End of life planning.....

[il Padrino Ute]

According to this report, Obama will use regulation to enact what he originally wanted in Obamacare.

Thoughts? I'd especially like to know what our physicians think about this.

[ERCougar]

According to this report, Obama will use regulation to enact what he originally wanted in Obamacare.

Thoughts? I'd especially like to know what our physicians think about this.

I'm 100% completely for it. Americans have gotten completely insane about the measures they expect to be done at the end of one's life.

I honestly can't imagine why a conservative would not be (outside of those who think we should completely cut Medicare). This will save a lot more money than it will cost.

[Jarid in Cedar]

I actually agree with restriction of end of life funding. If you want heroic care to postpone the inevitable a few months/weeks, do it on your own dime.

[LA Ute]

I think the conservative noise over this is ridiculous. (Keep in mind how conservative I am politically.) I’ve been advising hospitals for years about the problems that result when end-of-life decisions are not well-planned. A lot of time and energy and scarce resources are devoted to situations that could have been avoided with a minimal amount of advance planning. If paying physicians to give advice about that kind of planning is setting up “death panels,” then I am not only a monkey’s uncle, I’m his aunt too.

[byu71]

I really don't get it. I mean I would think the conservatives would be for it and the liberals against it.

If the government decided to restrict heroic measures to extend life, then only the rich could spend their own money to stay on the planet. To me that seems like a self determination thing the conservatives should be for and the liberals outraged the rich have another unequal advantage.

Maybe the ultra conservatives believe the government would provide heroic measures to progressives and not conservatives. Other than that, I don't get it.


Edit: This board isn't really the board to get the pulse on conservative thinking on the issue. I have gone to the fountain of conservatism, CB, and asked the question.

[il Padrino Ute]

Is Jefe's board home of conservatives or neocons? My guess would be the latter.

I was just curious of others' thoughts here. I don't really like this idea, because just as progressives don't trust the private sector to do the right thing, I don't trust the government to do the right thing. End of life planning may be a good idea, but it's not something in which I want the feds. Decisions like this are, IMO, best left to the elderly, their children/family and their physician without any input from the government.

But I'm more ticked that Obama is using regulation to force it on the American people. He just doesn't get that when folks say no to his policies, they mean no. This also goes for other politicians no matter the party affiliation.

[doctorcoug]

Sheer stupidity from the conservatives. This end of life care is likely to be supported by all docs (maybe not nephrologists and pulmonologists).

We preform inhumane acts to keep patients alive for a few more days or weeks. Many ICU patients are there because of poor advances directives and we keep them alive while the family starts the grieving process. Often it results in withdrawal of care, but not after spending a mini fortune on redicilous measures.

Reducing ICU admits by an appreciable amount should do more to curb healthcare costs than any other single measure on the table.

The one bad thing from this is that there might be less ICU admits, which is a decreased learning opportunity for those in training.

[Uncle Ted]

I was just curious of others' thoughts here. I don't really like this idea, because just as progressives don't trust the private sector to do the right thing, I don't trust the government to do the right thing. End of life planning may be a good idea, but it's not something in which I want the feds. Decisions like this are, IMO, best left to the elderly, their children/family and their physician without any input from the government.

I agree but the question is really who will be paying for it. If it is the government taxpayers then I suspect a lot of these elderly and/or their children/family will push for the treatment that extend their life for a little bit longer. If it is not then I suspect a lot more people may come to the conclusion that it may not be worth it. It is so much easier to spend other people's money.

IMHO, government health care should maybe just cover the minimum. Any thing more should maybe handled privately (e.g. supplemental insurance).

[ERCougar]

JIC might be the best person to answer this question, but I think that some of you are misunderstanding what this is. To my understanding, it stipulates that Medicare will pay primary physicians to address end-of-life issues with patients ahead of time. The government is not telling anyone what to do with their grandparents--it's merely facilitating the discussion between the patient, the family, and the physician. The reason this saves money is that the default planning generally becomes "do everything", which leads to ridiculous scenarios of 65 yo patients with metastatic cancer on ventilators, all covered by the government.

[Moliere]

I agree but the question is really who will be paying for it. If it is the government taxpayers then I suspect a lot of these elderly and/or their children/family will push for the treatment that extend their life for a little bit longer. If it is not then I suspect a lot more people may come to the conclusion that it may not be worth it. It is so much easier to spend other people's money.

IMHO, government health care should maybe just cover the minimum. Any thing more should maybe handled privately (e.g. supplemental insurance).

Well said. The government isn't taking away choices or options, they are just going down a path where the individual or their family will be paying for those options. This sounds like a conservative dream world where the government is actually getting out of part of the health care business. Although you could make the argument that you should also expect a related drop in Medicare taxes but that won't happen.

[il Padrino Ute]

I agree but the question is really who will be paying for it. If it is the government taxpayers then I suspect a lot of these elderly and/or their children/family will push for the treatment that extend their life for a little bit longer. If it is not then I suspect a lot more people may come to the conclusion that it may not be worth it. It is so much easier to spend other people's money.

IMHO, government health care should maybe just cover the minimum. Any thing more should maybe handled privately (e.g. supplemental insurance).

I agree completely that people would probably push for treatment to extend life if they're not paying for it. But I see it more that the government would rather look for alternative ways to spend that money rather than for health care. It's track record shows that it will move funds for one program to another.

[Moliere]

JIC might be the best person to answer this question, but I think that some of you are misunderstanding what this is. To my understanding, it stipulates that Medicare will pay primary physicians to address end-of-life issues with patients ahead of time. The government is not telling anyone what to do with their grandparents--it's merely facilitating the discussion between the patient, the family, and the physician. The reason this saves money is that the default planning generally becomes "do everything", which leads to ridiculous scenarios of 65 yo patients with metastatic cancer on ventilators, all covered by the government.

Thanks for pointing this out as I was a bit fuzzy on details.

The conservative talking point on this though is that once the government starts regulating these discussions they will start telling you what kind of treatment is/is not allowed, thus the "death-panel" will be born. Seems like a stretch.

[doctorcoug]

ERC:

That was my point. Not having the advanced directive results in huge costs while the family comes to grips with death. They don't want to "pull the plug" unless they have tried all that we can. If there is no plug to pull, then the families don't have to make that decision, and it is easier on them.

[LA Ute]

This is the kind of thing people should be worried about:

'Death Panels' Come Back to Life: The FDA's restrictions on the drug Avastin are the beginning of a long slide toward health-care rationing..

[Uncle Ted]

This is the kind of thing people should be worried about:

'Death Panels' Come Back to Life: The FDA's restrictions on the drug Avastin are the beginning of a long slide toward health-care rationing..

Yes, exactly. It should be the patient that decides if they want to take the risks and not the FDA. While saving thousands the FDA has most likely killed hundreds of thousands.