End of Life Planning Effective Jan. 1, 2011

[Rick]

There was an interesting article in Sunday's NY Times regarding the reenactment of what was a very controversial component of the Obama Health Care plan. Namely, end of life planning and the fact that it will be covered Jan. 1 under Medicare. Here's the article if you would like to read it.

http://www.nytimes.com/2010/12/26/us...ref=robertpear

I'm actually for the addition because it provides seniors with more options than they might otherwise have known they have. What concerns me, however, is how it came about. So I've been doing some digging the last couple of days.

Medicare evidently tried to pass the change by adding it to the price controls for 2011. If you've never heard of Medicare's hospital and physician price controls don't feel like the lone stranger. Most folks haven't.

The fact that it was buried without a peep and it got added as a rider is a little disturbing to me. The only reason they did it can only be to avoid the controversy that ensured not so long ago on the same subject during the Health Care debates. That's NOT how Medicare is supposed to work. And while I'm on the subject, has anyone heard of Dr. Donald Berwick? No? He's the new czar that oversees what doctors and hospital are reimbursed by Medicare. In short, he was appointed by Obama to oversee a reimbursement policy Congress opposed. I might also add he was appointed when the Senate was in recess this summer. Smooth. Real smooth.

But, lest I get political, my real intent is to make folks aware, especially if you are Medicare eligible, that end of life planning will now be paid for. Another benefit you can take advantage of. Now, if you can just get your drugs paid for.

[crashdive123]

I've been following it. Without getting political, I share your concern. On the surface, I don't have an issue with all options being explored, but in addition to how it was implemented, I am concerned about what will follow. I fear that it is an initial step, not a solution to a problem.

[2dumb2kwit]

But, lest I get political, my real intent is to make folks aware, especially if you are Medicare eligible, that end of life planning will now be paid for. Another benefit you can take advantage of. Now, if you can just get your drugs paid for.

So will that be paid for out of the 35% death tax, that goes into effect 1-1-11?

[canid]

I'm sure I'm betraying my ignorance here, but I can't understand why it's even remotely permissible for a resolution, proposition or bill to contain two or more items not directly, necessarily and irrevocably related.

[crashdive123]

I'm sure I'm betraying my ignorance here, but I can't understand why it's even remotely permissible for a resolution, proposition or bill to contain two or more items not directly, necessarily and irrevocably related.

It's the only way they (both sides) can get 99% of the trash they foist upon us through. If every spending thing/law/regulation was its own stand alone entity it would not pass muster with the light of day shinning brightly on it.

[canid]

that can't be the answer; it makes too much sense...

[huntermj]

End of life planning, I hope i go into a bridge abutment at 110 miles per hour. at 92 years old.

[Rick]

I'm going out at the hands of a jealous lover at 102.

It's also another reason we can't get a line item veto. No one in D.C. really wants it.

[canid]

well; i own a motorcycle, so my end of life planning is pretty straight-forward if i'm still ambulatory in old age.

[SARKY]

Can we please call this what it truly is..... The Obama administration has done yet another end around the people and it's elected representatives and has reinstated death panels!

[crashdive123]

Can we please call this what it truly is..... The Obama administration has done yet another end around the people and it's elected representatives and has reinstated death panels!

We could, but that would be injecting politics into it, and as you are well aware - political discussions are verboten.

[Rick]

It would also be mis-labeling what the benefit is for. Death panels has nothing to do with it. I am eligible for end of life planning, fully paid for, with my private insurance. Why would we not want seniors, facing a life crises, to not be fully informed about their options such as pain management, hospice, medical power of attorney, durable power of attorney or state sponsored ombudsmen? To NOT provide it would be unethical and inhumane, IMHO.

[2dumb2kwit]

It would also be mis-labeling what the benefit is for. Death panels has nothing to do with it. I am eligible for end of life planning, fully paid for, with my private insurance. Why would we not want seniors, facing a life crises, to not be fully informed about their options such as pain management, hospice, medical power of attorney, durable power of attorney or state sponsored ombudsmen? To NOT provide it would be unethical and inhumane, IMHO.

OK...but what about when the state or federal social workers, that advise the elderly about their end of life planning, are instructed to start pushing the old folks into just kicking the bucket without using up all that expensive medical attention?
You know..."Well Mrs. Jones, you could get dialysis,....or you could just let nature take it's course, and let some child benefit from the medical care provided by the money saved, by you not using that expensive dialysis. Think how much happier that will make your family."

[Rick]

Well, I don't think the dialogue would go quite like that. At least it didn't with my mom. In any case, yes, one of the options is to let nature takes its course and what you can expect if you make that choice. Some people actually DO make that choice because the quality of life during treatment is less than they are willing to accept.

If your concern is that some bureaucrat will not want to pay for services because it's just to expensive and it will impact their bottom line then think again. It happens today under private insurance. All the time. It happens with Medicare today. There are some things the government will not pay for. Obama himself suggested that his grandmother's hip replacement AFTER she received a diagnosis of terminal cancer was probably not a "sustainable model". I'm not certain whether it should be either.

But that's an entirely different question than just sitting down and discussing what options are available and what planning should take place during that time. That's all this is talking about. It just pays for the time to do that.

[2dumb2kwit]

I understand what you are saying, but you are not thinking like a politician. I tend to think that sooner or later, politicians will look at it as..."I'm paying these people, so they need to push what I want them to push." (The social workers, I mean.)

[Rick]

I'm not disagreeing with you. It could easily happen. But if it's going to happen then it will happen whether end of life planning goes forward or not. And there is much more incentive for it to happen in the private sector where the insurance company's bottom line is the be all end all.

[2dumb2kwit]

I'm not disagreeing with you. It could easily happen. But if it's going to happen then it will happen whether end of life planning goes forward or not. And there is much more incentive for it to happen in the private sector where the insurance company's bottom line is the be all end all.

I guess I just don't trust the Gov't, very much.

I mean think about it.....if the Gov't is so trustworthy, why do federal workers have unions?

[crashdive123]

I can see very easily - and that is why I have great concerns about the entire program -that the giant bureaucracy that is involved, coupled with limited resources will lead to rationing. While the conversation may not go as stated above, it might go something like - Sorry Mr. Crash - based on your life expectancy and the cost of "that" procedure, we are not able to authorize that. It's happening in other countries with government sponsored/single payer health care.

[Rick]

Indeed. Canada is a great example. Socialized medicine is not the answer. Just look at any inner city ER in the U.S. That's socialized medicine at work in most cases.

[Justin Case]

Indeed. Canada is a great example. Socialized medicine is not the answer. Just look at any inner city ER in the U.S. That's socialized medicine at work in most cases.

all the Canadians on another forum i frequent say it great,,, just sayin