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Death panels exist and are essential to the success of OBAMACARE

In Healthcare on July 5, 2012 at 4:07 PM

Death Panels do exist and will exist as long as Obamacare is allowed to exist! It is almost comical at the amount of people who are lining up behind Obama and shouting that death panels do not exist. The “number 1 lie of all time” I read in one article recently. Of course, you know this is a tactic to get you to believe them.

They, whomever they are, do not want you to grasp the fact that our own federal government has the capability to ration care, make life or death decisions based on whether it is finically responsible. Surely this would surely fire up the constituency and lead to millions that would stand at the steps of the US Capitol and demand changes to the plan or at the very least repeal it! Right?

Easily dismissing something as huge as our government enforcing a healthcare bill that puts American lives in jeopardy is the easy way out. Its an inner protection mechanism that makes us sleep better at night. Sort of like if I just believe that monster under my bed is not there, then it must not be there. I simply ask of you that if you are going to be so quick to judgement and so bold to dispel a fact at least have the cahunas to provide substantiating proof of why you are denying it. Far more often than not people will roadblock an idea based soley on the fact the person shouting the loudest believes only that there is “no way that can be true” instead of researching themselves and coming up with an informed conclusion. In this setting, simply going with your gut is not the end all tell all.

I have personally taken the time here in this blog to provide information that I knew was true because I have read alot of the plans, have watched the votes and have researched the data. The death panels, use another name if that makes you feel more comfortable, but in some form or another they do and will exist just as they have in some form or another for years. Now that mandatory healthcare is a priority in this country and the president has given this panel of 15 bureaucrats unlimited powers, we will see rationing and death panels as we have never seen them.

Death panel or allocation specialists have been buried in and out of 1000s of pages and in different proposals for several years. People are in your healthcare facilities right now evaluating who need optimization of a payment or who needs to not have that procedure that may prolong life. Death panels are in every social medicine scheme and are even in presidential hopeful Romneys state health care plan in his home state. Some have failed and some entered the plan in a fractured state but were submitted regardless. Several amendments and proposals have made it in or have been removed by legislation because of public outcry and demand for change. They are essential to the bottom line of OBAMACARE and will eventually be a reality by whatever name you choose to place on it!

As a healthcare worker I am intimately involved in day to day rationing and as a lead plaintiff in the Obamacare Class Action Lawsuit that challenges the constitutionality of Obamacare focusing on the Commerce Clause, particularly the case of Wickard v Filburn I feel an obligation to be versed on the subject and make conclusions based on fact.

With nearly 30 years of healthcare experience under my belt and a direct observation of the inner workings of a healthcare machine while it is running, I as many others see this upcoming dilemma very clearly and first hand. The many changes I have seen over the years both good and bad does not surprise me. The bottom line healthcare is a business and for a business to survive the healthcare industry must make money. Making money means practicing within certain guidelines, withholding or redirecting care to the most cost efficient form of delivery and maximizing profit regardless of who may or may not get the needed services to prolong or shorten their lives.

Many want the appearance that it is all about the care and the quality of that care, but really it is about the money. Every person that presents to the churning machine and gets inside with a qualifying illness is facing the brutal honest truth and that is we as healthcare professionals have one goal, to get you in and out with as much left over profit as possible. During your visit you will observe a fragile balancing game between CEOs and providers of that care each battling over their vantage points of quality Vs quantity. The end game still is we must make money and to make money we must conserve or ration as much care a possible without harm to the patient in the least costly manner. The patient is mostly unaware of this wrangling behind the scenes but the almighty dollar and the bureaucrats behind the scenes are lurking and pushing providers with “friendly” visits to their lounges and in dimly lit hallways are more than willing to discuss the plan to get the patient out on the other side with as much economic viability as possible when care is completed.

We have always in healthcare had some type of restrictions on how much and what kind of care is delivered and the cost of providing that service. It is no secret that Doctors are perhaps not ordering a test because they know that the hospital wll not get paid for that service or will God forbid plunge the care facility into a negative balance while forcing the provider to provide an alternate therapy, one that is less costly to the care facility, especially if the patient is indigent or with no insurance. In America, we are blessed with technology advances that may prolong our lives but I am afraid that with OBAMACARE that technology may not reach us because te likes if death panels will redirect less costly procedures or tests in another direction because of the associated cost. Do I believe many will die because of the decisions of a bureaucrat in DC pulling the strings of our healthcare system? You bet they will and in great numbers!

Fear of litigation or a genuine compassion usually weighs heavy in the minds of some care givers and they will order the expensive test anyway resulting in a slap on the wrist by some cost driven administrator only looking at his bottom line when a caregiver dares step outside the decision making grid.

With the advent of Managed Care in the last few years we have seen even greater changes and have seen people that just a few years ago may have received the better more diagnostic test to effectively and efficiently render an accurate diagnosis, now being shifted to less costly, less invasive procedures.

So when I hear that a government panel will now be making decisions on your care and the result of that care it does not surprise me one bit. We have been doing it in some form for years. A healthcare facility must make money to survive period! It is a huge multi trillion dollar industry. They have to and must make money, so why does it surprise you when you hear that our government that has decided to get into the healthcare business must ration your care or at the end of your life direct you toward a less costly end and use a death panel to do it?

Granny’s has had end of life prolongation discussions at the foot of her bed for years by nurses, care providers, case managers, utilization review specialist and Physicians concerned about moving forward cautiously would be in the best interest of the hospital, family and the providers.

Many factors weigh in the decision making process but essentially it boils down to does granny go to heaven today or does she go a week from now using more resources? Does granny eat up valuable resources that could be used on someone else half her age in another setting? If granny is laying there and she has exhausted many resources from a stingy Medicare repayment program the decision in most cases ends with the family deciding to let go. This is the desired ending. The dilemma occurs when family or provider wants to apply the full court press and hopefully see granny healthy once again. This causes many “alerts” to go off at many levels and causes concern for vested parties that are seeing her profitability melt away and granny laying there as a liability. This is where the patient gets alot of attention and many begin the process of trying to minimize a disastrous extended stay with no future earning potential. Granny is now a number. She is marked as an outlier with an exhausted or bursting at the seams DRG payment structure that will fall short of what is needed to make granny a profitable entity. It is a necessary evil, the bottom line has to matter or you don’t float. When the eventual money is plopped down on granny, the care facility must make a decision at this time to either hasten grannies departure or eat the cost hoping for only a big tax incentive at years end. This is a tough business and when the thought of someone rationing care at the end of a persons life seems unspeakable but It is happening daily even as I speak. Ask any provider this is probably one of the toughest times in their careers. I know it is in mine. I gave gone home and had many sleepless nights as this life and death battle unfolded in front of me during a long shift.

The struggle has been going on for a long time, the struggle with me is to see it done so casually by our federal government that should not be laying a hand on us period let alone making life and death decisions based on whether my illness provides you a profit! The result is a nice clean job with everyone happy and unaware that the government, provider or insurance company has profited off of your misfortune. No ones hands are dirty and the deed is done, everyone is satisfied and granny is better off and unaware of the balancing act that surrounds her. Does it now surprise me that the government has decided to apply these same methods to their own mandate? Not at all!

In light of what is happening already, why is it such a big shocker that Obama has placed it in his healthcare plan moving forward. Exactly, now the government is doing it to us directly and taking all the delicate caring intricacies that are visible at the beside and replacing it with a panel of 15 getting paid 165,000 dollars a year to make end of life decisions. Regardless of what the end product of death panels makes it past our legislators, remember there will always be those people somewhere in the shadows of a dying patient making those crucial decisions that will affect their bottom line, it is just harder for me to swallow when it is the federal governments presence at the bedside of a dying patient.

It seems the word death panel makes us uneasy, let’s use the term rationed care or granny’s had enough care or why are we still beating a dead horse care! I like that one the best!

Think about it people. The way OBAMA and our government to fully make this massive multi trillion dollar plan work there has to be some major corners cut somewhere. With no lifetime caps on care, exclusions for pre-existing illnesses, 32 million new people in the system that were previously uninsured, perhaps 28 million new immigrants, millions of people with the vision of sugar plums in their heads and saying “I have free insurance now, let’s go to the hospital” there will little money if any left over at the end of the day.

The end conclusion will be someone is going to have to ration care and make some tough decisions and it want be the patient, their family or the provider. It will be an independent board of 15 government appointees and paid bureaucrats with more power with decision making capabilities than Congress. Yes, we are definitely talking about a “death panel or as you prefer a stop beating a dead horse panel to control the massive influx of needed care and that leads me to the next point, the death panel that supposedly doesn’t exist!

I am specifically talking about IPAB! (Note source of info for this definition) The Independent Payment Advisory Board, or IPAB, is a fifteen-member United States Government agency created in 2010 by sections 3403 and 10320 of the Patient Protection and Affordable Care Act (OBAMACARE) which has the explicit task of achieving specified savings in Medicare without affecting coverage or quality.[1] Under previous and current law, changes to Medicare payment rates and program rules are recommended by MedPAC but require an act of Congress to take effect. The new system grants IPAB the authority to make changes to the Medicare program with the Congress being given the power to overrule the agency’s decisions through supermajority vote.

IPAB was created with its ostensible purpose to “control costs.” In reality, it will do nothing at all about costs. Instead, the board’s fifteen “experts” will impose old-fashioned price controls. Before Obamacare was signed into law in March of 2010, only Congress had the power to make changes to Medicare’s reimbursement rates. But PPACA, for all intents and purposes, transfers that power to this tiny cadre of presidential appointees who will have no accountability to the voters. In theory, IPAB can only propose changes to Medicare’s payment rates. In practice, however, the board’s proposals will take effect automatically unless Congress passes contrary legislation and the President signs it into law.

I know, I too wince when I say it but the “death panel seems to exist!” Rationing of care has been going on for years, the major difference now is it will be the federal government with it’s board of 15 advisors of whom will consist of businessmen and women and very few caregivers. Granny is going to have her care regulated or rationed by a “panel of business men and women” with a lot of statistics lying out in front of them complete with a matrix decision making grid plugging in past best practice measures and coming to a determination and forcing providers to make end of life decisions and withholding procedures because it makes best economic sense.

Congressman Scott Dejarlais (R) 4th District TN and local Physician said it best recently in an interview telling reporters that the IPAB panel was “designed to put a Washington bureaucrat between the patient and their doctor.”

If death panels or rationing panels do not exist then why are Congressmen taking a stance against it? Why does the proposal keep making it to every bill? Why is it always the topic of conversation and rolls so easily off the presidents lips? Because they see it as the only way to reign in spending and by rationing care this is the only way they see for OBAMACARE and our country to survive under this oppressive healthcare system.

Fortunately, for now, Congress, just a few months ago voted to stop IPAB and death panels from making it’s way into the final healthcare bill in it’s present known form. Warning to you that since this stop gap measure there is already talk of slipping this back in to the plan in the future. The government just has to make it palatable or simply hope for you not to be looking when it is made permanent. The goal is to restore death panels, that Congress just knocked down for the time being to have them active by 2013, no later than 2017. This president has shown he doesn’t need Congress or the constitution to make decisions, he only needs to speak it and it happens.

Congress repeals “death panel provision.”
March 22, 2012-

The U.S. House of Representatives today voted to repeal a portion of the Obamacare law that pro-life advocates strongly opposed because it could lead to rationing of health care for patients across the nation.

Leading pro-life groups had been asking members of Congress to approve legislation that would repeal the Independent Payment Advisory Board, which has been derisively called “death panels” by detractors.

Today, the Republican-controlled House voted for legislation to do just that on a 223-181 vote, with seven Democrats supporting the measure. The Senate is not expected to take up the measure and the vote could turn Obamacare into even greater election issue than it is currently.

“Both create government panels to dictate quality and cost containment,” Santorum explained. “Some of you may be familiar with the Independent Payment Advisory Board — which is a board separate from Congress, independent of Congress — that President Obama created to control health care costs. How? By cutting reimbursements to doctors and hospitals under the Medicare program. Well, Gov. Romney has a similar program called the Council on Health Quality and Costs.”

“Some people refer to these types of boards as death panels,” he added. “Why? Because they ultimately decide to ration care to those procedures and people because they don’t believe these procedures are effective in providing care, that the utilization isn’t worth the costs.”

“So, again, you have government making decisions and rationing and apportioning care based on research that shows what outcomes are dictated by the research that’s out there.”

In 2009, Politifact named “death panels,” a term thought to have been first used by former Alaska Gov. Sarah Palin (R), as their “Lie of the Year.”

What then Alaska Governor Palin failed to do was make her argument against IPAB. Instead she made her argument against coordinated voluntary end of life decisions, which was in the original bill and has been softened to make you accept it. The proposed and recently turned down death panel or IPAB fight is far from over. Still stuck in the OBAMACARE health bill is even if the IPAB is repealed the President can still delegate the “death panel” chores over to Secretary of HHS Kathryn Sebelius and then she will delegate to a panel of fifteen again.

The term Death panel or whatever you call it does exist and is ready to take over in 2013. The death panel in any form will go forward. For the plan to work and to display a significant profit for the insurance companies inside the exchanges they will need some very strict oversight, which will be seen as a necessity.

Whether you call it a death panel or not, decisions will be made by a set of bureaucrats and many will die because of those decisions. Because they say it makes economical sense and provides a huge profit for all involved, even for the US Government, now the largest healthcare manager in the world, it doesn’t make it right.

Other interesting reading on IPAB!

This according to my research was not accepted in the final bill! Many spoke up and said they didn’t want the government paying Providers to counsel or approach family members with a profit incentive to discuss end of life care.

Even as you slept the powers that be are dead set on getting some type of control over your end of life decisions, they have to! Be aware of moves in the future and the next time you decide to scoff at others informing you, do a little research and see the light that is blinding you is also keeping you from seeing the truth.

SEC. 1233. VOLUNTARY ADVANCE CARE PLANNING CON6 SULTATION. 7 (a) IN GENERAL.—Section 1861 of the Social Secu8 rity Act (42 U.S.C. 1395x) is amended— 9 (1) in subsection (s)(2)— 10 (A) by striking ‘‘and’’ at the end of sub11 paragraph (DD); 12 (B) by adding ‘‘and’’ at the end of sub13 paragraph (EE); and 14 (C) by adding at the end the following new 15 subparagraph: 16 ‘‘(FF) voluntary advance care planning con17 sultation (as defined in subsection (hhh)(1));’’; and 18 (2) by adding at the end the following new sub19 section: 20 ‘‘Voluntary Advance Care Planning Consultation 21 ‘‘(hhh)(1) Subject to paragraphs (3) and (4), the 22 term ‘voluntary advance care planning consultation’ 23 means an optional consultation between the individual and 24 a practitioner described in paragraph (2) regarding ad 1 vance care planning. Such consultation may include the 2 following, as specified by the Secretary: 3 ‘‘(A) An explanation by the practitioner of ad4 vance care planning, including a review of key ques5 tions and considerations, advance directives (includ6 ing living wills and durable powers of attorney) and 7 their uses. 8 ‘‘(B) An explanation by the practitioner of the 9 role and responsibilities of a health care proxy and 10 of the continuum of end-of-life services and supports 11 available, including palliative care and hospice, and 12 benefits for such services and supports that are 13 available under this title. 14 ‘‘(C) An explanation by the practitioner of phy15 sician orders regarding life sustaining treatment or 16 similar orders, in States where such orders or simi17 lar orders exist. 18 ‘‘(2) A practitioner described in this paragraph is— 19 ‘‘(A) a physician (as defined in subsection 20 (r)(1)); and 21 ‘‘(B) another health care professional (as speci22 fied by the Secretary and who has the authority 23 under State law to sign orders for life sustaining 24 treatments, such as a nurse practitioner or physician 25 assistant). 651 •HR 3962 EH 1 ‘‘(3) An individual may receive the voluntary advance 2 care planning care planning consultation provided for 3 under this subsection no more than once every 5 years 4 unless there is a significant change in the health or health5 related condition of the individual. 6 ‘‘(4) For purposes of this section, the term ‘order re7 garding life sustaining treatment’ means, with respect to 8 an individual, an actionable medical order relating to the 9 treatment of that individual that effectively communicates 10 the individual’s preferences regarding life sustaining treat11 ment, is signed and dated by a practitioner, and is in a 12 form that permits it to be followed by health care profes13 sionals across the continuum of care.’’. 14 (b) CONSTRUCTION.—The voluntary advance care 15 planning consultation described in section 1861(hhh) of 16 the Social Security Act, as added by subsection (a), shall 17 be completely optional. Nothing in this section shall— 18 (1) require an individual to complete an ad19 vance directive, an order for life sustaining treat20 ment, or other advance care planning document; 21 (2) require an individual to consent to restric22 tions on the amount, duration, or scope of medical Link: http://energycommerce.house.g…

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