Overuse or Humane?

The following article appeared on page A - 11 of the San Francisco Chronicle

Health care reform: What is costly overuse, what is humane?
Katherine Dowling Schlaerth
Wednesday, July 29, 2009

President Obama has impressed me once again with his multifaceted talents.

Citing his grandmother's hip-replacement surgery as a personalized experience, he has made his case to deny aggressive and costly end-of-life care, and his concepts have been embodied in HR3200, "America's Affordable Health Choices Act of 2009," rocketing its way through Congress.

All of us would agree that putting a dying person through painful and useless procedures not only costs a lot, but also interferes with normal developmental tasks of the end of life, such as putting one's financial and spiritual house in order and saying goodbye to loved ones. To quote President Obama, we must correctly inform families who might otherwise approve of "additional tests or additional drugs that the evidence shows (are) not necessarily going to improve care." My problem, as a physician who has practiced medicine for decades, is that I just can't predict with certainty what is end-of-life care, nor can I determine for another individual the meaning of "quality of life."

I recall cases like that of the nonagenarian WWII veteran, comatose for days with multiple organ failure, who with the help of a loving family and dedicated ICU nurses walked out of the hospital, brain intact, to live a few more years.

I've seen "terminal" cancer patients kept alive long enough to hold a new grandbaby, and a 2-year-old's cancer-ridden body sustained for the weeks it took for his heartbroken parents to finally come to peace with his passing.

This current legislation, however, seeks to prevent such costly overuse of health resources through a program of "advance care planning consultation," wherein those on Medicare, or their families, could meet with a "practitioner of advance care planning" every five years, or sooner if illness supervened. Such an adviser need not be a physician, either.

This specialist would discuss care issues such as "the individual's desire regarding transfer to a hospital ... the use of antibiotics and the use of artificially administered nutrition and hydration." The discussion may, in fact, be triggered if "there is a significant change in the health condition of the individual, including diagnosis of a chronic, progressive, life-limiting disease."

I would be loath to talk a person on dialysis or in a wheelchair from a stroke into forgoing antibiotics for a pneumonia that may itself be treatable.

HR3200 has created tiers of administrators, who do not necessarily have medical experience. They will attempt to facilitate your end-of-life care, probably with the assistance of the electronic medical records each medical facility will shortly be required to use.

These and other provisions of the health choices act frankly scare me. As a physician, I took an oath long ago to put my patient's interests above all else, but provisions in the bill have a quality of coerciveness that make me wonder if I can fulfill my oath. Certainly they bear deeper inspection than possible during the brief monthlong look-see President Obama wants lawmakers to give this 1,000-page bill before passage.

Katherine Dowling Schlaerth is a practicing physician and associate professor emeritus of the University of Southern California School of Medicine.

This Is What It Says

Regarding healthcare reform, President Obama has said that no one will have to sacrifice. He has also said seniors should reconcile themselves to the difficulties of old-age and realize they should get less benefits.

A healthcare adviser to the President, Dr. Ezekiel Emanuel, brother to Rahm Emanuel, has written extensively on his beliefs about healthcare. In his writings he has stated that he believes no money should be spent on someone with an incurable disease.

Recently, Besty McCaughey, a health policy expert, has read the full house bill on healthcare reform. She has been reporting on what she read. In light of the Presidents statements and the beliefs of the people he surrounds himself with, we should not be surprised to see these "benefits" included in the healthcare reform bill:

• Over 10 years the Medicare budget will be cut by 500 billion dollars to pay for the healthcare reform provisions (this is roughly half of what the President has said reform will cost). [This likely means rationed care with fewer hip and knee replacements, bipass surgery and angioplasty-- all procedures that extend life and increase enjoyment and participation in activities.]
• On pages 425-430 a new benefit is found that requires mandatory counseling for seniors on end-of-life issues: how to refuse antibiotics, hydration, nutrition. After you reach a certain age a senior must receive this counseling every five years. If a senior becomes ill before the next scheduled counseling session, they must receive end-of-life counseling at that time.
• On pages 442-443 another benefit is described called "Shared Decision Making-- it will not be the patient and possibly their family who will be making healthcare decisions; doctors guided by government panels will also way in.

These are only a few the frightening provisions in the proposed healthcare reform.

There has got to be a better way to provide for those who do not have access to affordable insurance! Must we tell one group to die more quickly so that another group might have access to rationed care?

Contact Information

Below you'll find contact information for the elected officials to the federal government for SE Wisconsin. If you don't live in SE Wisconsin, use the link provided to find your officials.

http://www.congress.org/congressorg/officials/congress

Obama
The White House,
District of Columbia 20500
Phone: (202) 456-1414
Fax: (202) 456-2461

Kohl
Washington, D.C. Office:
330 Hart Senate Office Building,
District of Columbia 20510-4903
Phone: (202) 224-5653
Fax: (202) 224-9787
Committees:
*Appropriations Committee
*Committee on Banking, Housing, and Urban Affairs
*Judiciary Committee
*Special Committee on Aging: Chairman

Milwaukee Office:
310 West Wisconsin Avenue, Suite 950
Milwaukee, Wisconsin 53203
Phone: (414) 297-4451
Fax: (414) 297-4455
Milwaukee Office:
310 West Wisconsin Avenue, Suite 950
Milwaukee, Wisconsin 53203
Phone: (414) 297-4451
Fax: (414) 297-4455

Madison Office:
14 West Mifflin Street, Suite 207
Madison, Wisconsin 53703
Phone: (608) 264-5338
Fax: (608) 264-5473

Eau Claire Office:
402 Graham Avenue, Suite 206
Eau Claire, Wisconsin 54701
Phone: (715) 832-8424
Fax: (715) 832-8492

Appleton Office:
4321 West College Avenue, Suite 370
Appleton, Wisconsin 54914
Phone: (920) 738-1640
Fax: (920) 738-1643

La Crosse Office:
205 5th Avenue South, Room 216
La Crosse, Wisconsin 54601
Phone: (608) 796-0045
Fax: (608) 796-0089

Feingold
Washington, D.C. Office:
506 Hart Senate Office Building,
District of Columbia 20510-4904
Phone: (202) 224-5323
Fax: (202) 224-2725
Committees:
*Committee on Foreign Relations
*Committee on the Judiciary
*Select Committee on Intelligence
*Committee on the Budget

Middleton Office:
1600 Aspen Commons, Room 100
Middleton, Wisconsin 53562-4716
Phone: (608) 828-1200
Fax: (608) 828-1203

Ryan
Wisconsin-1st, Republican
1113 Longworth HOB
Washington, DC 20515-4901
Phone: (202) 225-3031
Committees:
* Committee on the Budget
* Committee on Ways and Means

Subcommittees:
* Health (Ways and Means)
* Oversight (Ways and Means)

The Assualt on Seniors

If you are a senior or love a senior, you need to listen to an interview and read this article: http://defendyourhealthcare.us/assaultonseniors.html

Interview can be downloaded here:http://fredthompsonshow.com/programhighlights the interview was on 8/27/09 and starts at minute 18 and goes to about minute 28.

Please pass this info on!

Magician Politics

by Thomas Sowell
first published at townhall.com

Distracting the audience's attention is one of the ways magicians pull off some of their tricks. President Barack Obama's televised news conference on medical care shows that he is something of a magician when it comes to politics.

The big trick for the president is to convince the public that he can add tens of millions of people to his government medical care plan without raising the costs. But an analysis by the Congressional Budget Office showed that Obamacare would in fact raise the costs and increase the deficit by billions of dollars.

With both common sense and economic analysis saying that Obama cannot expand government medical care without expanding the already runaway federal deficit, it is quite a trick to get the public to believe otherwise-- a big challenge requiring big distractions.

One of those distractions has been to blame current high costs on scapegoats whom the president can rein in. Talking about the high pay of the CEOs of pharmaceutical companies is one of those distractions.

In an industry where developing just one new pharmaceutical drug can cost a billion dollars, whether the head of a mega-billion-dollar pharmaceutical company is paid a million dollars a year, 20 million dollars or works free of charge is not likely to raise or lower the cost of the medicine you buy by one dollar.

But, if making the CEO's pay an issue can distract your attention from the impossible math used by Barack Obama and his supporters, then that is a trick worthy of Houdini.

Insurance companies are another distraction and a scapegoat because they do not insure "pre-existing conditions." Stop and think about it: If you could wait until you got sick to take out health insurance, why would you buy that insurance while you are well?

You could avoid paying all those premiums and then-- after you got sick-- take out health insurance and let the premiums paid by other people pay for your medical treatment.

That is not "bringing down the cost of health care." It is sticking somebody else with paying those costs. So is taxing "the rich." So is passing on those costs to your children and grandchildren through government deficit spending.

When Obama makes the insurance companies the villains for not insuring pre-existing conditions, that gives him another distraction and enables him to be another escape artist, like Houdini.

What is the point of government-controlled medical care if it is not going to lower costs but just shuffle them around, like a shell game?

The government does not have some magic wand that can "bring down the cost of health care." It can buy a smaller quantity or lower quality of medical care, as other countries with government-run medical care do.

It can decide not to spend as much money on the elderly as is being spent now. That can save a lot of money-- if you think having a parent die earlier is a bargain.

The idea of a "duty to die" has been making some headway in recent years around the fringes of the left. It is perfectly consistent with the fundamental notion of the left, that decisions should be transferred from ordinary citizens to government elites.

Liberals don't have to advocate it. But, once you have bureaucrats empowered to decide what treatments you can and cannot get, they may well decide that money spent keeping some 75-year-old grandmother alive for a couple of more years could be better spent politically by enabling ten younger people to have acupuncture or visit a shrink.

Even if her children or grandchildren are willing to spend their own money to keep grandma alive, when bureaucrats control the necessary technology or medication they may decide that it is not for sale.

Those pushing for government-controlled medical care say that you can keep your doctor. But bureaucrats in Washington will decide whether what your doctor prescribes will be allowed. Talking about your doctor is another distraction from the crucial question of who will actually have the power to decide, which can be the power of life and death.

originally posted at Townhall.com

Simple Arithmetic

By K. Johnson

I've been in to definitions lately.

I love words, but they can be a little nebulous, a little shifty, their meaning can be so easily, and subtly, changed. It is the user who chooses to alter a word's meaning (usually, for their own benefit) and they never tell the listener.

I hate when I realize a conversation I just had does not mean what I thought it meant, because my definition of "like" was not the same as my conversation partner's. You could insert any word or phrase here-- our politicians do it all the time, so do teenagers.

Numbers, they are different, their definitions pretty much defy manipulation. One is one, if you make one, two, someone, if they can count, will notice, quickly.

Recently, however, I've become conscious of what proves to be a long standing trend (it takes me awhile, sorry) to obscure the definition of numbers. The definition cannot be changed, so, by a little mixing of numerical notations, the definition is obscured.

What does $3.5 trillion mean?

I'm not sure. It's a little confusing-- what is a decimal doing in a number typically represented by threesomes and commas? Decimals usually appear in measurements: meters, centimeter, millimeters and the like. One quarter of an inch, can also be written 0.25 inches. A dot is used when writing monetary amounts, but to signify amounts less than one dollar. It does not signify a fraction or percentage of one dollar. It signifies cents. So again, what does $3.5 trillion mean?

I'm not sure, but here is what I came up with (work with me, I had to do it in steps):

1 = one
10 = ten
100 = one hundred
1000 = one thousand
10,000 = ten thousand
100,000 = one hundred thousand
1,000,000 = one million
100,000,000 = one hundred million
1,000,000,000 = one billion
100,000,000,000 = one hundred billion
1,000,000,000,000 = one trillion

700,000,000,000 = 700 billion = in dollars, the approximate amount of one of the federal bailouts

3,500,000,000,000 = three trillion, five hundred billion = 3.5 trillion = in dollars, the President's proposed budget

I think this is correct, anyone a mathhead? Check it for me.

Oh yes, 100 million, that's a lot of money. But what percentage of three trillion, five hundred billion?

Check me again:

100,000,000/3,500,000,000,000 = .00002857 => .0029% = a little more than one quarter of one percent = the amount President Obama asked his cabinet to cut from the three trillion, five hundred billion dollar budget.
---

New problem:

The average income in my town was (prior to the last 9 months) approximately $55,000 per year. That's a federal tax bracket of 15% (2008, married, filing jointly) which would put $8,250 into federal coffers every year.

The 2008 estimated US population was 304,059,724. I'll estimate a quarter of that number for individuals/couples who file taxes: 76,019,931 filers at $8250 each = $627,123,180,750. That's six hundred twenty-seven billion, one hundred twenty-three million, one hundred eighty thousand, seven hundred fifty dollars the IRS will collect each year from private taxpayers.

The federal government is spending more than it is bringing in and the only people they get their money from is us and business. Businesses need to contribute $2,872,876,819,250 (two trillion, eight hundred seventy-two billion, eight hundred seventy-six million, eight hundred nineteen thousand, two hundred fifty dollars) to make the federal budget break even. Hmmm, did someone say offshore tax havens?

Please write your politician and explain to them some simple arithmetic and budgeting.

© 2009, Currently Seeking A Country To Rule and the author.