US Health care reforms

[Oddball]

Err, oddball, saying that "liberal media" only tells one side of the story hardly distinguishes it from conservative media.

And honestly: all of the items on that list that I read, and it was a random sample, were fear-mongering lies. Oh, no, the government is going to kill me, the government is going to drain my bank account, oh noes! Yeah, no, those are wrong. For a particularly egregious example,

Page 145 Line 15-17: An Employer MUST auto-enroll employees into public option plan. (NO choice!)

Thats funny, because there is no public option in the plan, and there hasn't been for months and months.

And, err, oddball, I would say that using generic drugs is a good reflection on VA. Name brand drugs are more expensive, miore risky, and are often found to be equally or less effective than generics. One of the dropped items of the healthcare bill, dropped after extremely heavy lobbying by the medical industry I must add, was a program to fund clinical studies comparing name brand and generic drugs for their effectiveness.

For more on this, look at EVERY SINGLE DRUG ADD ON TV! Ask your doctor about XXX drug! Why should you, wouldn't he know best? Here's why they say that: patients pressure doctors into giving them what they feel is the best, irrespective of the doctor's judgment. Hence antibiotics for the common cold, and and your blithe assumption that generic drugs were inferior to name brand ones.

well, that's funny, because your blither assumption that all these statistics and feedback are accurate. Out of personal observation and notification....Generic, sorry aobut my mix-up of organic, was thinking about food (although there are also organic meds, too) are NOT as effective. As far as the adds, they say ask your doctor if your are safe to use this drug, blah blah blah, of course they will know the side effects and precautions.... safer of course they are, they don't do anything. you get what you pay for, they're too cheap.

Stefan: Of course businesses are going broke, it's capitalism, competition, free market. It happens all the time. Particularily more now than ever do to the state of the economy.

and you think all the kids in those schools watch tv and play video games 24/7....no....no... not at all.

[[130.Pz]I.Kluge]

Page 425 Lines 4-12: The Govt mandates “Advance-Care Planning Consult.” (Think senior citizens end-of-life patients.)
Page 425 Lines 17-19: The Govt will instruct and consult regarding living wills, durable powers of attorney, etc. (And it’s mandatory!)
Page 425 Lines 22-25, 426 Lines 1-3: The Govt provides an “approved” list of end-of-life resources; guiding you in death. (Also called ‘assisted suicide.’)
Page 427 Lines 15-24: The Govt mandates a program for orders on “end-of-life.” (The Govt has a say in how your life ends!)
Page 429 Lines 1-9: An “advanced-care planning consultant” will be used frequently as a patient’s health deteriorates.
Page 429 Lines 10-12: An “advanced care consultation” may include an ORDER for end-of-life plans.. (AN ORDER TO DIE FROM THE GOVERNMENT?!?)
Page 429 Lines 13-25: The GOVT will specify which doctors can write an end-of-life order.. (I wouldn’t want to stand before God after getting paid for THAT job!)
Page 430 Lines 11-15: The Govt will decide what level of treatment you will have at end – of-life! (Again — no choice!)

how does that tickle your fancy?

I mean to take no offense but...

You are full of shit.

I went on to actually read that section of page 425.

Takes into account those who are near death and are in the last days, weeks or even moths.(Natural or Other)
Advance-Care Planning Consult is provided if such has not taken place in the last 5 years and cover it.
This leads to Hospice care were most people are ( if they have the cover) put.
End-Of-Life care refers to making a person death comfortable (Options that are available already and won't be changed but rather are fully explained), not assisted suicide. For those who suffer from a terminal illness such as cancer.


  

Page 424, Line 15:

    SEC. 1233. ADVANCE CARE PLANNING CONSULTATION.

    (a) MEDICARE.--

    (1) IN GENERAL.--Section 1861 of the Social Security Act (42 U.S.C. 1395x) is amended--

    (A) in subsection (s)(2)--

    (i) by striking "and" at the end of subparagraph (DD);

    (ii) by adding "and" at the end of subparagraph (EE); and

    (iii) by adding at the end the following new subparagraph:

    Page 425:

    "(FF) advance care planning consultation (as defined in subsection (hhh)(1));"; and

    (B) by adding at the end the following new subsection:

    "Advance Care Planning Consultation

    "(hhh)(1) Subject to paragraphs (3) and (4), the term 'advance care planning consultation' means a consultation between the individual and a practitioner described in paragraph (2) regarding advance care planning, if, subject to paragraph (3), the individual involved has not had such a consultation within the last 5 years. Such consultation shall include the following:

    "(A) An explanation by the practitioner of advance care planning, including key questions and considerations, important steps, and suggested people to talk to.

    "(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,

    Page 426:

    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.

    "(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; and

    "(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

    Page 427:

    unable to communicate those wishes, including requirements regarding the designation of a surrogate decisionmaker (also known as a healthcare 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;

    (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;

    Page 428:

    "(III) provides training for health care professionals across the continuum of care about the goals and use of orders for life sustaining treatment; and

    "(IV) is guided by a coalition of stakeholders includes representatives from emergency medical services, emergency department physcians 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.

    "(2) A practitioner described in this paragraph is--

    "(A) a physician (as defined in subsection (r)(1)); and

    "(B) a nurse practitioner or physician's assistant who has the authority under State law to sign orders for life sustaining treatments.

    "(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).

    Page 429:

    "(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.

    "(4) A consultation under this subsection may include the formulation of an order regarding life sustaining treatment or a similar order.

    "(5)(A) For purposes of this section, the term 'order regarding life sustaining treatment' means, with respect to an individual, an actionable medical order relating to the treatment of that individual that--

    "(i) is signed and dated by a physician (as defined in subsection (r)(1)) or another health care professional (as specified by the Secretary and who is acting within the scope of the professional's authority under State law in signing such an order, including a nurse practitioner or physician assistant) and is in a form that permits it to stay with the individual and be followed by health care professionals and providers across the continuum of care;

    Page 430:

    "(ii) effectively communicates the individual's preferences regarding life sustaining treatment, including an indication of the treatment and care desired by the individual;

    "(iii) is uniquely identifiable and standardized within a given locality, region, or State (as identified by the Secretary); and

    "(iv) may incorporate any advance directive (as defined in section 1866(f)(3)) if executed by the individual.

    "(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;

    "(iii) the use of antibiotics; and

    "(iv) the use of artificially administered nutrition and hydration."

[Stefan]

[Lobo]

are generic drugs inferior to name brand ones?, who said you such bullshit, Oddball?...yeah, well, the big pharmaceutic trusts, not a valid source, pal. An old crusade of doctors (the decent ones) is the generalization of generics, so effective and way cheaper than name brand medicines.

[Tedacious]

I'm starting to have enough with this... HOW can you be so simple minded!?
SOLIDARITY =/= GULAGS AND STALINISM

death tax, they would rather send you a 50$  for an "end of life pill" than pay for the necessary medical expenses

Oh really? so the government only really thinks of itself?
The government IS the people


if you haven't already. see this vid stefan posted
http://www.youtube.com/watch?v=pilG7PCV448

and realize that you people are part of those idiots.


I saw that video and read half of this thread (oddball) before I had enough, i'm getting sick and tired of you how you can be so narrow minded.
Meadow said it very very good:

Which is a good thing.

All this rage is just proving to me something I've considered for a while - that Europe is a more mature society than the US. We're more tolerant of homosexuals, different faiths and cultures and so on (while not at the expense of our own - ignore the racist propaganda) and are no longer scared of 'the big Red boogeyman'. One day America will grow up and realise that 'socialism' does not equate to gulags and forced labour, or even particularly high taxes. It's simply the pursuit of a fairer society. Oddball, you're an example of the mentality that has to be broken down to get to that stage. Open your eyes and look at the successes of the British NHS or the French healthcare system. The real successes, that is, not the hilarious lies we all saw being spouted in DC by Teabaggers and lobbyists ('you have to wait 8 weeks for a dental appointment' - I nearly died with laughter).

God bless America - and I say this as a Christian myself. Socialism (a democratic form of which I am committed to as an ideology) is consistent with the quality of life Americans seem to want for themselves - they just need to take off the Reagan-imposed blinkers and see it. There's a new day dawning for Americans - I wish them luck and all the best in seizing it with both hands. God bless America and her people.

[Dnarag1M]

It has nothing to do with me not being able to afford health insurance.  Its that I just plain don't WANT it.  The difference between it and car insurance is that you don't HAVE to drive around, its a choice, and its a dangerous choice, that could result in you killing other people.  Thus, you need insurance.  I do not want a poll tax for the pure fact that I am ALIVE, something I had no choice OVER.  I do not want to pay for health insurance, to either private or government, even if I can afford it.  I don't need it yet.

I just had to respond on this. I'm sorry, generally you come by as a aware person. But let me give this quick example why your point is faulty.

- You are insured. You get cancer (a very very common decease among all age groups). You get an operation for removing cancer tissue. You get hospitalized for a few weeks minimum. You get chemo and if you're unlucky local radiation. If you are really unluck you get bone marrow transplantation as well.

- You are VonMudra. You get cancer (a very very common decease among all age groups). You cannot afford the total of €250,000 euro of treatment on average. YOU DIE.

(the €250,000 is without followup years of echo's, x-rays and checkups.)


I'm sorry, everyone not having healthinsurence is just plain stupid. My father died of cancer, my mother in law has cancer right now - both quite young (43 and 45). There are many other deceases with very high costs that I am not even mentioning. You are likely to get such a decease now, in the near future or in the distant future.  

So. How are you going to pay for that once-in-a-lifetime (in your case for sure) €250,000 of treatment cost ? You wont.

[VonMudra]

Ummmm, you realize that emergency care is REQUIRED to be treated, even if I don't have healthcare, right?

[Dnarag1M]

That depends greatly on where you live!.

 And since we're talking America in this thread, I have seen many documentaries where life-essential treatment was withheld because a person was not properly or totally not insured...

[VonMudra]

Annnnddd if that happened, its against the law and those doctors who did would be held on homicide. 

[Fuchs]

I would rather die then to spend the rest of my life trying to pay back 250,000. Once you got such a debt you can't get out of it..

[VonMudra]

And you don't have to.  The tax payers would simply pay for it.  Of course I"m against that as well, and I'm all with Archimonday on moving medicare/medicaid into a private industry/like sector which turns a profit which in turn is put towards free healthcare for those who don't have healthcare but occasionaly, rarely, need help. 

[Archimonday]

Medicare and Medicaid claim they are a non-profit organization, but as we see it now both are going bankrupt because they are being paid for by people who can't afford to pay for it. So instead the government subsidizes them and the whole thing loses money. If people can buy into Medicare and Medicaid, as oppose to creating a new government option, you can then start to spin the tides of loss by making people on the plans healthier over the course of many years.

In some European countries doctors will get rewarded for getting a set number of patients to quit smoking, or by lowering the percentage of alcohol someone consumes. It seems like a good way to create reasons why medical professionals would want to perform preventive care.

Currently we have one major problem in the United States: The number of sick people.

There are so many people who are sick that our hospitals are being overrun, so what happens? Well as the hospitals spend more and more money to treat those people, especially in our emergency rooms, the taxes go up, the premiums hike, the cost of supplies rises because the demand is outweighing the supply.

There needs to be programs like Medicare and Medicaid that can stem the tide of that over-powering sickness in this country. Along side them needs to be an agency like the FDA that works with private insurance companies to regulate the amount of preventive care being given out.

The next biggest problem is just that: no regulation. You've got hundreds of Health Insurance companies around this nation who are doing what they please because there are no rules. You need to say to those companies look, you cant deny people cause of preexisting conditions, you can't drop their coverage once they get sick, you can't bias customers with higher premiums just because they are a seemingly higher risk, and you absolutely positively need to get LESS people going to the hospital/doctors office/etc. by making America healthy again. Its sad when we are in the mid 40's on the list of healthiest countries.

Once we do that, Private Companies can improve their care, Medicare and Medicaid can gain profit, and you can start to see a decrease in health care prices across the board, from supply's to visits to premiums.

[Meadow]

Just because a General, or a large group of people in the United States openly opposes Homosexuality, doesn't speak for the entire population Meadow.

I didn't say that. What I said was that general is still in a job. As are the congressmen and state senators and others who describe homosexuality as an abomination and who fight it wherever they can. In the UK, I'm proud to say that voters would despise such bigotry, and indeed the media would create a shitstorm over such intolerance. In the US, that point has yet to be reached. You see my point?

[Archimonday]

But you seem to misunderstand our system. While your Democracies may have the power to remove whoever they want, whenever they want, our system must wait for election day, and voters don't get to remove Generals, or Admirals.

Add in the fact that our entire government is run by wealthy men, and you get a situation where the American people are helpless.

[DLFReporter]

...with Archimonday on moving medicare/medicaid into a private industry/like sector which turns a profit which in turn is put towards free healthcare for those who don't have healthcare but occasionaly, rarely, need help.  

How would the private sector help to turn things towards free healthcare? The market is always looking for profits, that is true, but it is mainly looking to profit itself and not the patients.

On a personal note:
The thing about social healthcare is that you pay for later. I pay about 17% of my income for healthcare atm and I go to the doc once a year and luckily I haven't been seriously ill for over 12 years now. Now that seems like a big loss of money, but should I ever require a surgery, then all that money goes back to me and even more than that since I will get expensive medical procedures even if my balance is negative.

You said yourself, that you would like to look at it after you are 40ish, but the fact is, that would be very selfish, since the money that you would be 'wasting' then, should you fall sick, will have to come from others. Healthcare a social contract and no one here would see it as a Poll Tax.

Edit: Had to edit my post, since the 17% are always charged upon what you earn contrary to a poll tax, which is fixed and doesn't take into account how much you earn.