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Section 1233, Sub Section (E): An explanation by the practitioner of the continuum of end-of-life services and supports available, including palliative care and hospice, and benefits for such services and supports that are available under this title.
The White House pressed the U.S. House of Representatives on Friday to give more power to a proposed independent commission to set doctor, hospital and other provider payments under Medicare.
White House budget director Peter Orszag wrote a letter to House Speaker Nancy Pelosi asking that House lawmakers embrace a plan in which Congress would give up much of its power to set annual Medicare payment rates for medical services.
The move comes as Democrats search for ways, including Medicare savings, to help pay for a sweeping overhaul of the U.S. healthcare system that has run into trouble in Congress. Medicare is the federal health insurance program for the elderly and disabled, covering about 44 million people.
In a letter to House Speaker Nancy Pelosi, D-Calif., White House Office of Management and Budget Director Peter Orszag suggested that Congress strengthen the Medicare Payment Advisory Commission, or MedPAC, to control health costs.
"We want to do is force Congress to make sure that they are acting on these recommendations to bend the cost curve each and every year, so that we're constantly adjusting and making changes that will reduce costs for families and for taxpayers," Obama said.
Congress would lose much of its current power to determine how Medicare pays for medical services - which range from home nursing care to colonoscopies .
Elderly people are SCREWED big time because Obama and Democrats don't want to spend too much money for their Medicare.
Last edited by NEPatriot; 07-18-2009 at 12:54 PM..
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Elderly people are SCREWED big time because Obama and Democrats don't want to spend too much money for their Medicare. They are required to see a counselor every 5 years.
I'm against this bill for a whole host of reasons but I read this section very differently. Too many times, people don't plan ahead and their relatives are forced to make decisions based on what their parent/spouse would have wanted. This is simply making people address the issue beforehand. Some have said that they would never want to be in a persistent vegetative state and would want to be DNR "do not resuscitate" i.e. don't do CPR if my heart stops while others want to do everything possible to try to stay alive. What's wrong with asking people beforehand of their wishes???
Re: ObamaCARE: Elderly people are SCREWED big time <---------MUST READ
Quote:
Originally Posted by Patsfanin Philly
What's wrong with asking people beforehand of their wishes???
You are right on this topic and I think that everybody should have a plan . Before my mother went to the hospital for the surgery, she told me what to do if nothing went well. I did what she told me.
Re: ObamaCARE: Elderly people are SCREWED big time <---------MUST READ
SEC. 1233. ADVANCE CARE PLANNING CONSULTATION.
This part I deleted because it simply says what pieces of existing law need to be changed for the following to work. It doesn't cite the existing law; it simply says things like, "(i) by striking ‘and’ at the end of subparagraph (DD)"
(B) by adding at the end the following new subsection:CommentsClose CommentsPermalink
‘Advance Care Planning Consultation
This part seems to mean that old people are going to be told the kinds of things they need to consider, such as about wills, proxies, etc.:
‘(A) An explanation by the practitioner of advance care planning, including key questions and considerations, important steps, and suggested people to talk to.C
‘(B) An explanation by the practitioner of advance directives, including living wills and durable powers of attorney, and their uses.
‘(C) An explanation by the practitioner of the role and responsibilities of a health care proxy.
‘(D) The provision by the practitioner of a list of national and State-specific resources to assist consumers and their families with advance care planning, including the national toll-free hotline, the advance care planning clearinghouses, and State legal service organizations (including those funded through the Older Americans Act of 1965).
‘(E) An explanation by the practitioner of the continuum of end-of-life services and supports available, including palliative care and hospice, and benefits for such services and supports that are available under this title.CommentsClose CommentsPermalink
‘(F)(i) Subject to clause (ii), an explanation of orders regarding life sustaining treatment or similar orders, which shall include
‘(I) the reasons why the development of such an order is beneficial to the individual and the individual’s family and the reasons why such an order should be updated periodically as the health of the individual changes;
‘(II) the information needed for an individual or legal surrogate to make informed decisions regarding the completion of such an order
This part seems to deal with the likelihood that some States will have laws that put some limitations on the above, and that all has to be figured out:
‘(III) the identification of resources that an individual may use to determine the requirements of the State in which such individual resides so that the treatment wishes of that individual will be carried out if the individual is unable to communicate those wishes, including requirements regarding the designation of a surrogate decisionmaker (also known as a health care proxy)
‘(ii) The Secretary shall limit the requirement for explanations under clause (i) to consultations furnished in a State-
‘(I) in which all legal barriers have been addressed for enabling orders for life sustaining treatment to constitute a set of medical orders respected across all care settings; and
‘(II) that has in effect a program for orders for life sustaining treatment described in clause (iii).
‘(iii) A program for orders for life sustaining treatment for a States described in this clause is a program that-
‘(I) ensures such orders are standardized and uniquely identifiable throughout the State;CommentsClose CommentsPermalink
‘(II) distributes or makes accessible such orders to physicians and other health professionals that (acting within the scope of the professional’s authority under State law) may sign orders for life sustaining treatment;CommentsClose CommentsPermalink
‘(III) provides training for health care professionals across the continuum of care about the goals and use of orders for life sustaining treatment; andCommentsClose CommentsPermalink
‘(IV) is guided by a coalition of stakeholders includes representatives from emergency medical services, emergency department physicians or nurses, state long-term care association, state medical association, state surveyors, agency responsible for senior services, state department of health, state hospital association, home health association, state bar association, and state hospice association.CommentsClose CommentsPermalink
This part seems to provide some definitions:
‘(2) A practitioner described in this paragraph is--CommentsClose CommentsPermalink
‘(A) a physician (as defined in subsection (r)(1)); andCommentsClose CommentsPermalink
‘(B) a nurse practitioner or physician’s assistant who has the authority under State law to sign orders for life sustaining treatments.CommentsClose CommentsPermalink
This says that you can't use a physical exam as a substitute for a meeting to help the elderly consider their future needs:
‘(3)(A) An initial preventive physical examination under subsection (WW), including any related discussion during such examination, shall not be considered an advance care planning consultation for purposes of applying the 5-year limitation under paragraph (1).
‘(B) An advance care planning consultation with respect to an individual may be conducted more frequently than provided under paragraph (1) if there is a significant change in the health condition of the individual, including diagnosis of a chronic, progressive, life-limiting disease, a life-threatening or terminal diagnosis or life-threatening injury, or upon admission to a skilled nursing facility, a long-term care facility (as defined by the Secretary), or a hospice program.
The consultation can actually result in the person getting treatment:
‘(4) A consultation under this subsection may include the formulation of an order regarding life sustaining treatment or a similar order.
This section simply described what an "order regarding life sustaining treatment means":
... is signed (by someone qualified, such as a physician), ...communicates the individual’s preferences regarding life sustaining treatment, etc.
This section puts limits on the care:
‘(B) The level of treatment indicated under subparagraph (A)(ii) may range from an indication for full treatment to an indication to limit some or all or specified interventions. Such indicated levels of treatment may include indications respecting, among other items--
‘(i) the intensity of medical intervention if the patient is pulse less, apneic, or has serious cardiac or pulmonary problems;
‘(ii) the individual’s desire regarding transfer to a hospital or remaining at the current care setting;CommentsClose CommentsPermalink
‘(iii) the use of antibiotics; andCommentsClose CommentsPermalink
‘(iv) the use of artificially administered nutrition and hydration.’
Sounds like a great program so far. The rest talks about payment issues by referencing other documents, limits the frequency of such services, provides for reporting of useful data so that best practices can be captured, and provides for useful consumer info being put online.
Looks really good, but I choose to think for myself, rather than have a puppet of corporate special interests like Fred Thompson do my thinking for me. Thanks for posting such a fine example of how national health care could really help the elderly and their families by educating people about various end of life issues.
Re: ObamaCARE: Elderly people are SCREWED big time <---------MUST READ
Quote:
Originally Posted by Patters
Sounds like a great program so far. The rest talks about payment issues by referencing other documents, limits the frequency of such services, provides for reporting of useful data so that best practices can be captured, and provides for useful consumer info being put online.
Looks really good, but I choose to think for myself, rather than have a puppet of corporate special interests like Fred Thompson do my thinking for me. Thanks for posting such a fine example of how national health care could really help the elderly and their families by educating people about various end of life issues.
When Obama cuts Medicare's spending, he forces elderly people to choose his health care. It means that they will spend more money.
You previously STATED that MA had a better health care system. When I pointed out the lawsuit, you didn't have much to say. We'll see how 'good' it is in the future.
Remember what you told everybody how Obama was going to 'change' this country last year? How does it work out for you? Not too good? We'll revisit these health care problems next year.
Last edited by NEPatriot; 07-18-2009 at 12:09 PM..
Re: ObamaCARE: Elderly people are SCREWED big time <---------MUST READ
Quote:
Originally Posted by NEPatriot
When Obama cuts Medicare's spending, he forces elderly people to choose his health care. It means that they will spend more money.
There's nothing in your link that shows Obama is cutting Medicare spending. That said, the theory of national health care is that there will be a lot of economies of scale (buying drugs in bulk, buying equipment in bulk) and lots of opportunities for efficiency (standardized billing forms, central database to help reduce likelihood of duplicate testing) that will save hundreds of billions of dollars.
Quote:
Originally Posted by NEPatriot
You previously STATED that MA has a better health care system. When I pointed out the lawsuit, you didn't have much to say.
I never stated MA has a better health care system. We do have some of the best hospitals and, like other liberal states, we seem to attract some of the best medical doctors, medical research companies, and facilities. We do have affordable health insurance, but the program was simply Romney's political boondoggle and he never figured out a way to pay for it. There are things I like about our health care system here, but I really don't know how it is in other progressive states.
Re: ObamaCARE: Elderly people are SCREWED big time <---------MUST READ
Quote:
Originally Posted by Patters
There's nothing in your link that shows Obama is cutting Medicare spending. That said, the theory of national health care is that there will be a lot of economies of scale (buying drugs in bulk, buying equipment in bulk) and lots of opportunities for efficiency (standardized billing forms, central database to help reduce likelihood of duplicate testing) that will save hundreds of billions of dollars.
The White House pressed the U.S. House of Representatives on Friday to give more power to a proposed independent commission to set doctor, hospital and other provider payments under Medicare.
White House budget director Peter Orszag wrote a letter to House Speaker Nancy Pelosi asking that House lawmakers embrace a plan in which Congress would give up much of its power to set annual Medicare payment rates for medical services.
The move comes as Democrats search for ways, including Medicare savings, to help pay for a sweeping overhaul of the U.S. healthcare system that has run into trouble in Congress. Medicare is the federal health insurance program for the elderly and disabled, covering about 44 million people.
Last edited by NEPatriot; 07-18-2009 at 12:23 PM..
But, this is the same thing that insurance companies do. They set limits, too. With some insurance plans, the consumer can pay the difference if the doctor wants to charge more than the insurance company will pay, but most doctors settle for what the insurance company pays.
Re: ObamaCARE: Elderly people are SCREWED big time <---------MUST READ
Quote:
Originally Posted by Patters
But, this is the same thing that insurance companies do. They set limits, too. With some insurance plans, the consumer can pay the difference if the doctor wants to charge more than the insurance company will pay, but most doctors settle for what the insurance company pays.
When they set the limit, they will tell you what they COVER or NOT. Am I right? The Medicare under Obama regime will not be the same as the one which elderly people have used in the last decades.
Do you know why they do it, don't you? Because they don't have 'money' any more. It's the time to 'cut' back everything WHILE Obama generously spends 18 million dollars to make his recovery site look good.
In a letter to House Speaker Nancy Pelosi, D-Calif., White House Office of Management and Budget Director Peter Orszag suggested that Congress strengthen the Medicare Payment Advisory Commission, or MedPAC, to control health costs.
"We want to do is force Congress to make sure that they are acting on these recommendations to bend the cost curve each and every year, so that we're constantly adjusting and making changes that will reduce costs for families and for taxpayers," Obama said.
Congress would lose much of its current power to determine how Medicare pays for medical services - which range from home nursing care to colonoscopies .
Obama and Democrats sure love elderly people.
Last edited by NEPatriot; 07-18-2009 at 12:55 PM..
Re: ObamaCARE: Elderly people are SCREWED big time <---------MUST READ
Government SHOULD NOT have anything to do with you health care, they will KILL YOU.
After watching the Sotomoto hearings how can anybody in their right minds want those stinking f-cking swine politician bastards involved in the health of themselves and their families, we have Medicaid we have Medicare, if you need a Colonoscopy now in America you can get one in two days even if your homeless, in the UK and Canada you will wait Two Years.
GOD DAMN GOVERNMENT keep the filthy pigs out of your lives as much as possible, oh jesus.
__________________
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In The Absence Of Law And Order Society Will Surely Destroy Itself
ObamaCARE: Elderly people are SCREWED big time <---------MUST READ
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