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Friday, August 14, 2009

End Of Life Provisions Removed From One Version Of Obamacare

The Hill reports that the Senate Finance Committee removed the controversial "end of life" consultations from their version of the Obamacare bill.

The Senate Finance Committee will drop a controversial provision on consultations for end-of-life care from its proposed healthcare bill, its top Republican member said Thursday.

The committee, which has worked on putting together a bipartisan healthcare reform bill, will drop the controversial provision after it was derided by conservatives as "death panels" to encourage euthanasia.

"On the Finance Committee, we are working very hard to avoid unintended consequences by methodically working through the complexities of all of these issues and policy options," Sen. Chuck Grassley (R-Iowa) said in a statement. "We dropped end-of-life provisions from consideration entirely because of the way they could be misinterpreted and implemented incorrectly."


The problem here is that this is only one version of this bill. The House already passed their version, which won't make it through the Senate, so the Senate Finance Committee has been working to create a bill that can pass.

Then it goes back to the House and the two versions have to be reconciled, so all this work, highly publicized, means nothing unless Pelosi and crew are willing to pass this version instead of simply adding all the crap that has been weeded out, back in.

Any truly trusting Pelosi?

More from Grassley:

"The bill passed by the House committees is so poorly cobbled together that it will have all kinds of unintended consequences, including making taxpayers fund healthcare subsidies for illegal immigrants," Grassley said. The veteran Iowa lawmaker said the end-of-life provision in those bills would pay physicians to "advise patients about end-of-life care and rate physician quality of care based on the creation of and adherence to orders for end-of-life care.

"Maybe others can defend a bill like the Pelosi bill that leaves major issues open to interpretation, but I can't," Grassley added.


The Wall Street Journal has a piece today, to which it explains why seniors are showing up at these townhalls in droves and why they are concerned and opposed to Obamacare.

Elderly Americans are turning out in droves to fight ObamaCare, and President Obama is arguing back that they have nothing to worry about. Allow us to referee. While claims about euthanasia and "death panels" are over the top, senior fears have exposed a fundamental truth about what Mr. Obama is proposing: Namely, once health care is nationalized, or mostly nationalized, rationing care is inevitable, and those who have lived the longest will find their care the most restricted.
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Far from being a scare tactic, this is a logical conclusion based on experience and common-sense. Once health care is a "free good" that government pays for, demand will soar and government costs will soar too. When the public finally reaches its taxing limit, something will have to give on the care and spending side. In a word, care will be rationed by politics.


The WSJ piece also shows examples from other countries that already have government run healthcare.

....Virtually every European government with "universal" health care restricts access in one way or another to control costs, and it isn't pretty.

The British system is most restrictive, using a black-box actuarial formula known as "quality-adjusted life years," or QALYs, that determines who can receive what care. If a treatment isn't deemed to be cost-effective for specific populations, particularly the elderly, the National Health Service simply doesn't pay for it. Even France—which has a mix of public and private medicine—has fixed reimbursement rates since the 1970s and strictly controls the use of specialists and the introduction of new medical technologies such as CT scans and MRIs.

Yes, the U.S. "rations" by ability to pay (though in the end no one is denied actual care). This is true of every good or service in a free economy and a world of finite resources but infinite wants. Yet no one would say we "ration" houses or gasoline because those goods are allocated by prices. The problem is that governments ration through brute force—either explicitly restricting the use of medicine or lowering payments below market rates. Both methods lead to waiting lines, lower quality, or less innovation—and usually all three.


Read the whole piece, as it does also touch on the "end of life" care issue, when they write :

From the point of view of politicians with a limited budget, is it worth spending a lot on, say, a patient with late-stage cancer where the odds of remission are long? Or should they spend to improve quality, not length, of life? Or pay for a hip or knee replacement for seniors, when palliative care might cost less? And who decides?

In Britain, the NHS decides, and under its QALYs metric it generally won't pay more than $22,000 for treatments to extend a life six months. "Money for the NHS isn't limitless," as one NHS official recently put it in response to American criticism, "so we need to make sure the money we have goes on things which offer more than the care we'll have to forgo to pay for them."


Politics should never be able to play a party in our medical decisions and choices.

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