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Politics : Politics for Pros- moderated -- Ignore unavailable to you. Want to Upgrade?

To: LindyBill who wrote (319611)	8/14/2009 6:15:55 AM
From: MulhollandDrive	5 Recommendations Read Replies (1) \| Respond to of 793957

as much as i find the 'end of life' counseling brought to you and paid for by big brother (elective of course) repulsive, what i find most appalling and emblematic of the state-ist command and control mindset is that this is a so called service to be performed which now has a FEE (incentive) generated by the provider... i had the unfortunate responsibility (along with my husband) to participate in an end of life counseling session as my FIL was fighting cancer in his late 70's...he had surgery, chemo, and the treatment was not successful, we had to take him to the emergency room at least 3 times for pain, toward the end of his care, which was approximately 2 years from the time of diagnosis, treatment, and eventually his death ....during the last visit, we had a meeting with his oncologist (a very fine doctor) who told us that he felt he needed to discuss palliative hospice care for my FIL and wanted our understanding of this and support...we discussed it with him, getting our assurance that this was the best option then we proposed this option to my FIL... this was a heartbreakingly sad, and highly personal moment for my FIL....he was completely lucid and fully aware of his condition, but he was a 'fighter', he had a wife who was in the early stages of alzheimers, a loving family, and was active, had many interests that kept him vital.... i'll never forget his reaction, the doctor took the lead, stood there and quietly and calmly explained why he felt palliative care was his best option....my FIL looked at him, then looked at his son, then at me and said "I knew this would happen eventually, but to me hospice means I'm giving up and nothing else can be done" (after which much re-assurance by his doctor and his children ensued) well just imagine at the moment in time, having some state appointed 'counselor' inserting themselves in that most private and intimate and sad time of a person's life that really should be handled by family and physician....the creep factor here is just off the chart....thanks, but no thanks oh and btw.... his oncologist didn't put an additional FEE on his billing statement for 'end of life counseling'....he just did what he felt was in the best interest of his patient and their family, giving them the options and allowing them to decide accordingly the only fees associated with it were his normal charge for his emergency room visit...and thankfully no gov't 'highly trained' personnel were involved...(thinking about the intransigent bureaucrat in the hospital scene when grandpa is pronounced dead in the move 'little miss sunshine' <ng>)

To: LindyBill who wrote (319611)	8/14/2009 7:20:19 AM
From: Brumar89	2 Recommendations Respond to of 793957

Good point - in that Obama interview he laid out that there was going to be rationing to save costs. And that it would be by "doctors, scientists, ethicists" in "some independent group that can give you guidance". Thats your "death panel". Of course, there would never be anything CALLED a "death panel", it would have some inocuous or even nice-sounding name - in England its actually N.I.C.E. ... Take the United Kingdom, which is often praised for spending as little as half as much per capita on health care as the U.S. Credit for this cost containment goes in large part to the National Institute for Health and Clinical Excellence, or NICE. Americans should understand how NICE works because under ObamaCare it will eventually be coming to a hospital near you. The British officials who established NICE in the late 1990s pitched it as a body that would ensure that the government-run National Health System used "best practices" in medicine. As the Guardian reported in 1998: "Health ministers are setting up [NICE], designed to ensure that every treatment, operation, or medicine used is the proven best. It will root out under-performing doctors and useless treatments, spreading best practices everywhere." What NICE has become in practice is a rationing board. As health costs have exploded in Britain as in most developed countries, NICE has become the heavy that reduces spending by limiting the treatments that 61 million citizens are allowed to receive through the NHS. online.wsj.com Okay, that tells us we need to watch out for the "best practices" and "clinical excellence" phrases. NICE stands firm, but the public must learn to respect rationing ..... In May the British Medical Association took the historic step of admitting for the first time that many health treatments will have to be rationed in future because the NHS cannot cope with spiralling patient demand. In A Rational Way Forward for the NHS in England, it argued that some procedures are already in jeopardy. These include fertility treatment, plastic surgery and operations for varicose veins and minor childhood ailments. ..... 'Twenty years ago politicians were not honest with people about it. They pretended it was possible for everything to be done. It wasn't then and it isn't now.' Sir Michael said he hoped this awareness would start to filter through to the media and the public. The NHS does not, he pointed out, have a 'bottomless pit of cash'. ... There is a long way to go to win over the public on the issue of rationing, says GP and Commons health select committee member Dr Howard Stoate. He tells of a woman at his constituency surgery demanding the NHS repaid her after going to Germany to have a hip operation that she would have had to wait three months for on the NHS. ..... Health and happiness: quality-adjusted life years There is a finite amount of money available and each treatment has to be judged on price. NICE uses a system known as the quality adjusted life-year (QALY), which gives each treatment a score for the benefit it gives in the quality and length of life, which is then compared with cost. QALY judges a year of perfect health as 1, while death represents 0. To judge quality of life, factors like mobility, pain, depression, and the ability for self-care are taken into account. So a treatment that results in four years of life with a health state of 0.75 gets three QALYs, where as four years with health state of 0.5 is two QALYs. The QALY is combined with cost to give cost utility ratios which are then used to judge treatment. .... NICE technology appraisals are prepared by an independent appraisal committee which includes health professionals working in the NHS and people who are familiar with the issues affecting patients and carers. hsj.co.uk That independent appraisal committee sounds like "independent group that can give you guidance" Obama was talking about in that interview and is what Sarah Palin labeled the "death panel". ----------------------------- "Most time, a man will tell you his bad intentions if you listen, let yourself hear." Charley Waite, Open Range