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Thread: Bipartisan support against Obama Death panel

  1. #1

    Bipartisan support against Obama Death panel

    Who says we can't have bipartisan agreement?

    [url]http://www.nytimes.com/2011/04/20/us/politics/20health.html?_r=1&hp[/url]

    [QUOTE]WASHINGTON — Democrats and Republicans are joining to oppose one of the most important features of President Obama’s new deficit reduction plan, a powerful independent board that could make sweeping cuts in the growth of Medicare spending.

    Representative Paul D. Ryan, Republican of Wisconsin, said expanding the board would put limitations on providers.

    Representative Allyson Y. Schwartz, Democrat of Pennsylvania, opposes the board.

    Mr. Obama wants to expand the power of the 15-member panel, which was created by the new health care law, to rein in Medicare costs.

    But not only do Republicans and some Democrats oppose increasing the power of the board, they also want to eliminate it altogether. Opponents fear that the panel, known as the Independent Payment Advisory Board, would usurp Congressional spending power over one of the government’s most important and expensive social programs.

    [B]Under the law, spending cuts recommended by the presidentially appointed panel would take effect automatically unless Congress voted to block or change them. In general, federal courts could not review actions to carry out the board’s recommendations. The impact of the board’s decisions could be magnified because private insurers often use Medicare rates as a guide or a benchmark in paying doctors, hospitals and other providers.[/B]

    Last week, in his speech on deficit reduction, Mr. Obama said he wanted to beef up the board’s cost-cutting powers in unspecified ways should the growth of Medicare spending exceed certain goals. Supporters say the board will be able to make tough decisions because it will be largely insulated from legislative politics.

    [B]Lawmakers do not agree. Representative Paul D. Ryan, Republican of Wisconsin and chairman of the House Budget Committee, called it “a rationing board” and said Congress should not “delegate Medicare decision-making to 15 people appointed by the president.” He said Mr. Obama’s proposal would allow the board to “impose more price controls and more limitations on providers, which will end up cutting services to seniors.” [/B]

    Senator John Cornyn, a Texas Republican who introduced a bill last month to repeal the Medicare board, said [B]the president’s proposal “punts difficult decisions on health spending to an unelected, unaccountable board of bureaucrats.” [/B]

    Representative Allyson Y. Schwartz, a Pennsylvania Democrat prominent on health care issues, said: [B]“It’s our constitutional duty, as members of Congress, to take responsibility for Medicare and not turn decisions over to a board. Abdicating this responsibility, whether to insurance companies or to an unelected commission, undermines our ability to represent our constituents, including seniors and the disabled.” [/B]

    Ms. Schwartz signed up on Friday as co-sponsor of a bill to repeal the board.

    The purpose of the panel, according to the health care law, is to reduce the rate of growth in Medicare spending per beneficiary. The law sets annual goals — “target growth rates” — for Medicare spending below the average of the last 15 years.

    Board members will be subject to Senate confirmation — no easy feat in the current political climate. Terms are six years. Members can serve no more than two full consecutive terms. The White House has yet to submit any nominations for the board.

    “Why have legislators?” asked Representative Pete Stark of California, the senior Democrat on the Ways and Means Subcommittee on Health.

    [B]In some ways, Mr. Stark said, expanding the power of the board could be as bad as giving vouchers to Medicare beneficiaries to buy private insurance. “In theory at least, you could set the vouchers at an adequate level,” he said. “But, in its effort to limit the growth of Medicare spending, the board is likely to set inadequate payment rates for health care providers, which could endanger patient care.” [/B]

    Representative Shelley Berkley, Democrat of Nevada, said she wanted to repeal the Medicare board.[B] “I have great faith that this administration can put together a strong, independent and knowledgeable board,” Ms. Berkley said, but she said she had less confidence in future administrations. [/B]

    Mark Parkinson, president of the American Health Care Association, which represents nursing homes, said his members disliked the board because it would allow Congress and the president to “subcontract out difficult decisions.”

    Still, the idea of a more potent Medicare board could be a live option if the White House insisted on it in budget negotiations with Congress.

    Mr. Obama said last week that he would “reduce wasteful subsidies and erroneous payments,” cut spending on prescription drugs and take other steps to save $500 billion in Medicare and Medicaid by 2023. “But if we’re wrong and Medicare costs rise faster than we expect,” he said, the Medicare board would have “the authority to make additional savings by further improving Medicare.”

    The president’s proposal would set stricter goals for Medicare spending and establish some type of automatic cost-cutting device as an “enforcement mechanism,” but Mr. Obama did not say exactly how it would work.

    Kathleen Sebelius, the secretary of health and human services, described the board as a backstop to “ensure that health costs are reduced.” The board might not have to take action if the president’s other proposals slow the growth of Medicare spending, she said.

    The board grew out of proposals by Mr. Obama and Senator John D. Rockefeller IV, Democrat of West Virginia.

    “Medicare payment policy should be determined by experts, using evidence, not by the undue influence of special interests,” Mr. Rockefeller said.

    AARP, the American Medical Association and the American Hospital Association voiced concern about the president’s latest proposal.

    [B]“Relying on arbitrary spending targets is not a good way to make health policy, especially when decisions may be left to the unelected and unaccountable,” said A. Barry Rand, chief executive of AARP, the lobby for older Americans.

    Under the law, the board cannot make recommendations to “ration health care,” raise revenues or increase beneficiaries’ premiums, deductibles or co-payments. This increases the likelihood that the board will try to save money by trimming Medicare payments to health care providers. [/B][/QUOTE]After all the attacks on the Ryan plan as death to Medicare it appears the President proposal isn't about making Medicare a world class health care system for Seniors but a plan to ration and ratchet back health care through the use of a panel with virtually no oversight once in place. Some might even consider these "Death Panels" especially if as Representative Shelley Berkley, Democrat of Nevada pointed out a President less responsible to the elderly then Obama is elected and controls the panel at some point.:rolleyes:
    Last edited by Winstonbiggs; 04-20-2011 at 07:45 AM.

  2. #2
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    More crickets from the left :rolleyes:

  3. #3
    Its not rationing. Its called smart medicine. Doing things that make sense. Not wasting millions of dollars on care that does not make medical sense. People get too emotional when having this discussion. They cant seperate sentiment from what is medically appropriate. Until the public accepts this , politicians (from either side of the aisle) can not have an honest, thoughtful discussion about such matters.

  4. #4
    people can complain about rationing but it already happens, all the time.

  5. #5
    [QUOTE=bitonti;4005308]people can complain about rationing but it already happens, all the time.[/QUOTE]

    I'm sensing a theme with you of late Bit.

    "Bit pops in, makes a "it is what it is, it will never change, deal" in so many words post on every subject where the (D) Party Line or Policy is in question.

    Then, when questioned about his milktoasty support, he says "I didn't say I support it, just telling it as it is, my name is eyore...." as if none of us politically minded folks know what the current status of these issues are.

    How very :zzz:

  6. #6
    [QUOTE=Warfish;4005314]I'm sensing a theme with you of late Bit.

    "Bit pops in, makes a "it is what it is, it will never change, deal" in so many words post on every subject where the (D) Party Line or Policy is in question.

    Then, when questioned, he says "I didn't say I support it, just telling it as it is" as if none of us politically minded folks know what the current status of these issues are.

    How very :zzz:[/QUOTE]

    Do you deny that it already is happening to some degree?
    Because it is. Sometimes it has to do with age, medical necessity, and unfortunately/sadly, sometimes it has to do with what insurance you have and how much they will reimburse.

  7. #7
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    [QUOTE=bitonti;4005308]people can complain about rationing but it already happens, all the time.[/QUOTE]





    My father passed away after new years and his care was most definitely rationed.

    And when My Mom died 10 years ago her care was rationed, too.



    Euthanasia needs to be part of this discussion.

  8. #8
    [QUOTE=kennyo7;4005316]Do you deny that it already is happening to some degree?
    Because it is. Sometimes it has to do with age, medical necessity, and unfortunately/sadly, sometimes it has to do with what insurance you have and how much they will reimburse.[/QUOTE]

    You tell me Doc. I have an HMO, and despite my ongoing poor health, I've yet to have anything denied thus far, including a whole host of expensive radiological exams. /shrug

  9. #9
    [QUOTE=kennyo7;4005316]Do you deny that it already is happening to some degree?
    Because it is. Sometimes it has to do with age, medical necessity, and unfortunately/sadly, sometimes it has to do with what insurance you have and how much they will reimburse.[/QUOTE]

    Of course it's already happening. That's not the point the President is completely disingenuous on this issue. He attacks the other side for destroying Medicare when his own plan calls for a panel of 15 people with no oversight at all once in place to reduce benefits based on their say so.

    If a Republican propossed this the left would be going bat $hit.

  10. #10
    [QUOTE=Warfish;4005329]You tell me Doc. I have an HMO, and despite my ongoing poor health, I've yet to have anything denied thus far, including a whole host of expensive radiological exams. /shrug[/QUOTE]

    You are one out of millions. The exception not the rule. Your personal experience does not define what actually is going on.

    I can give many examples, for instance a patient with an MI who did not get a cardiac cath but rather "medically managed" because their insurance's reimbursement wasnt worth the invasive cardiologists effort. Not the wrong decision medically, but if he had a better insurance that paid more, he would have had the cath (not that this would have been the right thing to do, but clearly a decision based on economics not medicine). There are too many instanced i can tell you about where PET scans were denied by insurance companies when i was in the private sector.

  11. #11
    [QUOTE=Winstonbiggs;4005338]Of course it's already happening. That's not the point the President is completely disingenuous on this issue. He attacks the other side for destroying Medicare when his own plan calls for a panel of 15 people with no oversight at all once in place to reduce benefits based on their say so.

    If a Republican propossed this the left would be going bat $hit.[/QUOTE]

    Making cuts in benefits is not destroying Medicare its saving it. There is way too much spent on things that make no medical sense.

    The republicans would never propose this, they dont have the guts. And neither do the Dems who oppose this.

  12. #12
    [QUOTE=kennyo7;4005343]Making cuts in benefits is not destroying Medicare its saving it. There is way too much spent on things that make no medical sense.

    The republicans would never propose this, they dont have the guts. And neither do the Dems who oppose this.[/QUOTE]

    He isn't propossing cutting benifits he's propossing cutting fees paid for services. That effectively puts the burden on either the provider or more likely on the patient to come up with the shorfall as doctors will stop taking Medicare.

    I don't want 15 people with zero oversight making those decisions.
    Last edited by Winstonbiggs; 04-20-2011 at 03:01 PM.

  13. #13
    [QUOTE=kennyo7;4005339]You are one out of millions. The exception not the rule. Your personal experience does not define what actually is going on.[/quote]

    So by logical extention, the "Top 400" referenced in another thread (0.000114% of U.S. Population, or more than 1 in 1 million) should ALSO not be used as "the rule", but the exception?

    Nice.

    [QUOTE]I can give many examples, for instance a patient with an MI who did not get a cardiac cath but rather "medically managed" because their insurance's reimbursement wasnt worth the invasive cardiologists effort.[/QUOTE]

    And you believe/claim this would not happen under a State/Universal System?

    [QUOTE]Not the wrong decision medically[/QUOTE]

    Interesting.

    [QUOTE], but if he had a better insurance that paid more, he would have had the cath (not that this would have been the right thing to do, but clearly a decision based on economics not medicine).[/QUOTE]

    So if it wasn't the wrong decision medically, and the cath may not have been the right thing to do.....whats the complaint? Perhaps I simply lack enough Medical Knowledge to understand tbh.

    I take it the "big issue" with a left-leaning desire for State Run Healthcare is the "cover everyone" social welfare concept then? Fair enough, and easy enough to debate against then.

  14. #14
    Ken on another level. I'm 56 years old have paid into SS and Medicare since I was 17 in one form or another.

    The argument I always heard from the left for not privatizing SS is you can't depend on the private markets. Now all the baby boomers who have paid in for 30 plus years and it will be 40 plus when they retire are going to bust the public system starting with Medicare and then SS.

    The same left is screaming that we take care of public employees who have gotten benifits that are off the chart many after 20 years.

    If anything we should all recognize that we are on our own and a private portable program that is self funded is every bit as good as the "Public gurantee" which is only a guarantee as long as you can guarantee that the government will be run in a fiscally responsible manner decade after decade and a combination of demographics, economic activity and govenment responsability all work together.

  15. #15
    [QUOTE=Winstonbiggs;4005383]If anything we should all recognize that we are on our own and a private portable program that is self funded is every bit as good as the "Public gurantee" which is only a guarantee as long as you can guarantee that the government will be run in a fiscally responsible manner decade after decade and a combination of demographics, economic activity and govenment responsability all work together.[/QUOTE]

    Wow.

    +1

  16. #16
    [QUOTE=Winstonbiggs;4005383]Ken on another level. I'm 56 years old have paid into SS and Medicare since I was 17 in one form or another.

    The argument I always heard from the left for not privatizing SS is you can't depend on the private markets. Now all the baby boomers who have paid in for 30 plus years and it will be 40 plus when they retire are going to bust the public system starting with Medicare and then SS.

    The same left is screaming that we take care of public employees who have gotten benifits that are off the chart many after 20 years.

    If anything we should all recognize that we are on our own and a private portable program that is self funded is every bit as good as the "Public gurantee" which is only a guarantee as long as you can guarantee that the government will be run in a fiscally responsible manner decade after decade and a combination of demographics, economic activity and govenment responsability all work together.[/QUOTE]

    Winston I appreciate you putting in 40 years worth into SS. Some of the stuff medicare pays for, far exceeds what you have put in. And medically it makes no sense.

    I have seen patients in their late 80s and 90s being kept alive in ICUs using vents, dialysis, IV pressors, antibiotics and other extra-ordinary means for months when there is absolutely no chance for any meaningful recovery. This comes at a cost of anywhere between $5,000 to $20,000 per [U]day[/U]
    . This goes on for months (ive even seen it happen for over a year). Were talking about 2.5-5 million dollars spent on a single patient when the situation is medically futile. And some doctors allow this to go on. Its wrong both ethically and financially. It makes no sense to spend this in futility. This is where most of the spending occurs (in the patients last few months of life).

    Yes I want a public system. The only way it will work (and does work elsewhere) is if we cut wasteful spending. That means making some tough decisions. Letting go of a loved one is very difficult even when its the right thing to do(morally and medically). I hate to say it, but the right choice becomes easier to make , if the financial burden falls on you. Spending money in medically futile situations has to stop, this is the first step.

  17. #17
    i find it disingenuous that the right complains about gov't spending and it also complains about rationing healthcare paid for by the government.

    there's no law that says Bill Gates can't pay for unlimited healthcare treatments no matter how much of a longshot it is to work. If you want to avoid the death panel, get rich. Isn't that the right wing's answer to everything?

  18. #18
    [QUOTE=Warfish;4005362]So by logical extention, the "Top 400" referenced in another thread (0.000114% of U.S. Population, or more than 1 in 1 million) should ALSO not be used as "the rule", but the exception?

    Nice.

    [B]This makes absolutely no sense. You said that you were never denied any care. Your implication is that because it did not happen to you it does not occur. You are flat out wrong. [/B]

    And you believe/claim this would not happen under a State/Universal System?

    [B]Of course it can AND IT SHOULD!. But because of medical necessity, not b/c of the physician's financial interests and not b/c of the patients type of insurance and what they are willing to pay. [/B]


    Interesting.

    [B]Very much so.[/B]

    So if it wasn't the wrong decision medically, and the cath may not have been the right thing to do.....whats the complaint? Perhaps I simply lack enough Medical Knowledge to understand tbh.

    [B]The complaint is costs can be controlled by doing what is medically necessary and sound. People will argue that they would have wanted the cath, even though its not necessary and if he had the right insurance it would have been done even though its wasteful. Costs are controlled by practicing smart medicine. This is not rationing even though the public may view it as such since some insurance will pay for it. [/B]

    I take it the "big issue" with a left-leaning desire for State Run Healthcare is the "cover everyone" social welfare concept then? Fair enough, and easy enough to debate against then.

    [B]Everyone can be covered if we are making smart rational medical decisions. That means not spending millions of dollars on a terminal patient's last 2-3 weeks of life for medical care that makes no sense. You call it rationing/welfare...i call it smart sound medicine. [/B]

    [/QUOTE]
    .

  19. #19
    [QUOTE][QUOTE]This makes absolutely no sense.[/quote]

    Perhaps you should read Doggies thread, to get the reference. The point was that a small limited pool of experience/subjects (the exception, although I doubt I am tbh) is not reflective of the whole, an idea you seem to support here in Healthcare, but not in taxation policy.

    [QUOTE]Of course it can AND IT SHOULD!. But because of medical necessity, not b/c of the physician's financial interests and not b/c of the patients type of insurance and what they are willing to pay.[/QUOTE]

    So then under the Govt. System, care would never be rationed due to fiscal interests? Lol, right.

    I wonder if it would ever be rationed on racial interests......like affirmative action. I'm betting you'd support that too, social justice and all that.

    [QUOTE]The complaint is costs can be controlled by doing what is medically necessary and sound.[/QUOTE]

    Implying Private Interests don't do that?

    [QUOTE]Costs are controlled by practicing smart medicine. This is not rationing even though the public may view it as such since some insurance will pay for it.[/QUOTE]

    Who has more interest in "practicing smart medicine", i.e. controlling costs. A for-profit business, or the unlimited funding Govt.? last I checked, private firms don;t buy $700 hammers....

    [QUOTE]Everyone can be covered if we are making smart rational medical decisions.[/QUOTE]

    Everyone doesn't deserve to be covered Ken, not at my (taxpayer) expense. Those able-bodied and not working have no right to free taxpayer funded healthcare, period. Healthcare is not a human right, and I've yet to be convinced intellectually or morally that I owe health services to a layabout milking the system.

    Happy to pay taxes for healthcare for the disabled. But not for welfare, and no, not for the elderly, who should have saved for that themselves.

    [QUOTE]That means not spending millions of dollars on a terminal patient's last 2-3 weeks of life for medical care that makes no sense.[/QUOTE]

    So kill them then? Euthanasia, by State decree? So enlightened you are Ken, thank God you're not my Doctor (although, given my ongoing poor health, maybe I could do worse....)

    [quote]You call it rationing/welfare...i call it smart sound medicine. [/QUOTE]

    Pretty much everything you support is Welfare of some kind or another. Free **** for one group who does nothing to earn it, taken away from another group who labors for what they have, only to have it taken away, as well as their own options, and forced to "do what the State wants".[/QUOTE]
    .

  20. #20
    [QUOTE=kennyo7;4005415]Winston I appreciate you putting in 40 years worth into SS. Some of the stuff medicare pays for, far exceeds what you have put in. And medically it makes no sense.

    I have seen patients in their late 80s and 90s being kept alive in ICUs using vents, dialysis, IV pressors, antibiotics and other extra-ordinary means for months when there is absolutely no chance for any meaningful recovery. This comes at a cost of anywhere between $5,000 to $20,000 per [U]day[/U]
    . This goes on for months (ive even seen it happen for over a year). Were talking about 2.5-5 million dollars spent on a single patient when the situation is medically futile. And some doctors allow this to go on. Its wrong both ethically and financially. It makes no sense to spend this in futility. This is where most of the spending occurs (in the patients last few months of life).

    Yes I want a public system. The only way it will work (and does work elsewhere) is if we cut wasteful spending. That means making some tough decisions. Letting go of a loved one is very difficult even when its the right thing to do(morally and medically). I hate to say it, but the right choice becomes easier to make , if the financial burden falls on you. Spending money in medically futile situations has to stop, this is the first step.[/QUOTE]

    Ken-I understand all of this and I'm willing to have an honest debate on it and I know you want that also. The President and the Democrats don't want to have an honest debate about it and I'm sure most Republicans don't want that either.

    Of course we need reasonable limits because we can only afford what we can afford and right now the country is in deep debt and the majority of Americans are getting sqeezed by food, energy inflation and health care inflation.

    Stop telling us we can cover everyone from craddle to grave with no changes in how and what is delivered.

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