Saturday, August 22, 2009

Death Panels

OK, as I have said before, I Am Not A Lawyer, I just read stuff they do.

So, apparently according to Betsy McCoughey (pronounced McCoy, May God Rest DeForrest Kelly's Tortured Soul) the reason to fear the 'end of life' consultation provisions of H R 3200 (Link is to the actual text of the bill in PDF format, it will require a bit of bandwidth to load....) is because Medicare reimbursement for doctors is tied to performance criteria and how many "Advanced Care Planning Consultations" a doctor has with their patients and how many actual "advanced directives" are produced, and of couse, are followed in the event they become operative will be part of the criteria. So of course, since their payment rates are involved, doctors are incentivized to make every patient have an end of life consultation and since the end of life consultation must include (yep, they said what it must include) discussion of "artificially administered nutrition and hydration" which is of course so horrible, we'll all immediately sign off on not receiving any of that and agree to die gracefully, thereby saving everybody a lot of money, it's MANDATORY, not VOLUNTARY. Uhmm, that's her argument, I don't get it so I bet I didn't state it right.

But thanks be to Google is your friend, here's what it actually says on Pp 431-432:

24 (A) IN GENERAL.—For purposes of re-
25 porting data on quality measures for covered
431 •HR 3200 IH

1 professional services furnished during 2011 and
2 any subsequent year, to the extent that meas-
3 ures are available, the Secretary shall include
4 quality measures on end of life care and ad-
5 vanced care planning that have been adopted or
6 endorsed by a consensus-based organization, if
7 appropriate. Such measures shall measure both
8 the creation of and adherence to orders for life
9 sustaining treatment.
432 •HR 3200 IH

Yes, End of Life orders defined in the bill include orders for using 'Life Sustaining Treatment" as well as withdrawal of same. You decide and the doctor gets to follow your orders. He just has to go through a prescribed list of things to talk about with you
1 ‘‘(F)(i) Subject to clause (ii), an explanation of
2 orders regarding life sustaining treatment or similar
3 orders, which shall include—
a whole bunch of things listed on pages 426 through 428. You can go read it, Google (and my link) is your friend.

If you want (and can afford the copays and deductibles without bankrupting your family) you can demand that heroic measures be taken until a physician is willing to say you are dead, dead, dead, beyond any hope of resuscitation of any kind with any medical technology available in any hospital they can move you to without you being made dead, dead, dead, beyond any hope of resuscitation. And the doctor's performance criteria (on which 5 percent IIRC of his reimbursement hinges) is "Did the directive get followed?"

Ok, so they're reaching to say government doctors will decide when to pull the plug on Grandma. Now you know it, too.

Ask yourself. "Why do they make this s.... (stuff) up?" Do you suppose it's maybe because they haven't got any other arguments? Any other arguments at all? This one reeks of desperation.

Of course, it worked in 1994....
On September 30, 1993, the last day of Hillary Clinton's congressional committee testimony, The Wall Street Journal published an op-ed by McCaughey, who said she had read and reread the 239-page draft health care reform plan and concluded that the plan differed markedly from the Clinton White House's public statements and that the plan would in her opinion have "devastating consequences."
Yes, just this sort of devastating consequences. Only it's a little harder to carry the lie when any of us can just download the bill and read it ourselves. Yep, Google is your friend. Unless it's not.;o)

2 comments:

gayle said...

If I ever get back to Pullman I will write a letter to the editor - this post will help me. J

elly_leaverton said...

Hangman: Yes, and when you are dead - dead - dead - you will be quite dead.

Punch: Oh! I never knowed that before.