining two/thirds will be there either with their hand extended palm-up or watching from the sidelines.

Health care is one of those emotionally-charged items used by politicians to raise the fear-level. Of the 45 million claimed by some to not have health insurance, this includes roughly 15 million or so illegal aliens, and why should citizens and legal residents be responsible for them anyway?

The remaining 30 million (which includes head-of-household, spouse and children) constitute approximately 10% of the population. With an unemployment rate average of 5% (yeah, it's higher now, but the concept isn't affected), an insurance plan which covers only those (and their family members) who are receiving unemployment benefits would cover a sizable number.

Now, the balance of uninsured folk have been whittled down to a number which offers even more flexible choices which are more logical than nationalizing (and actually diluting services) the health care industry.

I knows this seems like a very simple approach to what has been marketed as a complex problem. However, until we examine the actual numbers in relation to the entire population, a true solution cannot occur.

For those who say that their health care premiums are too high, that solution is also straightforward. If we can give tax credits for a myriad of things from "green" programs to kid quantum, then providing dollar-for-dollar (or other ratio) reduction in income tax for paying health care premiums is an option. This keeps folk with their coverage without increasing the size of the federal government to "run" a program with the typical government "efficiency" when government inserts itself into the private marketplace.

However, the current administration seems hell-bent on establishing a "health czar" office which would need assets to manage in order to "czar" over an empire. As those federal assets don't currently exist except for selected portions of the population, the need for more federal offices to be created becomes inherent to czar-ism.

In the end, as health care, banking, and other industries are nationalized one-by-one, we would all be working for the government. That's the ultimate socialist goal.....

Excellent post Steve.

Let's also add in TORT reform. Frivolous lawsuits and malpractice insurance for doctors drive health care costs enormously high. Not to say some lawsuits are warranted but I know there are many that are totally frivolous and we all pay for those in a big way.

Why don't we have TORT reform? Because many in congress and their friends are lawyers and that's how they get rich. Why don't we go after them for $$ instead of demonizing all the companies that provide us jobs and health care plans.

If the jokers in congress get their hands on private hearth care we are in big trouble.

There are so many things that can be done yet the only solutions presented by the current administration is government control. People, we are being scammed.

Health care
 

The beginning of this thread, the comment from Daschle caught my eye. I can give you a real scenario. My mother has been ill and passed away earlier this month. The explanation of benefits from medicare/ blue cross arrived yesterday. The bill was over $4600. Out of pocket expenses would be $0. I'm sure other bils from specialists with trickle in. Meanwhile, the average Joe before medicare but with healthcare would not have a zero bill. Think about it. If you are 96 years old you have been blessed and lived a pretty full life. Expensive surgeries at that age are not cost effective nor would the chances of surviving some procedures would be risky. So if two folks needed a kidney transplant- one was 16 and the other was 96 which recipient would more than likely enjoy quality of life from such a procedure.

I don't know about the accuracy of the 1/3 pay the taxes for the remaining 2/3. That would mean 200 million Americans get a free ride? I do know there are too many loopholes in the tax system that favor the wealthy. I wonder how those were added? We all need to make sacrifices. If you have been collecting medicare for awhile who do you think is footing that bill now that you are no longer working?
Speaking of politicians, how about a referendum that their pensions and medical coverage are in line with everyone else. The same goes for postal workers.
Lobbyist control our country. Big oil, insurance companies, the casino-like NYSE fueled on fear and greed, pharmaceutical companies, big banks. That doesn't even touch the issues with the Federal Reserve and the possible insolvency of the FDIC. It isn't a Democrat or Republican issue. Both wink and look the other way.

The sage advice of Ron Paul sounds better right now.

Healthcare
 

From what I'm reading on this one, most of us "elderly" would just like to have access to health care so that we might be as fortunate as your mother to live to be 90+. Most any surgeon that I know of will not do procedures on anyone that they know the probability of them not making it or having a quality of life exists. At what age would you like to exclude care? Many young ones receiving the care you are talking about die early deaths anyway from other causes. None of us has a guarantee on life. Those of us on medicare pay premiums for healthcare through our SS checks. That's what the Part B premium is, so we certainly aren't getting anything for free. That is better than all of us paying for the illegals that have not and do not contribute a dime. Just because we are not rich (just working stiffs all our adult lives...I started paying at 16 when I was old enough to get a job) and cannot afford to pay big bucks for private insurance does not mean that we should just go away. If you can afford to do your own thing, good for you.

True
 

We should be so lucky to have their pensions and medical care.
:cus::cus:

In 2006, the Tax Foundation said that 41% of all americans are outside the tax system meaning they dont pay taxes or get refunds equal to what was deducted !!!!!

This was what they concluded in this report....

"Conclusion
These findings raise serious questions about the future of the U.S. income tax system, and the possibility of base-broadening tax reform when the majority of the federal tax burden is borne by a shrinking pool of taxpayers. As Congress considers tax reform proposals during the coming year, this is an issue lawmakers should begin to debate."

http://www.taxfoundation.org/news/show/1410.html

Also as of 2006, the top 10% income earners pay 70.79% of the TOTAL income tax.

Remember the guy who cheated on his cancer riden wife as he was trying to become the Democratic nominee for president??? aka John Edwards.... he made his fortune suing physicians.

:agree:

As the details for the coming so called health care reform come forth...
 

pay particular attention to those changes that include less coverage for treatments of the elderly...that would be most of us...there is a philosophy in the Obama team that proposes the elder of the USA don't really need all the care and treatment as they are closer to meeting thier maker and hence don't need as much as the younger, th poorer, the illegals, the minorities, etc.

The devil is in the details which the current administration is purposely short on.

One thing is certain, aging and the aged are not partisan attributes....eh?

BTK

Your point?

I don't believe the comment "there is a philosophy in the Obama team that proposes the elder of the USA don't really need all the care and treatment as they are closer to meeting thier maker and hence don't need as much as the younger, th poorer, the illegals, the minorities, etc." is accurate.
There are in fact decisions that should be addressed regarding care. Not to belabour the point, but how many are aware, or willing to be aware of some of the practices we have in health care?
There are tens of thousands of people well beyond 70 that are severly demented, completely bedbound, suffering from multiple comorbidities such as diabetes, coronary artety disease, cancer, chronic bedsores and others that are kept "alive" with surgically placed feeding tubes because they can no longer function at the most basic levels. Many if not most of these people will have multiple hopsitalizations in their last year of life, including ICU care and even artificial ventilation. For the overwhelining majority these interventions are simply minimally life prolonging. Realize that up to 30 percent of ALL mediacre dollars are spent on the last year of life. Realize that if you arrest over the age of 70, even in the hospital with access to quick care your chances of ever leaving the hospital alive, much less surviving at one year out are dismall. Your chances of being "kept alive" with all of the technology we have, perhaps for weeks in the ICU with little or no change in the ultimate outcome are pretty high unless you EXPLICITLY spell out your wishes to your family.
Should we be spending money and putting people through things that we know will not appreciably change their outcomes? Should we resucitate terminally ill patients when they arrest knowing that they have weeks, or at best months to live? Is it morally and ethically the right thing to do?
These are some of the tough questions facing us, questions that european and other countries have long since addressed on different levels. Besides the moral/ethical dilemma of putting people through this, there is a cost associated with it well into the billions. At what time do we aquiesce to God's time clock?
I believe these are some of the questions being brought foward. Not a pan-withdrawl of care from the elderly, and certainly not so we can provide more care for those dastardly illegals, poor, and minorities.
These are not societaly pleasing questions but they do need to be addressed. If you really want to go through this how long should you be able to? At what point is it ok for the doctor to say to the family "I will not put your mother/grandmother through this pain and discomfort anymore?"

As an aside if you don't (or do) want to go through these things YOU MUST SPELL OUT YOUR WISHES. Cookbook living wills are rarely worth the paper they are written on due to their general terms, and to the families that refuse to honor them as the patient desired. Yes, make an advanced directive and be EXPLICIT in what you do and don't want done. Do you want to be resucitated(brought back if you arrest)..being shocked, chest compressions, having a tube placed in your throat and placed on a ventilator, having a tube put in to feed you, receiving IV fluids if that is all that is keeping you alive? Not the easiest things to address with family but make your wishes known so they can be honored. And for the love of God appoint someone that you trust, and that you know loves you and knows and will respect your wishes as your MEDICAL POWER OF ATTORNEY. I cannot begin to tell you the strife and conflicted ethics resulting because people don't take the time to do this. If your doctor has not mentioned it you mention it to him.

Serenity Seeker...good job of detailing some very tough issues
 

and there are far too many individuals and families that will not address the real issue of living wills and their impact.

An area I would have focus placed upon first is the obvious abuse of the system. There are many more billions being paid to doctors/hospitals/health care providers that are nothing but greed fleecing a system that allows it.

This category alone will relent sufficient $$$ to more worthy needs than these medical professional "medicare perps".

BTK

Medical Power of Attorney.
 

This is a very good point about the Medical Power of Attorney. My husband and I have this. It's not easy to have to talk about and face these issues, but after caring for my Dad for almost 20 years, I realized some things just have to be faced head on.

On a lighter note, my hubby said I am a softie and would let him hang on forever and I'm afraid he'll pull the plug on me if I nap too long! :a20:

You are missing a very important point. You are talking about the most extreme cases. Soon as you give government decisions over live and death, treatment or no treatment, the standards will slowly be lowered over time

First it will be those "kept alive with surgically placed feeding tubes" denied care. Next it my be those over 80 who get cancer. Then it may be those over 70 who get cancer. Next it may be your wife or your husband.

Trust me when I say just like social security the standards will start to change and the only difference is, limits will go down instead of up.

I've heard the pro abortion folks say a million times. "Its between a woman and her doctor." Guess that only counts for abortions and not keeping people alive.

As the money gets tighter, the care for the elderly will get less.

I don't know about you but it scares the hell out of me thinking the government will have a part in making those decisions.

It's up to God when it's your time to go not the government.

health care
 

It could be the government. But it already is between you and the insurance companies who can deny coverage.

Actually if one addresses the outrageous administrative costs....over 30% of all healthcare costs in the USA, and the plethora of unwarranted tests done for liability concerns( you cannot imagine the likely billlions from this), and the above examples of innapropriate care ,the percieved fleecing by doctors and hospitals pales in comparison. Not that it is tolerable in any instance but in my experience (mostly not for profit and teaching hospitals, and private practice) the majority of these people and institutions struggle within the current system to honestly make a living and take care of patients.
Not sure was a professional medicare perp is?
I do appreciate the space to get out the word on living wills/advanced directives though..please listen, that little form they give you at the hospital is not adaquate.
Chels, I would invest in a lot of espresso if I were you!

I'll take my chances with the insurance company.

I can assure I am not missing the point and I can further assure you I am not talking about the most extreme cases. This is a large and ever growing issue as the demographics of our society show bigger shifts toward the aging of our population with more to come. Equating it with abortion is simply more sensationalism and does not address the issues above. "Keeping people alive" is one of the issues at the very essense of the discussion here. The definition of "living" seems to vary (from simply a beating heart sustainable only by massive amounts of drugs and support to actually viable existence). SO often patients are left to languish on extraordinary support measure likely causing intense discomfort up until the moment of death because either the physician is to uncomfortable to broach the subject or because the family refuses to.
I don't believe for a minute the people of this country or the goverment are looking for wholesale culling of the elderly population by witholding care.
Ultimately it is up to God when it is your time to go, not the government or anyone else. I also think that God gives us intelligence, knowledge and choice to some extent as to how we partcipate in that process.

Call it what you want but it's still true. Life is life and when you start defining levels of it, you're on a very slippery slope in my opinion... for the young or old.

Its not true in that context nor is it that simple. There are "levels" of life or existence and putting our heads in the sand and not recognizing that and dealing with it does the biggest diservice of all to the patients affected.
The technology alone afforded us in this day and age requires we be educated about and discuss the ramifications of our actions and decisions in healthcare.
When you get right down to it these decisions are made or affected by a variety of entities, public and private, and have been for some time.
This not a party depenent issue, but one of greed and beuracracy on many levels, both public and private in nature.

Point is, if we get as cavalier about the elderly as we do with the unborn, tell me where that will lead? Bottom line, If the government gets yet more control over the process the outcome will not be a good one. Health care should be left to the private sector. I work in the private sector health care industry and good things are coming if the government doesn't screw it up first.

I work in the private sector health care industry and would like to know where and when these good things are coming, and where they have been. The system has been in decline for decades and is grinding to a halt...bottom line.
Linking abortion to this holds no water and is tantamount to fanning the fires of fear IMHO. The only possible link I can see is that the individual decision about about abortion is a personal moral and spiritual decision since there is no definable point of when life occurs from a scientific standpoint, much as is the decision on when the time for stopping certain interventions is in some instances.That discussion could go on indefinatley for exactly that reason.
The present powers at be in health care have had a long time to show how well they can run our healthcare system, and internationally accepted measures of success show we are failing dismally given the dollars we spend.

Our health care system is certainly not grinding to a halt. We still have the best health care in the world and that's a fact.

Name one thing the government does well? Except spend money... In fact most things they totally screw up. The reason why our health care has been in decline is BECAUSE of the government, yet you still seek them out for the fix.

More and more employers are providing on-site occupational heath and pharmacy services for their employees at extremely low cost or even free in some cases.

Walgreens are putting in Take Care Health Clinics in more and more of their stores everyday, where anyone 7 days a week can walk in and get primary care with or without insurance for them and their families. I think a visit costs about $40 and they are expanding their range of services daily. Their mission statement is to change the face of health care in America. CVS is doing the same thing. Even now a lot of pharmacies give away free antibiotics.

The key is competition and TORT reform. Punish the lawyers, not our private health care system. The government talks about spending billions on modernizing electronic patient records (EMR) Well guess what? We have already been doing that in the private sector with no government help and we are far beyond them in that technology. Are we there yet? No, but we are getting there very quickly.

What does Obama want to do? Tax the crap out of the very companies that have already been moving forward in these areas of health care technology. If the government steps in we'll see nothing but lower standards, rationed care and a shortage of medical professionals.

Talk to someone that lives with socialized medicine and ask them how long they have to wait for an MRI.

I'm sure what I say basically falls on deaf ears when so many have been conditioned to believe our savior is the government for all things in life.

"We still have the best health care in the world and that's a fact." Actually not a fact, we are well behind in many categories including infant mortality and adjusted life expectancy, ranking in the forties on each. Couple that with the fact that we spend more per capita than any other country in the world for those mediacore results as measured by internationally accepted standards and the insult worsens. It is about outcomes, not how many doc-the boxes or MRI machines we have. Your part of the healthcare system might not be grinding to a halt but it certainly is for millions. I see them in the e.r. because they cant afford the office visits and the medicines and the preventive care so they wait until they have the heart attack, stroke, or advanced cancer and have to be seen on an emergent basis to get care.
"Name one thing the government does well? Except spend money... In fact most things they totally screw up. The reason why our health care has been in decline is BECAUSE of the government, yet you still seek them out for the fix." Our healthcare is in decline for a number of reasons, some of which you address but make no mistake, one of the outstanding reasons we are in decline is the HMO's PPO's, every other O, and the greed that drives not only rationing of care but the out of control liability and lottery system. Obscene levels of profits and bonuses while procedures, medicines and hospital stays are routinely denied to maintain those profits in the norm now. Dropping thiose that have long held insurance as soon as they get HIV or cancer is the norm now. The visit you use as an example...from a mid level practitioner in most cases, is the begining, next comes the cost of the medicines, therapy, and/or procedures that have to be be done to complete the visit. Now you are easily up into the hundreds.
"The key is competition and TORT reform. Punish the lawyers, not our private health care system. The government talks about spending billions on modernizing electronic patient records (EMR) Well guess what? We have already been doing that in the private sector with no government help and we are far beyond them in that technology. Are we there yet? No, but we are getting there very quickly." I agree wholeheartedly with the idea of tort rform though I doubt it will occur in a meaningful way beacause the same legal lobby that rapes the system every day is the same one making the laws as they relate to medicine.. Where else can people make easy money with frivolous claims and essentially legaized extortion? The private sectors EMR?? Rudimentry at best. There is no gold standard, no standardization of systems so that they can communicate, and the notes and information generated by the cookbook templates is only good for maximizing billing potential at this point by making sure all the boxes are checked. Physicians dread getting the records from other offices for these reasons. As an aside, most people recognize that the VA of all places has probably one of the more useful and advanced systems as shown by improvements in patient outcomes.
"What does Obama want to do? Tax the crap out of the very companies that have already been moving forward in these areas of health care technology. If the government steps in we'll see nothing but lower standards, rationed care and a shortage of medical professionals." We have had low standards, rationed care, and a dramatic shortage of medical professionals for a while now that is getting precipitously worse. NO ONE wants to go into primary care anymore, a cursory examination of statistics for those entering residencies associated with primary care shows steady declines and projected shortages which, while not receiving the bulk of press right now are going to be catastrophic. I know, I live and work within the system every day.
"Talk to someone that lives with socialized medicine and ask them how long they have to wait for an MRI." The old "how long does it take to get (fill in the blank)" just doesn't address the issue anymore, its a tired argument based in fear of not getting what we feel we need right this minute. For every one of those people there is at least one other in the system that are well satisfied with their care as evidenced by those from Canada (for instance) that post on this board.
This is not some BS political argument about "the savior", it is about honestly recognizing the severe problems we as a nation have in healthcare and being willing to address them, and that will mean changing our perceptions about what we deliver, how we do it, and what is appropriate to deliver.

Is that why people from all over the world come here when they need the best health care.. or care they can't get elsewhere? Is that why we provide our medical services all over the world to other countries that don't have the technology or the skill we do? Is that why doctors come from all over the world to practice medicine here?

But I digress. The government will fix it. After all, they are so skillful at administering programs, cutting costs and raising the level of service. Oh and BTW, who's going to pay for it all?

Been to a DMV lately or tried to get a building permit?

It's not about anectdotal stories, its about about outcomes measured with objective criteria. All the sarcasm and anger in the world doesn't change that.

Oh, and by the way, we already pay for it in a ineffeciant system filled with waste and inneffeciency.

It's not about sarcasm or anger. It's about the truth.

The government has been a miserable failure at running programs not to mention their own budgets. Just look at our public school system. They are a total mess and getting worse by the year. SS and medicare are all but bankrupt. Now the government is taking steps to nationalize our economy, banks, private industry and health care.

Are you really at peace with that?

And how has the government be doing with that so far? F-

If I recall, I never indicated I was at peace with any of it. What I did do was relate objective, true information regarding our healthcare system or lack thereof.

This thread wasn't about the current state of our health care or it's issues, it's about government takeover of our health care system and their rather shocking admissions about how they view future care for the elderly, which to me is a moral issue.

If you feel our current system is so rotten, maybe that's a new topic.

Again your incessent need to extrapolate and try to put words into someones mouth clouds things. Never said it was rotten.

Additionally, seems this thread has been about a lot of things including but not limited to tort reform, tax reform, abortion, medical POA's, decisions on the appropriateness of treatment in certain situations,and nationalizing the banks and private industry.

Sorry, I embellished. You did say our health care system was grinding to a halt among other things. If were true, to me that would be pretty rotten for all of us. Thus the word rotton.

I hate that it is, and I do feel that's rotten for the people of this country. It's just that in my experience people tend to see things based on thier own experiences (of course). The people that are fortunate enough to have good coverage and don't want the boat rocked are often not familiar with so much of the information (and much much more) I attempted to relate here. And in the beginning of the thread I really did address, I think, the OP.
Recognizing the flaws and continued degradation of the system does not amount to a blanket condemnation, nor does it pigeon hole me in a certain political idealogy. It is a field I love and sacrifice for and have for years. I also feel it comes with some responsibility to show the other side of the coin.

I've lived in countries with socialized medicine. No thanks!!!