Wednesday, August 12, 2009

Healthcare: Skewing End of Life Counseling and 5 Freedoms Lost

ht to Bizzyblog

There are two really good articles out there that highlight the dangers of Obamacare and the deception out there from the Left about what Obamacare is and is not and what it will do. Two articles found by Bizzyblog highlight the truth and show this for the folly it will be. First, the most recent. It deals with end of life care. Now, this has had a lot of coverage with Sarah Palin calling them death panels and such, and there has been some hyperbole out there. However, Charles Lane cuts to the chase:
I was not reassured to read in an Aug. 1 Post article that "Democratic strategists" are "hesitant to give extra attention to the issue by refuting the inaccuracies, but they worry that it will further agitate already-skeptical seniors."

If Section 1233 is innocuous, why would "strategists" want to tip-toe around the subject?

Perhaps because, at least as I read it, Section 1233 is not totally innocuous.

Until now, federal law has encouraged end-of-life planning -- gently. In 1990, Congress required health-care institutions (not individual doctors) to give new patients written notice of their rights to make living wills, advance directives and the like -- but also required them to treat patients regardless of whether they have such documents.

Section 1233, however, addresses compassionate goals in disconcerting proximity to fiscal ones. Supporters protest that they're just trying to facilitate choice -- even if patients opt for expensive life-prolonging care. I think they protest too much: If it's all about obviating suffering, emotional or physical, what's it doing in a measure to "bend the curve" on health-care costs?

Though not mandatory, as some on the right have claimed, the consultations envisioned in Section 1233 aren't quite "purely voluntary," as Rep. Sander M. Levin (D-Mich.) asserts. To me, "purely voluntary" means "not unless the patient requests one." Section 1233, however, lets doctors initiate the chat and gives them an incentive -- money -- to do so. Indeed, that's an incentive to insist.

Patients may refuse without penalty, but many will bow to white-coated authority. Once they're in the meeting, the bill does permit "formulation" of a plug-pulling order right then and there. So when Rep. Earl Blumenauer (D-Ore.) denies that Section 1233 would "place senior citizens in situations where they feel pressured to sign end-of-life directives that they would not otherwise sign," I don't think he's being realistic.
What's more, Section 1233 dictates, at some length, the content of the consultation. The doctor "shall" discuss "advanced care planning, including key questions and considerations, important steps, and suggested people to talk to"; "an explanation of . . . living wills and durable powers of attorney, and their uses" (even though these are legal, not medical, instruments); and "a list of national and State-specific resources to assist consumers and their families." The doctor "shall" explain that Medicare pays for hospice care (hint, hint).

Also, folks, it isn't that Obama necessarily wants to kill grandma or the baby. It is that his advisers have said this should be explored. And Obama told us during the campaign that if we wanted to know him, we should look at who he associates with:

Zeke Emmanuel, the guy who advocates for rationing where those between 15 and 45 years old get the best care;

John Holdren, who advocated for putting sterlizing potions in drinking water and forcibly removing children from parents, who advocated for forced abortions as well as saying that children were not people until they were at least two, and even then may not be a "full human being"

These are two of the people Obama will turn to in a crisis. Let's say, impossible scenario I know, let's say that our dollar falls apart and we run out of money and the dollar is totally valued. How do we pay for healthcare? Who decides who gets what? This bill sets up the apparatus for that. It sets it up so that the government will decide that, based on Emmanuel's and Holdren's ideas quite possibly. We don't want to let the government in to be able to exercise that control. That is why we oppose healthcare. I do not think Obama wants retarded children killed, but let's say there is a crisis involving money and the US. This bill provides for ways for the government to begin to allocate resources it didn't have a hand on. That should scare anyone. Especially when you factor in you are now incentivizing doctors to discuss "end of life" care with patients, and will be compensated for doing this as well as awarded quality points or something in order to keep their licenses. This is dangerous.

OK, next article discussing what happens to those who have insurance already. Bizzy also highlighted this one. Over at, which I am surprised they let this through, an author examines this issue quite well. Shawn Tully has read House versions of the bill and finds we will be losing freedom if we join in:
5 freedoms you'd lose in health care reform
If you read the fine print in the Congressional plans, you'll find that a lot of cherished aspects of the current system would disappear.
In promoting his health-care agenda, President Obama has repeatedly reassured Americans that they can keep their existing health plans -- and that the benefits and access they prize will be enhanced through reform.

A close reading of the two main bills, one backed by Democrats in the House and the other issued by Sen. Edward Kennedy's Health committee, contradict the President's assurances. To be sure, it isn't easy to comb through their 2,000 pages of tortured legal language. But page by page, the bills reveal a web of restrictions, fines, and mandates that would radically change your health-care coverage.
If you prize choosing your own cardiologist or urologist under your company's Preferred Provider Organization plan (PPO), if your employer rewards your non-smoking, healthy lifestyle with reduced premiums, if you love the bargain Health Savings Account (HSA) that insures you just for the essentials, or if you simply take comfort in the freedom to spend your own money for a policy that covers the newest drugs and diagnostic tests -- you may be shocked to learn that you could lose all of those good things under the rules proposed in the two bills that herald a health-care revolution.

And what are these five freedoms? Glad you asked:
1. Freedom to choose what's in your plan

The bills in both houses require that Americans purchase insurance through "qualified" plans offered by health-care "exchanges" that would be set up in each state. The rub is that the plans can't really compete based on what they offer. The reason: The federal government will impose a minimum list of benefits that each plan is required to offer.

Today, many states require these "standard benefits packages" -- and they're a major cause for the rise in health-care costs. Every group, from chiropractors to alcohol-abuse counselors, do lobbying to get included. Connecticut, for example, requires reimbursement for hair transplants, hearing aids, and in vitro fertilization.

The Senate bill would require coverage for prescription drugs, mental-health benefits, and substance-abuse services. It also requires policies to insure "children" until the age of 26. That's just the starting list. The bills would allow the Department of Health and Human Services to add to the list of required benefits, based on recommendations from a committee of experts. Americans, therefore, wouldn't even know what's in their plans and what they're required to pay for, directly or indirectly, until after the bills become law.

Now we see that this is not about lowering cost. The process the government would be doing of requiring this and that is exactly what has caused insurance rates to rise. Why should there be a pregnancy benefit in a guy I know's healthcare coverage if he is single? That is crazy, but the state requires it, so he has to pay for stuff he may never use....See, that is the problem. Too much interference, not enough choice. We don't need more. Ok, back to Mr. Tully and the freedoms:
2. Freedom to be rewarded for healthy living, or pay your real costs

As with the previous example, the Obama plan enshrines into federal law one of the worst features of state legislation: community rating. Eleven states, ranging from New York to Oregon, have some form of community rating. In its purest form, community rating requires that all patients pay the same rates for their level of coverage regardless of their age or medical condition.

Americans with pre-existing conditions need subsidies under any plan, but community rating is a dubious way to bring fairness to health care. The reason is twofold: First, it forces young people, who typically have lower incomes than older workers, to pay far more than their actual cost, and gives older workers, who can afford to pay more, a big discount. The state laws gouging the young are a major reason so many of them have joined the ranks of uninsured.

Under the Senate plan, insurers would be barred from charging any more than twice as much for one patient vs. any other patient with the same coverage. So if a 20-year-old who costs just $800 a year to insure is forced to pay $2,500, a 62-year-old who costs $7,500 would pay no more than $5,000.

Second, the bills would ban insurers from charging differing premiums based on the health of their customers. Again, that's understandable for folks with diabetes or cancer. But the bills would bar rewarding people who pursue a healthy lifestyle of exercise or a cholesterol-conscious diet. That's hardly a formula for lower costs. It's as if car insurers had to charge the same rates to safe drivers as to chronic speeders with a history of accidents.

So, folks, once again, rather than fixing the problem--too much legislation and restrictions--the feds want to codify the states' mistakes and make us ALL suffer! Not good! Look, I get that last example. In my recent past, I garnered a few speeding tickets, which raised my insurance rates. I would not think it fair that someone else with a none is paying my same higher rate. But the government thinks we all need to suffer...or something...
3. Freedom to choose high-deductible coverage

The bills threaten to eliminate the one part of the market truly driven by consumers spending their own money. That's what makes a market, and health care needs more of it, not less.

The bills seriously endanger the trend toward consumer-driven care in general. By requiring minimum packages, they would prevent patients from choosing stripped-down plans that cover only major medical expenses. "The government could set extremely low deductibles that would eliminate HSAs," says John Goodman of the National Center for Policy Analysis, a free-market research group. "And they could do it after the bills are passed."

Kill the things that are working in favor of bureaucracy...that seems to be the Obama way....
OK, these first three should be reason enough to be against this nonsense, and again, this guy HAS READ THE BILL, AND HAS DONE THE TRANSLATING... But these last two are the most insidious of all:
4. Freedom to keep your existing plan

This is the freedom that the President keeps emphasizing. Yet the bills appear to say otherwise. It's worth diving into the weeds -- the territory where most pundits and politicians don't seem to have ventured.

The legislation divides the insured into two main groups, and those two groups are treated differently with respect to their current plans. The first are employees covered by the Employee Retirement Security Act of 1974. ERISA regulates companies that are self-insured, meaning they pay claims out of their cash flow, and don't have real insurance. Those are the GEs (GE, Fortune 500) and Time Warners (TWX, Fortune 500) and most other big companies.

The House bill states that employees covered by ERISA plans are "grandfathered." Under ERISA, the plans can do pretty much what they want -- they're exempt from standard packages and community rating and can reward employees for healthy lifestyles even in restrictive states.

But read on.

The bill gives ERISA employers a five-year grace period when they can keep offering plans free from the restrictions of the "qualified" policies offered on the exchanges. But after five years, they would have to offer only approved plans, with the myriad rules we've already discussed. So for Americans in large corporations, "keeping your own plan" has a strict deadline. In five years, like it or not, you'll get dumped into the exchange. As we'll see, it could happen a lot earlier.

The outlook is worse for the second group. It encompasses employees who aren't under ERISA but get actual insurance either on their own or through small businesses. After the legislation passes, all insurers that offer a wide range of plans to these employees will be forced to offer only "qualified" plans to new customers, via the exchanges.

The employees who got their coverage before the law goes into effect can keep their plans, but once again, there's a catch. If the plan changes in any way -- by altering co-pays, deductibles, or even switching coverage for this or that drug -- the employee must drop out and shop through the exchange. Since these plans generally change their policies every year, it's likely that millions of employees will lose their plans in 12 months.

So Obama is offering a shady argument on this one. Yes, you can keep your current plan, but only for five years...and if the plan changes, you have to go into the drowning pool of spit that is Obamacare. Don't believe this fork tongued thug in chief. His own bills say otherwise, just like he is trying to say he is not an advocate for single payer (socialized) healthcare, when we have him on video saying otherwise (see healthcare and/or Obama tabs for these clips and posts). And lastly, this suppposed great idea for giving more people access to good health care won't let you necessarily keep or choose your doctor:
5. Freedom to choose your doctors

The Senate bill requires that Americans buying through the exchanges -- and as we've seen, that will soon be most Americans -- must get their care through something called "medical home." Medical home is similar to an HMO. You're assigned a primary care doctor, and the doctor controls your access to specialists. The primary care physicians will decide which services, like MRIs and other diagnostic scans, are best for you, and will decide when you really need to see a cardiologists or orthopedists.

Under the proposals, the gatekeepers would theoretically guide patients to tests and treatments that have proved most cost-effective. The danger is that doctors will be financially rewarded for denying care, as were HMO physicians more than a decade ago. It was consumer outrage over despotic gatekeepers that made the HMOs so unpopular, and killed what was billed as the solution to America's health-care cost explosion.

Funny, I thought we were going to have more options, not less. I thought we were going to be able to keep our doctors. Not so. Obama and Congress are Lying to us. Don't believe them. Hold them to task. Do we want a return to the horrible HMO situation we had 10 years ago? I say no. And, do we want the government to have so much control over a system that will be vital in a time of crisis? I think not.