The Alan Katz Health Care Reform Blog

Health Care Reform From One Person's Perspective

Health Care Reform and the Euthanasia Hoax

Posted by Alan on August 13, 2009

Health care reform is complicated. Constraining the cost of medical care in the face of an aging population, new technologies, and increased health care expectations is hard. Providing health care coverage to the millions of Americans who cannot afford it or feel they don’t need it is challenging. And the list goes on.

Given this reality, one might hope the focus of the nation would be on the many legitimate public policy differences worthy of debate. Are current proposals for a public plan creating fair competition with private carriers or unfair competition? What is the appropriate role (if any) for an exchange? How can comparative effectiveness research restrain medical costs without shackling doctors to menu medicine?

Unfortunately attention is being diverted from these substantive issues to those which generate fear and conflict, but do nothing to illuminate or resolve tough issues.

Take euthanasia, or what former Governor Sarah Palin refers to as the “death panels.” Section 1233 of "America’s Affordable Health Choices Act" (HR 3200) is the source of this controversy. Section 1233 makes consultations between patients and doctors concerning end-of-life discussions a covered expense under Medicare. It does not require these discussions. Nor does it require patients to consult with a government panel nor is the patient obliged to take any action as a result of the discussion. All this section does is reimburse doctors for taking the time to talk about what services (such as palliative care and hospice) Medicare will cover and how powers of attorney, living wills, and the like work. That’s it. And it only covers these consultations once every five years, when there is “a significant change in the health condition of the individual,” or when the patient enters a skilled-nursing facility, nursing home or hospice. In other words: twice a decade or when the individual needs to talk about these matters.

Section 1233 is written in legislative language which is, admittedly, difficult to follow (but then, it is legislation). Take the time to read it, however (it starts on page 424), and it clearly does not encourage euthanasia. It takes a substantial twisting of common sense and logic to make it even seem so. Apparently it’s all about “context.” Here’s Governor Palin convoluted reasoning as presented on her Facebook page:

  1. President Barack Obama has said that one purpose of health care reform is to “bend the curve” on medical costs. Authorizing payments for end of life consultations is, consequently, a cost cutting move. Costs will be reduced not by informing patients of lower cost options (hospice versus nursing home versus hospital care versus home care), but by encouraging the patient to commit suicide.
  2. Because HR 3200 calls for paying doctors to have these consultations physicians will have an incentive to initiate these talks. Due to the fact that doctors are authority figures in white coats, unwilling seniors will be pressured to have them. In order to reduce overall medical care spending in the country, doctors will use their influence to coerce patients into “’formulation’ of a plug-pulling order right then and there. Apparently doctors are so greedy a fee for spending time with a patient is enough to turn Dr. Welby into Dr. Kevorkian. Yet they are so patriotic they will kill off their patients in order to reduce health care costs. They also must be dumb. Because if they initiate these discussions only to make a few bucks, you’d think they’d be smart and  greedy enough to figure out that dead patients pay no bills. If Governor Palin was being consistent, wouldn’t she assume the doctors would be encouraging people to hang in there and consume as much health care services as possible?
  3. Dr. Ezekiel Emanuel, an advisor to President Obama on health care and the brother of White House Chief of Staff Rahm Emanuel has written that medical spending needs to take into account the patients age, condition and chances of recovery. While I haven’t seen Dr Emanuel’s statements in context, what do they have to do with the legislation? The language of a bill is the language of a bill. What someone wants it to say does not trump what it does say. You’d think a governor might know that.
  4. So, as mentioned, it all comes down to context. Health care reform is about cutting medical costs, doctors are greedy, patriotic and stupid, and what a presidential advisor says trumps the clear meaning of the legislative language.  Given this context, Section 1233 can only be read as a cost cutting measure that will encourage doctors to talk their patients into committing suicide. (I still don’t see where the death panels come into this. They must be in the fine print only real Americans can see).

Maybe it’s me, but this doesn’t strike me as logic. But it does look like fear mongering. Or ignorance. Or maybe it’s just evidence of a world view that sees Democrats as elder-killers, doctors as untrustworthy, and older Americans as incapable of comprehending that that suicide is not only illegal, it’s optional.

Nah. It’s fear mongering.

There are plenty of reasons to oppose the health care reform put forward in Congress thus far and to fight for a better reform package. Let’s stick to the rational ones.


23 Responses to “Health Care Reform and the Euthanasia Hoax”

  1. mark durant said

    There is one additional comment to make here. Sarah Palin forgets that doctors take the hypocratic oath to be an advocate for their patients. Doctors who don’t act in their patients’ best interests are not worthy of practising medicine.

    The whole healthcare debate is a mystery to me. As someone from the UK, I would much rather have a Government make decisions than some stuffed shirt in a cubby at an insurance company. The present system is that there’s NO system. Insurance companies are not accountable for disgraceful practices, patients who pay for policies that are worthless, the working poor who want to be covered are denied or simply can’t afford coverage, the profit motive is an incentive for waste and the current “system” is dysfunctional at best.

    How can insurance companies complain about taking the least healthy out of the system (the poor – who proabably aren’t covered anyway), forcing the most healthy to get insurance (the young) having already taken other riskier patients (the elderly) out of the pool with a government system that works.

    This whole debate is full of non existent bogey-men. Sarah Palin is a disgrace to her office (look how long she stuck that out) for peddling such nonsense. President? Heaven help us all if past behavior is an indicator of the future.

  2. Frank said

    The “Healthsteria” that has gripped America is so very disheartening. With the millions of Americans losing their homes, or finding themselves underwater with a devalued property, as big banks and mortgage brokerage companies walk away with profits and bonuses. More millions have lost their jobs, as Corporate America lops off large vestiges of their workforce, just to pad the bottom-line, and deliver dividends to the share holders. With this economic nightmare that has sent shockwaves through Wall Street, and continues to unleash a drowning tidal wave on Main Street, just the thought of a Healthcare system that puts the care back into Healthcare, offered a tiny glimmer of hope. Then the nay-Sayers began to chant the Public Option was about to throw Mama from the train in her twilight hours. As I watched the Bill Moyer show featuring Mr. Wendell Potter, the former chief corporate spokesman for Cigna, I wondered how many Americans got the opportunity to view this broadcast. I wanted it to be mandatory viewing at all public forum discussions on Healthcare Reform. I wanted it to be broadcast day and night like one of those less than blockbuster movies that cable TV puts into a continuous loop of air time.

    I tried to reassure myself and say that the American people are not as ignorant as the Big Insurance industry would believe them to be, that they would see clear the smoke and mirrors, that they would indeed pay attention to the man behind the curtain. I tried to convince myself that they would see, as Mr. Potter’s presentation so clearly showed, who was pulling the purse strings, and speaking through these ventriloquist dummies, more commonly known as conservative politicians, and those who now have let the Blue Dogs out. But as the weeks have passed, and the heckling calls failed to die down, what saddened me so, is that there are many poor Americans who have been duped by all the fear mongering and have brandished the Anti Health Reform regalia, to the chant of the party line!

    How I know with all my heart, that so many of the well intended Anti-Health Reformists could benefit personally, if not have a dear loved one benefit, from caring health system. Yet, I am reminded that not so many generations ago hysteria swept many as Orson Wells read the War of the World, over the air waves. Should I be surprised by the waves of panic that now sweep many over this modern day War of the Words.

    How I just wish there could be a young child, who would yell it out, to all of the highly intellectual conservative thinkers and their adherents, that the cloth of the argument that now cloaks the Insurance Empire as being the best healthcare delivery system in the world, that shrouds all those who rally to this rant, is in reality devoid of any substance at all, and will leave all of America naked and openly exposed to the status quo that keeps rewarding big business, as they continue to give the small guy (or the little boy) if you will, the business!!!

    • JimK said


      Thanks for the reference. Mr. Moyer’s interview with Mr. Potter was very enlightening and should put to rest the myth that only government will ration healthcare when Mr. Potter points out that the rationing of healthcare is the very basis on which the Health Insurance Industry maximizes their profits.

      I have attached a link to the interview which runs approximately 35 minutes. It is highly recommended.

    • Leda said

      Regardless of how you slice and dice up the health care bill, it infringes upon, if not removes many of our Rights under the Constitition.

      In the debate over the vague language and how it is defined, one fails to see that something as simple as the Government having “real time” access to our bank accounts deminishes our Fourth Amendment Rights. The fact that under HR1, the Government has ALREADY determined that they will have access to all medical records and make determination of our health care needs, strips us of our rights.

      Wake up, the Bills HR1, HR3200, HR1728, Cap and Trade all remove our rights and pave the road to dictatorship.

      Quit dissecting these vague bills and focus on what rights are being stripped away.

      Furthermore, the very implementation of Nationalized Health Care violates the Constitution of the United States. Read the Articles of the Constitution and the Powers allocated in them.

      • Alan said

        Leda: There are real reasons to be concerned about elements of the health care reform bills working their way through Congress. While I respect your right to have opinions, I don’t believe the concerns you cite here are factual. The bill gives the government no more rights to access bank accounts than it already has. There’s no stripping of rights. Instead, there’s a legitimate effort to fix a broken health care system.

        If you’re going to make claims like these, it would be useful to show evidence for them. For example, the government already pays for 50% of health care through programs like Medicare, Medicaid, the Veterans system, etc. What access to medical records does HR 1 grant to the government they don’t already have?

        There’s a lot legitimate discussion needed concerning health care reform. Claiming it creates death panels or that it is paving the way to a dictatorship does nothing to enlighten the issues or further the debate.

        • Leda said


          Actually, under the Constitution, Amendment 4, Search and Seizure: The Government cannot access a persons bank account without permission or without probable cause. Those persons contributing to receiving Medicare (Social Security) and Medicaid (Welfare) have premiums deducted from their payment prior to the direct deposit of payments to their accounts. Your mistaken sir. HR3200 allows “real time access” to all persons bank accounts at their discretion, to deduct sums as they deem necessary. . . Page 59, HR3200.

          Your statement that “the Government already pays for 50% of health care” under Medicare, Medicaid and VA, only address access to a certain number of persons who benefits are in fact paid for by the Government. You fail to acknowledge the Millions upon Millions of individuals whom the Government does not contribute funds for health care, nor does the Government have access to their health care records without probable cause, and appropriate legal proceedings.

          This bill is not health care reform. It has little to do with Health, far less to do with Care and everything to do with the invasion of privacy (in violation of HEPA), the Government’s budget and how to cut costs by ultimately rationing health care as defined by the Government, the theft of monies set aside in trust by American Citizens under Social Security; removed by the Government for “others” and “other programs” as the Government deems necessary, which includes the 400 Million for cost efficiency studies under HR1, Section 1900.

          No where in this health care bill does it discuss 1) Tort Reform, 2) Abridgement of FDA regulations to distribute generic pharmaceuticals rather than formulary 3) Defining Quality of care as it applies to care itself, but rather the financial burden of the Government 4) the ability for Americans to have fair and equitable competition of open markets by allowing Americans to purchase insurance across state lines (Breaches the 2nd,3rd,4th Articles of the Constitition) which would drastically reduce premiums. No where does this bill address community clinics wherein physicians and nurses alike could contribute time for tax credits, thereby reducing the burden and expense of emergency rooms (or is that too logical?). No where in this bill does it address any form or true reform, just control.

          I don’t know your age, however, over my lifetime I have seen the Government mismanage Medicaid, Medicare, Amtrack, the Postal Service, Social Security and all are Bankrupt! The Government was the oversight committee over Fannie Mae and Freddie Mac, and did such a good job that they desecrated the financial system of not only a nation, but the world.

          So, I agree there is a need for legitimate discussion about health care reform. None of it exists inside this bill nor the sections of HR1 (Stimulus Bill) which addresses health care, records and determination of care by panels set up by the Government.

  3. Mark Goodman said

    Magical is what comes to mind when I think of the current state of health insurance reform. Either a government run plan or not-for-profit co-ops will magically lower health insurance premium. If it were so simple then this could have been done years ago. It seems the administration has punted on root cause and want to just blame the health insurance industry for all the ills of the system.

    Johnathon Alter of Newsweek describes Medicare as government run free healthcare for seniors and then there is the nice person in South Carolina who wants the government to stay out of his Medicare. It is difficult to have an intelligent discussion when the level of debate is so low.

    • JimK said

      Attached are links to articles in the NY Times on suggestions to control healthcare costs. Since the cost of healthcare in America has doubled every ten years for the past 40 years, you are correct in asserting that the current system has failed.
      However, both articles actually point to the cooperative model as a means of controlling healthcare costs. I do not know how the cooperative models are going to function, but if the doctors are salaried employees, the incentive to order expensive unnecessary tests is removed.
      At the current time, I am undecided on Healthcare Reform. Apparently in the Reply to my last post the writer drew the inference that because I cited a specific section of HR 3200 that I was in favor of this legislation. With this in mind I will state, up front, that I do not currently support Healthcare Cooperatives. I will reserve judgment until I have seen more detailed information, but right now the idea strikes me as just another HMO.

      • Tony said

        I am a doctor. I strongly disagree with the statement “if the doctors are salaried employees, the incentive to order epxensive unnecessary tests is removed”. I think people here (and almost everywhere else) have taken Gawande’s article as gospel. The article is good, but it has been overblown.

        The main incentive I have for ordering “unnecessary” tests is I want to be “extra sure” of something. I have ordered CT scans in cases where I expected a less than 2% chance of something serious being found. Of course, since I saw over a 1000 pts last year, I have diagnosed 2 tumors in pts with CT scans that deep in my heart I thought were not needed and I almost did not order them , except to “just be sure”.

        These tumors would have eventually been found. ANd probably detecting them early with CT did not change outcome (one was metastatic already). But I (and the pts in question) are certainly glad I ordered them .Please do not tell me if I was salaried I would not have ordered those tests. And good luck with telling a patient ‘I will not order this test for you because it is not “cost-effective”‘.

        Ordering expensive tests has little to do with whether an MD is on salary or fee-for-service. It has lots to do with the small margin of error doctors and patients are willing to tolerate.

        • J Williams said

          To quote Kris Roc “money is god in this country”; therefore, greed is the path to god. I believe greed has the ability to destroy any institution or reforms to those instutions.
          The out come of greed looks a lot like the effects of sociopathology. The question is how do we change our culture?

        • JimK said

          Re: Tony

          My interpretation of your reply is that you ordered CT scans because you thought they were necessary. Therefore, I shall rephrase my above statement: “If doctors are salaried, the “monetary” incentive to order unnecessary tests is removed.” If the monetary incentive is removed then the intent of the physician is beyond reproach.
          As far as Dr. Gawande’s article being overblown, the article is primarily about per capita medical expenditures under the current system in McAllen TX. Dr. Gawande further states that there is the possibility that the McAllen model may expand. Therein lies the real issue at the center of the Healthcare Debate; it is not so much about the uninsured as it is about the unsustainability of the current system.

  4. Leda said

    Jim: Apparently you are not reading the bill correctly. The bill mandates that all private carriers who are “priviledged” enough to be allowed to join the health care exchange follow the guidelines set forth by the Government, i.e. Public Policy. Also, the penalties imposed on parties maintaining private insurance, predominantely employers be penalized 8%, which in most cases is the majority of the profit margin.

    What you fail to comprehend at all is that HR 3200 infringes on your rights under Article 4 of the Constitution by have “real time access to your bank account” to withdraw sums them deem appropriate for you premiums and healthcare. When the Government mandates the level of care you receive, they breach your freedom in general.

    This bill as it is written is nothing short of Government control over citizens and their wealth. It is step one to a dictatorship and should be voted down all together as it is an unconstitional bill altogether. Secondly it would not reduce costs (when has the government ever reduced costs?) It will, by the very nature and historical abilities of our Government to manage anything, be burdened by financial crisis (also based upon the economy) and force rationed care.

    This bill is a mockery of Government takeover and a disservice to the American People who have contributed long and hard to Social Security and Medicare.

    Most Americans agree that Health Care Reform is Necessary, but this bill has nothing to do with Health, or Care, but evolves around money, larger government and control of the people.

    • Dave Wood said

      Great post Leda, but you fail to understand that the current system has all kinds of restrictions and regulations that amount to controls over our health care. We do not have unlimited health care now. Decisions are made, budgets and money are considered all along the way.

      The main problem with our system is that the very structure of it is rotten, wasteful, and unfair to its core. There are no large authoritys to make decisions of any substance.

      Medicare reforms must pass through a dysfuntional congress where money talks. Even a change in the reimbursement of a doctors visit requires hearings, lobbying, organizing, votes out of committees, and must compete with other prioritys on the congresses agenda. WHAT A SYSTEM!

      Notice that the pieces of American health care where there is a leader at the top like the private insurers, seem to be doing very well indeed. They seem to get what they want for their shareholders.

      But when it comes to Joe six pack he ends up paying copays on his private health insurance premium, then the medicare tax, then the income taxes, then the state taxes, then the sales and property taxes, then his auto insurance policy, then workers comp, all for this horrendous health care system we have.

      Even the so called uninsured fella pays 7 out of 8 of the above fees and taxes, yet he is only covered if hes on the job, or in his car, or over 65, or broke enough to get medicaid.

      What we need is a new authority held accountable through a local election. This new authority would be given the power to negotiate prices and taxes, everyone would be covered, and over time we could tackle the obesity epidemic, smoking, and other poor lifesytle habits we do.

    • JimK said

      Since I do not know what specific provision you are referring too in your statement which says the government will have “Real Time Access to Your Bank Account,” I can only assume you are referring to the fact that HR 3200 calls for mandatory coverage and will use changes to the IRS code as an enforcement mechanism. The only problem here is that the Bills I have reviewed all call for mandatory coverage and changes to the IRS code as a means of enforcement. I admit I have not read all of the Bills but so far it looks like mandatory coverage will be part of whatever is passed.

  5. After watching Sarah Palin run for Vice-president I can not understand why anyone would care what she said about anything.

  6. I think the disconnect between the payer (insurance company) and beneficiary (patient)of health care distorts the system wildly.

    If you go to a fixed price smorgasbord that offers all you can eat and drink, a good portion of us will eat like pigs.

    If, on the other hand, you go to place where every single item is offered a la carte, each with its own price tag, then we are more likely to pick only the items we want and can afford.

    Insurance is like the smorgasbord–we pay our monthly fee, which gives us entrance to the pigfest. Granted, co-pays and deductibles try to put a bit of a check on wanton overindulgence, but they don’t really do this effectively, in my view, unless the deductible and co-pay are reasonably high, at least high enough to feel some pain.

    Imagine yourself in your old age, you’ve had a good life, managed to accumulate something of an estate you hope to leave to your kids.

    You get some significant illness for which the treatment is, at best, going to extend your life another few months. With good insurance, you say, what the heck? I will get to see my grandkids a couple months longer, my church says life is sacred, what the hell! Extend my life a couple more weeks. Let the insurance company pay the $100,000 bill, that’s what my premiums have been paying for all these year.

    If you have bad insurance, you may opt to sell your house to pay for the operation, but where does that leave your kids? Would they rather have you around a couple more weeks looking sick and sleeping most of the time? Or would they do better–and you, in fact, feel happier, about letting nature take its course and your heirs take the $100,000?

    Maybe I am in a minority on this forum, but there’s such a disconnect here between patient, payer, doctor, etc. that it just seems whacky to me.

    To let patients talk to their doctors about end of life directives seems the opposite of death panels–it puts the individual in charge of his or her own fate. Maybe some right to lifers don’t like this on philosophical grounds–no abortions, no withdrawal of extreme medical interventions in anybody’s life, whether that person wants it or not. In fact, the only killing allowed whatsover are criminals and our enemies, and we need to kill many more of the bad guys as soon as possible.

    All of which segues me into what I think people are REALLY talking about when they talk about health care reform.

    Most of the liberals I know are for fairness. The see healthcare not as a privilege but a right that all Americans should get, rich or poor, black or white, employed by a big company or self employed or unemployed.

    Conservatives, especially those of a libertarian bent, see healthcare as something people should provide for themselves and their families, that charity begins at home, and it is not fair for them to be asked to pay tax dollars to subsidize less fortunates, or lazy people, or whatever other descriptions they can come up with the 47 million uninsured Americans, and those excluded from the market by preexisting conditions, or who simply cannot afford what the best deal is charging.

    I suspect this is a legitimate philosophical split: help your brother man vs. take care of your own.

    But what I also think is the case, especially when there is so much heat and shouting and apoplexy, often about demonstrably false things, is that the far right wing objectors are not against health care reform per se, but rather they are being fueled by much more deeply seated emotional issues.

    Race is absolutely one of these. Illegal aliens is another. The abortion stuff is a proxy for how people view the sexual revolution–there is a sense, I suspect, that many many conservatives think America went down the tubes when the birth control pill came out and women’s sexual behavior gained a kind of freedom, right or wrong, that it had not had before when intercourse could lead to pregnancy.

    I think liberals have a view of the world that reflects Rodney King’s infamous phrase: Why can’t we all just get along?

    I think conservatives have a view of the world that the cream rises to the top, that the cream deserves more than the dregs of society, and that even if a conservative has not yet become the cream yet, he surely will someday–and wants what will coming to him waiting.

    Perhaps this is unfair, but I do think that for people of a certain mindset, it doesn’t matter if they are personally getting screwed. It just matters if someone they don’t like is getting screwed worse.

    There are an amazing number of hardcore conservatives who hate Obama because he is black, hate Pelosi because she is woman from San Francisco, home of gays, hate Barny Frank because he is gay, and hate Harry Reid because he seems like a weak sistered milque toast. Ronald Reagan, Ollie North, G. Gordon Liddy, the assorted Blondie Brigade on Fox News: these are individuals that have rectitude, wear button down shirts, salute crisply, keep their lawns mowed.

    The whole thing is so disastrous, in my mind, because meaningful reform would benefit EVERYBODY in the country, perhaps at some slight expense of an insurance industry, pharmaceutical industry, hospital industry, etc. that have been benefiting for so long from the status quo.

    Xenophobia, chauvinism, racism, contempt for Bohemians and free thinkers, a sense that the poor remain deadbeats and welfare queens and the rich have gotten everything they have purely by the sweat of their brow (as opposed to inheritance, sweetheart deals, lobbying that helps special interests as the expense of the public, etc.–

    The whole country is being manipulated by the big money, and the loud and the furious among us are too stupid, too misinformed, and too manipulated to see straight. And the genius of the bill-of-goods salesman’s tactic: we all think we are none of these things. We all think we are just deeply philosophical intelligent analysts of the society.

    If there is one rational man among a thousand rationalizing ones, I would be stunned! But Alan, you come pretty close.

  7. Nosedoc said

    OK, it’s time for a physician’s perspective on this issue. First, some background. I practice general otolaryngology, or general ear, nose & throat medicine and surgery. I have performed hundreds of tracheostomies (surgical airways in the neck) over the past 17 years, mostly on patients in the Medical and Cardiac Intensive Care Units of the hospitals at which I have had privileges. These are primarily done on patients who are intubated (meaning, having a breathing tube in their windpipes via the mouth) and require mechanical support in breathing with little hope of getting off the ventilator without the tracheostomy. I would conservatively estimate that in at least 25 percent of these patients I believed that the patients “window for salvage” had long since passed. The result was that such patients were forced to endure considerable pain and suffering in the absence of any realistic hope of ever leaving the hospital alive. I also believe that the majority of these sorts of health crises were foreseeable to the patients’ physicians well before the patients landed in the hospital for the last time. I have witnessed the end-stage of many peoples’ lives, and I truly believe that were these patients and their families sat down for serious discussions regarding the patients’ overall health status and the possible end-of-life care scenarios prior to the last health crisis, many of these patients could have been spared significant suffering and indignities in their last few weeks of life, while their family members could have avoided the torment/guilt from having to make decisions about the care of their loved ones at a time when their rational thought is often clouded by intense emotions.

    My perception is that the main goal of this portion of this legislation is to highlight this need for people with multiple chronic medical conditions for whom a major health crisis (i.e., requiring advanced life support measures) is foreseeable to be empowered to make decisions about what measures they would or would not want in the event of a such an medical event. Living Wills and Advanced Directives have existed for a long time. The problem is that only a subset of elderly patients with serious chronic medical issues have these documents in place, and physicians are not always comfortable bringing up mortality and end-of-life issues with their patients, and they do not have the time for a lengthy discussion/consultation for which their time will not be compensated. This portion of the health care reform bill aims to reduce some of that reluctance by health professionals (via paid consultations) to raise the subject of end-of life care, with the idea that by empowering the patients on end-of-life decisions, that everyone can benefit–the patients get to leave this world in a manner they planned and are at peace with, the families get to say goodbye to their loved ones knowing that his/her wishes were followed (sparing them considerable guilt), while at the same time saving the health care system billions of dollars in what would have otherwise been very expensive unwanted care.

    This said, I need to read the specifics of the legislation to see if there are any questionable elements, such as enforceability in the face of family members not wanting to abide by the Living Will or Advance Directive. Without liability protections the health professionals would tend to go along with the wishes of the next of kin, ignoring the documented wishes of the patient.

  8. tracey said

    Healthcare reform is important to me. In 2008, my 10 y/o son was diagnosed with Chronic Myeloid Leukemia. That’s a rare disease caused by a fluke translocation of 2 chromosomes. It’s not genetic. My son never smoked or drank. It just happened (and it mostly occurs in people age 67+)

    Anyway, I just don’t understand why no one is discussing the REAL DEATH PANEL. IT DOES EXIST. I’M NOT PREPARED FOR IT. You see, my son’s medicine – that will let him live a normal, relatively uncomplicated life – costs $6000 per month. Additionally, he requires testing & bloodwork on a monthly, quarterly and annual basis.

    I pay high insurance premiums and have excellent coverage. However, the insurance company is calculating and tabulating every penny used to treat my son. In only a few years, I will receive a letter from my insurance company that reads: “Your son has reached his lifetime maximum benefit. He has no more coverage.” That letter is a death sentence. Without the targeted gene therapy medicine, my son’s CML will return and he will DIE in about 2 years.

    Where do we go? What do we do? I’ve raised these issues on the anti-Obama sites and on the senior “don’t touch my Medicare” sites. As expected, they have nothing to say.

    When will we put aside the differences and go after the profiteering insurance companies. Their making lots of money – despite my son’s medical costs. Right now, the insurance companies have the power to kill my son. We never could have anticipated this situation, but it can happen to anyone.

    I think we all should remember, but for the grace of God go I! Who will be next to face the Panel? It will happen again, again and again unless we make a concerted effort to stop the insurance industry now.

    • J Williams said

      Thank you for speaking up. My heart goes out to you and others like you! Who are these evil people on here giving you a thumbs down.

  9. Jamie said

    I have been trying to pinpoint what bothers me so much about the proposed healthcare reform (besides the expansion of government and entitlement programs that we can’t afford). I have been laying awake at night thinking about it. And here is what I have come up with. The government rations and allocates funds everyday – what crops to subsidize, what banks to bail out, what auto manufacturers to buy up, which companies are “too big to fail”. All of these decisions on how to allocate limited funds are based on economic models of where the government thinks that they will get the best return on their investment short term and long term.
    Now, try to add human life and healthcare into that economic equation. It is a scary thought. I do not believe that the president or the proponents of this bill want to ration healthcare or make decisions on who gets what treatments based on their productive value to society. But I do believe that it could come to that, whether it is what the framers of this bill intended or not.
    Imagine that the United States finds itself in a national economic crisis because, I don’t know, maybe we spend too much and accumulate more debt that we can pay and other countries no longer want to finance the US. Or perhaps we have massive inflation because we do something crazy like print a bunch of money. In an economic crisis where there are not enough funds to cover everyone’s healthcare, tough decisions would have to be made, hard cuts would have to be rationalized. And the basis for those cuts or rationing would then have to be on who gives the government the best return on their investment. Which healthcare recipients will give back to society in productivity? Which recipients are close to death anyway and therefore are not a good investment? Which newborn or unborn should be let go because the government has no investment in them yet? Which disabled person will only be an economic drain on society?
    I think of my quadriplegic father. What if the government, out of money for healthcare, had to decide if his irreversible condition was worth investing in treatment for? My dad might have private insurance today, but is it even possible that, under this proposed plan, those successful individuals who have private insurance that they pay for will get tired of paying for health insurance twice? They would be paying once for their own private insurance and again to subsidize through taxes the insurance of those who have not purchased private insurance. It is possible that more and more people will decide to take the government subsidized option until private insurance companies go out of business and we are left with a single-payer system? Is it possible that companies that pay for their employees health insurance today will decide that it is cheaper to pay “the fine” for not providing health insurance and let their employees get on the public option? Again, driving private insurance companies out of business and leaving us with single-payer government run healthcare. Again, I am not saying that this is the design of the creators of this plan; rather that it is a flaw in the design that is not being considered.
    We are living in a crazy time where our country may be fundamentally transformed from what our founding fathers designed. I am not a political activist. I am not part of any lobby or special interest group. I am an American who is deeply troubled by what I see as the possible ramifications of this transformation and the miasma of government control of industry, that once established, will be very difficult to disentangle ourselves from. I am also very excited. I do believe that America is a “sleeping giant” and once awakened, everyday American’s that love their country and pay their taxes will wake up, flex their muscles, raise their voices and say “not in my country.” And that will be a marvelous thing to behold.

    • PCL said

      What makes you think that any private insurer would continue to pay for your father’s expenses indefinitely? Their main goal is to make money, so any patient with costs that exceed the premium they pay is a liability to them. I agree that the government will do the same when their supply of money runs short. The problem is that as more partial cures to more and more once-fatal conditions are found, the percentage of patients with incredibly expensive chronic conditions will keep increasing. Eventually, all insurers, public and private, will have to find a way to say “no” to their most expensive patients. The question is whether they do it in an honest way, or resort to tricks like waiting lists (a favorite end run around coverage mandates for public insurers) and policy cancellation (the method of choice for private carriers). I believe this country (and much of the world) will be totally bankrupted by health costs before we finally face up to reality. Whoever wins, it will not be “a marvelous thing to watch”.

  10. Enrique Torres said

    I think there is a lot of paranoia surrounding the President’s health care reform initiative but I think a lot of it is justified. Take for example the many other times politicians have come to the people saying “We need this for the common good.” When the nation began taxing due to the high cost of the War of 1812 the income tax was caped at 3% and politicians at the time really meant 3%. The problem is that politicians don’t ever pay heed to the problems their bills, and laws create in the future. Social Security started as a good program, look at it now. Medicare and Medicaid had noble beginnings and look at those programs now. Welfare programs that were supposed to help people, did help at the beginning and now have created government dependency.
    See, once you give power to politicians, they never give it back, or are responsible for the way they wield this power. Case in point; During the housing boom, when the greedy corporate leaders were cheating the system, politicians were too happy to turn a blind eye. When the bubble exploded they paraded and castigated CEO’s and corporate heads. Some even went to jail. But the politicians that turned the blind eye, the ones that years earlier were touting the good deeds of Fannie Mae and Freddie Mac for putting minorites in homes (That they couldn’t afford), they are still around. See w can prosecute and throw in jail CEO’s and corporate heads if they get caught, but politicians get away with it and even get to point fingers… It’s no wonder the American people don’t trust them, so why would we trust them with health care?
    Yes, they may have good intentions now in 2009, but tell me? Can they guarantee that these new powers over health care won’t be abused by politicians in 2050?? The answer is NO!! So I rather take my chances with a less than perfect system where I have many choices, over another goverment program that will surely cause headaches for the nation in 30 or 40 years!! Just like income tax, Social Security, Medicare, Medicaid, Welfare, Freddie Mac, Fannie Mae, etc, etc, etc.


    Enrique Torres
    (pardon me if I made some gramatical errors. I typed this in a hurry) 🙂

    • Dave Wood said

      Heya Enrique, great post, just wanted to say that we are now entering an era of limitations. That is to say we can no longer afford the tax cuts from the right, nor the giant programs like Obama care from the left.

      Consider that our national debt reached 5 trillion when Bush Jr. took over, and is now over 10 trillion. And that Obama’s first budget is 1.7 trillion in ONE YEAR, and next year it will be 1.3 trillion! Can we even afford a new can opener for the white house kitchen?

      This debt will carry a price tag for decades to come. Mostly in the form of a weaker dollar, which will mean higher prices for our imported oil, and goods from China that we love so much now. Our power will erode in the world marketplace.

      And consider that the American people are the fattest people EVER to graze the planet earth. How can a workforce loaded with diabetes, arthritis, asthma, and a host of chronic diseases out work the skinny workforces of Asia?

      We have little discipline these days, kids have learned they want it NOW.

      If we do nothing to reverse the obesity-diabetes epidemic, the nation will surely sink under the weight of increased taxes to pay for the current promises made to old folks and the poor. States already spend 30% of their entire budgets on health care, that will only go up as the bill for all those fries and twinkies come due.

      Reform must come, but at the local level. We need to set up a system of smaller more local authoritys that know the local issues, and would be held accountable by way of a local election.

      This new authority could oversee either a single payer French style system, or a private insurance based choice and competition system like they have in Holland or Switzerland.

      Vermont would surely vote in a single payer authority and would self tax and self rule. Alabama would vote in the private insurance choice and competition system and would self tax and self rule.

      In this way, the people of Vermont or Alalbama would decide how much money to invest in obesity reduction. The local authority would run the program and be held accountable for its results.

      This idea I call the TWO BILL SOLUTION and I welcome your input and help in spreading this big idea.

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