Friday, August 21, 2009

Obamacare & Death Counseling


Washington Post Charles Krauthammer

Let's see if we can have a reasoned discussion about end-of-life counseling.

We might start by asking Sarah Palin to leave the room. I've got nothing against her. She's a remarkable political talent. But there are no "death panels" in the Democratic health-care bills, and to say that there are is to debase the debate.

We also have to tell the defenders of the notorious Section 1233 of H.R. 3200 that it is not quite as benign as they pretend. To offer government reimbursement to any doctor who gives end-of-life counseling -- whether or not the patient asked for it -- is to create an incentive for such a chat.

What do you think such a chat would be like? Do you think the doctor will go on and on about the fantastic new million-dollar high-tech gizmo that can prolong the patient's otherwise hopeless condition for another six months? Or do you think he's going to talk about -- as the bill specifically spells out -- hospice care and palliative care and other ways of letting go of life? [...]

5 comments :

  1. Somehow when I saw this in my morning paper, I knew I'd find it on your blog.

    Although I generally enthusiastically agree with Dr. Krauthammer, in this case I think he's totally off the mark.

    Mr A, 89 years old with severe dementia and metastatic prostate cancer comes to see the doctor. There are no treatments that will alter the course of his cancer but they will make him feel sick. He's already a mess as it is despite 20 different medications. Please explain to me why I, as a palliative physician, should not be concentrating on making his final days more comfortable instead of subjecting him to experimental treatments that won't extend his life anyway?

    Al pi halacha, let's say I have access to a new fantastic gizmo that will extend his life by 6 months? But during those 6 months he'll be in exquisite agony? Which should I choose? That, or comfort and 2 months?

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  2. Private insurance companies today ALL limit medical care for people over 60.

    My father was 60 when he was diagnosed with leukemia. He was given a 10% chance of survival even with the most aggressive treatment. He had Blue Cross which is supposed to be the best private insurance. Even Blue Cross would not authorize any treatment only "end of life" care.

    We got a lawyer, sued and Pop had 5 rounds of chemo.

    What is the end of the story? Our father is still B"H alive.

    But after 5 rounds of chemo, a specialist at Univ of Penn. ordered genetic testing that should have been done first and told us that Pop never had leukemia. It was a hereditary red blood cell disorder that affects as many as 25% of Sephardic men (G6PD Def. ).

    My grandmother a"h who was 88 when she had a stroke that put her in a coma. She had only Medicare which is the US gov't insurance policy for senior citizens.

    When our grandmother was brought to the hospital, the doctor saw that we were observant Jews and told us that he would not ask or do anything that would be a violation of Jewish law. We were pleasantly shocked.

    My grandmother remained alive, in a coma with oxygen and tube feeding for a week and a half until her kidneys failed and she passed away naturally.

    Gov't provided Medicare covered all of the care without question.

    In fact, the doctor who was not Jewish, consulted an Orthodox Rabbi from YU regarding my grandmother's care.

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  3. Recipients and PublicityAugust 26, 2009 at 11:02 AM

    What the UK's health system teaches will be the end-result of ObamaCare[less]: "The babies born in hospital corridors: Bed shortage forces 4,000 mothers to give birth in lifts, offices and hospital toilets (26th August 2009):...Thousands of women are having to give birth outside maternity wards because of a lack of midwives and hospital beds.
    The lives of mothers and babies are being put at risk as births in locations ranging from lifts to toilets - even a caravan - went up 15 per cent last year to almost 4,000. Health chiefs admit a lack of maternity beds is partly to blame for the crisis, with hundreds of women in labour being turned away from hospitals because they are full..."

    It will only get worse as countries that mindlessly socialize their medical systems inevitably become no different than Third World countries.

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  4. Recipients and PublicityAugust 26, 2009 at 11:07 AM

    Someone finally admits (a Jewish senator, who else): "Feingold: No health care bill before Xmas: Large Mercer crowd opposes reform plans (The Lakeland Times, August 25, 2009):...U.S. Sen. Russ Feingold told a large crowd gathered for a listening session in Iron County last week there would likely be no health care bill before the end of the year - and perhaps not at all.

    It was an assessment Feingold said he didn't like, but the prospect of no health care legislation brought a burst of applause from a packed house of nearly 150 citizens at the Mercer Community Center.

    "Nobody is going to bring a bill before Christmas, and maybe not even then, if this ever happens," Feingold said. "The divisions are so deep. I never seen anything like that."

    Feingold reiterated his appraisal a bit later.

    "We're headed in the direction of doing absolutely nothing, and I think that's unfortunate," he said when asked about the plight of uninsured Americans..."

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  5. Recipients and PublicityAugust 27, 2009 at 7:52 AM

    It can only get worse, just looking at the UK's "great" healthcare[less] system that the ObamaCare[less] scheme is running to emulate:

    The Telegraph: "'Cruel and neglectful' care of one million NHS patients exposed (27 Aug 2009) One million NHS patients have been the victims of appalling care in hospitals across Britain, according to a major report released today...In the last six years, the Patients Association claims hundreds of thousands have suffered from poor standards of nursing, often with 'neglectful, demeaning, painful and sometimes downright cruel' treatment. The charity has disclosed a horrifying catalogue of elderly people left in pain, in soiled bed clothes, denied adequate food and drink, and suffering from repeatedly cancelled operations, missed diagnoses and dismissive staff.

    The Patients Association said the dossier proves that while the scale of the scandal at Mid-Staffordshire NHS Foundation Trust - where up to 1,200 people died through failings in urgent care - was a one off, there are repeated examples they have uncovered of the same appalling standards throughout the NHS.

    While the criticisms cover all aspects of hospital care, the treatment and attitude of nurses stands out as a repeated theme across almost all of the cases..."

    --------

    ObamaCare[less] anyone? Come and get your laced Jim Jones cool-aid!

    ReplyDelete

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