Originally Posted by KyWoman

As a nurse who has seen way to much suffering due to family members not being able to "let go" and also as a hospice nurse who has seen people "pass" as comfortable and with as much love as possible, I see a real need for people to be aware of their options.

However, IMHO, the government has absolutely no business sticking its nose in the most private and personal decisions one will ever make. That is heading down a very frightening path.

Amen.

If you believe it is good that families and their doctors talk about advance directives, living wills, DNR orders, etc., what is the arguement you have with the doctor getting paid for the discussion?

That's what I'm wondering. I mean, if a doctor was to be asked about this by a patient and they said "sorry, I can't talk to you because I can't bill for this time", people would be outraged at how short-sighted Medicare would be.

I don't think that "mandatory discussions" will be the end of government interference in my health care decisions. What else will Doctors be forced to discuss, or God forbid do in the future? This is the beginning of a slippery slope.

It is government control that I am against. Plain and simple! What my Doctor and I choose to discuss is none of their business!!

Originally Posted by djplong

That's what I'm wondering. I mean, if a doctor was to be asked about this by a patient and they said "sorry, I can't talk to you because I can't bill for this time", people would be outraged at how short-sighted Medicare would be.

This has got to be one of your most mind blowing comments. You mean to tell me that a doctor bills his patients for SPECIFIC information now? I've got to see one of your doctor bills to see this for myself. I've been to the doctor plenty of times in my life and I've never been billed separately for specific pieces of information he gave me.

We're talking about doctor's instructing their patients about the efficacy of ending their lives, FOR THE DOCTOR'S FINANCIAL GAIN, at the behest of the GOVERNMENT.

You really defend this outrageous dictate?

BK, as usual, had the most thought out reasonable rebuttal to any of your's or Tbug's comments and was completely ignored by you.

We're going down a dangerous road here dj, and I don't want to travel it with you.

Originally Posted by KyWoman

As a nurse who has seen way to much suffering due to family members not being able to "let go" and also as a hospice nurse who has seen people "pass" as comfortable and with as much love as possible, I see a real need for people to be aware of their options.

However, IMHO, the government has absolutely no business sticking its nose in the most private and personal decisions one will ever make. That is heading down a very frightening path.

KyWoman and bkcunningham.

As you see I did speed read and you both have redirected me without malice and with wisdom. I have obviously not been paying attention to the details again. Thank you for your intelligent information and how you presented it.

Hugs to both.

this congress and this president regarding what they say they intend and what actually happens. Check out Nancy's acceptance speech as speaker to hear what she intends for the future America...paraphrasing....no new deficit spending...pay as you go...we will not create a debt burden for our future families....
Then read today's article regarding the debt level created by this congress and president is has increased the debt level more than all, ALL prior sessions in history.

Now apply that lack of credibility to their intentions end of life discussions.
So, supporters of the current administration, from whence comes your comfort?

btk

Originally Posted by billethkid

this congress and this president regarding what they say they intend and what actually happens. Check out Nancy's acceptance speech as speaker to hear what she intends for the future America...paraphrasing....no new deficit spending...pay as you go...we will not create a debt burden for our future families....
Then read today's article regarding the debt level created by this congress and president is has increased the debt level more than all, ALL prior sessions in history.

Now apply that lack of credibility to their intentions end of life discussions.
So, supporters of the current administration, from whence comes your comfort?

btk

I think you read the article wrong. The 111th congress created more debt than the first 100 congresses, not all prior sessions.

Originally Posted by djplong

That's what I'm wondering. I mean, if a doctor was to be asked about this by a patient and they said "sorry, I can't talk to you because I can't bill for this time", people would be outraged at how short-sighted Medicare would be.

He can still bill for consultation. At a higher rate, I bet.

Yoda

Originally Posted by bkcunningham1

Grace and cologal, you are missing the point and proving the point all at once. It should be up to individuals to make these decisions and have these discussions with their physicians. Families and individuals have been doing it for years without the government's intervention.

But should the government dictate and regulate this? "Under the new policy, outlined in a Medicare regulation, the government will pay doctors who advise patients on options for end-of-life care, which may include advance directives to forgo aggressive life-sustaining treatment."

When the final version of the health care bill was signed into law by Obama in March it did not include the regulation for advance directives. Now it has been written back into the bill with Medicare regulations...and supporters are being told to not broadcast their accomplishment.

US Rep. Earl Blumenauer of Oregon, said in an email to people like John Rockefeller, who were working with him on adding this back into the already approved bill, "While we are very happy with the result, we won’t be shouting it from the rooftops because we aren’t out of the woods yet. This regulation could be modified or reversed, especially if Republican leaders try to use this small provision to perpetuate the ‘death panel’ myth," Blumenauer said in the hush-hush email.

“We would ask that you not broadcast this accomplishment out to any of your lists, even if they are ‘supporters’ — e-mails can too easily be forwarded. Thus far, it seems that no press or blogs have discovered it, but we will be keeping a close watch and may be calling on you if we need a rapid, targeted response. The longer this goes unnoticed, the better our chances of keeping it.”

If it is such a wonderful thing, why keep it quiet?



http://www.nytimes.com/2010/12/26/us...h.html?_r=3&hp

I really wasn't trying to make any point other than I already have them and no one forced me to do so.

This statement concerns me.....

But should the government dictate and regulate this? "Under the new policy, outlined in a Medicare regulation, the government will pay doctors who advise patients on options for end-of-life care, which may include advance directives to forgo aggressive life-sustaining treatment.


With all do respect this regulation allows for payment of a consultation for what you the patient wants at the end of life. No where does it indicate that the government will, at this time nor any time in the future, make you select options you don't want. If you can provide any written proof otherwise I would surely like to see it.


And who turned off the heat it is warmer in Colorado than here.

Originally Posted by cologal

I really wasn't trying to make any point other than I already have them and no one forced me to do so.

This statement concerns me.....

But should the government dictate and regulate this? "Under the new policy, outlined in a Medicare regulation, the government will pay doctors who advise patients on options for end-of-life care, which may include advance directives to forgo aggressive life-sustaining treatment.


With all do respect this regulation allows for payment of a consultation for what you the patient wants at the end of life. No where does it indicate that the government will, at this time nor any time in the future, make you select options you don't want. If you can provide any written proof otherwise I would surely like to see it.


And who turned off the heat it is warmer in Colorado than here.

Explain this to me cologal. You said, "I already have them and no one forced me to do so." And your doctor talked to you and discussed the process for the directive. Fine. I agree. No big deal. Happens every day a thousand times a day in this country.

So why all of a sudden is the government offering payment for something that is obviously already being done between patients and physicians? Why are they using a regulation writing procedure to put it into Medicare regs and why are they acting so weird about doing it and wanting it kept on the downlow?

As for proof that the government is making you select options you don't want. Yeah, I know that is unrealistic. There is no way the government would force something on you. No wait. There is something I'm remembering. Yeah, I've got it. Remember, there are about twenty states with lawsuits right now concerning the Constitutionality of the individual mandate to purchase health insurance!

You should look into Dr. Donald M. Berwick agenda and beliefs.

BK...... Actually no I never discussed any of this with a doctor.
No need to do so. My family is very Catholic, I was taught from a very early age that we need not invoke extraordinary means to save a life. I watched as the medical and clergy in my family decided what should be done. Add to that 40 years in hospitals and I know what I want.

On a general note I try to not live in fear...I take things at face value. To me this regulation is a good thing because it gets the discussion going on these issues. Trust me you will not be in control at the end .... sometimes even if these papers are available. I have seen it....

Still your concern should be addressed....

Originally Posted by RichieLion

We're talking about doctor's instructing their patients about the efficacy of ending their lives, FOR THE DOCTOR'S FINANCIAL GAIN, at the behest of the GOVERNMENT.

You really defend this outrageous dictate?

Yoda mentioned about billing for a 'consultation'. Now, I'm not 100% up on everything you can or can't bill for - I'm most personally familiar with the disgusting practice of DRG days.

But while not billing for specific information, I *have* seen bills for *time* - much as Yoda mentioned about consultations.

And, yeah, *to a degree* I defend the idea. If someone is going to ask the government to pay the bills they, yeah, the DAMN WELL *SHOULD* be educated on some of the trade-offs, the consequences and, yes, the expenses. Many families do this as a matter of course - like you said, no harm, no foul. But what about the willfully ignorant? The people who (and I'll put this politely) may very well be wrapped up (justifiably) in their own stressed emotions concerning a family member?

Sometimes you HAVE to face that which is unpleasant (you can apply that to just about any of the political topics here).

Screaming "death panels" like a demogogue as if these consultation are something new doesn't change the fact that private insurers have been doing this for quite some time.

Originally Posted by djplong

Screaming "death panels" like a demogogue as if these consultation are something new doesn't change the fact that private insurers have been doing this for quite some time.

First, I haven't been screaming "death panels", but if the government health care bureaucrats are paying doctors to convince you that for everyone's benefit it would be great for you to die; what would you call it?

Also, AND A GREAT BIG ALSO!!!, I can hire a lawyer and take my private insurer to court to compel them to authorize treatment or SUE THEM IF THEY TRY TO SCREW ME. No matter the right or wrong of it, you cannot take the government to court over this. I'll take the private sector over government administration anytime, warts and all.

Ok, so how did we go from "consultation on end-of-life options" to "paying doctors to convinve you that (it) would be great for you to die"?