WSJ misrepresents Obama interview to fearmonger about end-of-life rationing
Claiming that it's "[n]o wonder so many seniors rebel" at President Obama's health care proposals, a Wall Street Journal editorial misrepresented a New York Times interview of Obama to claim that Obama seems to believes that end-of-life "medical issues are all justifiably political questions that government or some panel of philosopher kings can and should decide." In fact, in the interview the Journal cited, Obama made clear that an advisory panel that would issue guidance on end-of-life issues would "not [be] determinative, but I think has to be able to give you some guidance."
Journal misrepresents Obama NY Times interview
Citing Times interview, Journal claimed that Obama "seems to believe" "government or some panel of philosopher kings can and should" make end-of-life decisions. The editorial added: "No wonder so many seniors rebel at such judgments that they know they could do little to influence, much less change." From the Journal editorial headlined, "Obama's Senior Moment":
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?
[...]
Before he got defensive, Mr. Obama was open about this political calculation. He often invokes the experience of his own grandmother, musing whether it was wise for her to receive a hip replacement after a terminal cancer diagnosis. In an April interview with the New York Times, he wondered whether this represented a "sustainable model" for society. He seems to believe these medical issues are all justifiably political questions that government or some panel of philosopher kings can and should decide. No wonder so many seniors rebel at such judgments that they know they could do little to influence, much less change. [Wall Street Journal, 8/14/09]
In fact, in the Times interview, Obama made clear an advisory panel is "not determinative, but ... has to be able to give you some guidance." From the Times interview:
THE PRESIDENT: I don't know how much that hip replacement [that Obama's grandmother received shortly before her death] cost. I would have paid out of pocket for that hip replacement just because she's my grandmother. Whether, sort of in the aggregate, society making those decisions to give my grandmother, or everybody else's aging grandparents or parents, a hip replacement when they're terminally ill is a sustainable model, is a very difficult question. If somebody told me that my grandmother couldn't have a hip replacement and she had to lie there in misery in the waning days of her life -- that would be pretty upsetting.
And it's going to be hard for people who don't have the option of paying for it.
THE PRESIDENT: So that's where I think you just get into some very difficult moral issues. But that's also a huge driver of cost, right?
I mean, the chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health care bill out here.
So how do you -- how do we deal with it?
THE PRESIDENT: Well, I think that there is going to have to be a conversation that is guided by doctors, scientists, ethicists. And then there is going to have to be a very difficult democratic conversation that takes place. It is very difficult to imagine the country making those decisions just through the normal political channels. And that's part of why you have to have some independent group that can give you guidance. It's not determinative, but I think has to be able to give you some guidance. And that's part of what I suspect you'll see emerging out of the various health care conversations that are taking place on the Hill right now. [The New York Times Magazine, 4/28/09]
Fox News previously misrepresented Obama's Times interview. Citing the same New York Times interview on Fox News, Special Report host Bret Baier and correspondent Shannon Bream claimed that Obama's "own words may have contributed to the atmosphere of fear" surrounding "talk about possible government mandates in so-called end-of-life issues" or "what critics call 'death panels.' " [Fox News' Special Report, 8/12/09]
Journal acknowledged that rationing currently exists but asserted that "in the end no one is denied actual care"
From the editorial:
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.
However, there are accounts of people not being able to receive care if they don't have cash
In congressional testimony, woman said hospital told her "unless your brother brings in cash, he is not going to get the procedure without insurance." Attorney Peggy Raddatz stated in congressional testimony that her brother Otto was diagnosed with non-Hodgkin's lymphoma and, after several rounds of chemotherapy, was scheduled for a stem cell transplant. In the midst of the preparation for this procedure, his insurance company canceled his insurance. Raddatz testified that when she called the hospital to see if she could still schedule the procedure for her brother, she was told: "[U]nless your brother brings in cash, he is not going to get the procedure without insurance." From Raddatz' testimony:
My brother was told he was canceled during what they called a "routine review" during which they claimed to discover a "material failure to disclose". Apparently in 2000 his doctor had done a CT scan which showed an aneurysm and gall stones. My brother was never told of either one of these conditions nor was he ever treated for them and he never reported any symptoms for them either.
After months of preparation, the stem cell transplant could not be scheduled. My brother's hope for being a cancer survivor were dashed. His prognosis was only a matter of months without the procedure.
When I called the hospital to see if I could schedule the stem cell transplant for him I was callously told "unless your brother brings in cash, he is not going to get the procedure without insurance."
[...]
After two appeals by the Illinois Attorney General's Office, Fortis Insurance Company overturned their original decision to rescind my brother's coverage and he was reinstated without any lapse.
Without the help of the office of the Illinois Attorney General, this would not have been possible. [Prepared testimony of Peggy Raddatz before the House Energy & Commerce Committee, 6/16/09]
Congressional testimony: "The hospital wanted a $30,000 deposit." Another person, Robin Beaton, testified that her breast cancer surgery was delayed by several months after her insurance company revoked its pre-clearance for her surgery and announced an investigation of her medical history that it said would last for months. Beaton testified that the hospital demanded a "$30,000 deposit" to schedule the surgery immediately, which Beaton was unable to afford. Beaton testified that her surgery was delayed several months until her insurance was reinstated, and due to the delay, her tumor had grown from two centimeters to seven centimeters and she was forced to have a double mastectomy and have all her lymph nodes removed. From Beaton's testimony:
In June 2008 I was diagnosed with invasive HER-2 genetic breast cancer, this is a very aggressive form of breast cancer. In the beginning, I was told I needed immediate surgery. The doctor told me you have a lumpectomy if the tumor is small enough. In the beginning the doctor said the tumor was 2 centimeters.
When the surgeons scheduled my surgery I was pre-certified for two days hospitalization and surgery. The Friday before the Monday I was scheduled to have my surgery Blue Cross red flagged my chart due to dermatologist chart. The dermatologist called Blue Cross directly to report that I only had acne (pimples) and to please not hold up my cancer surgery. Blue Cross called me on the Friday before I was to have cancer surgery on Monday and informed me that they were launching a 5 year medical investigation into my medical history and this would take approximately 3 months.
I was frantic. I was totally alone as my family lives in Jacksonville Florida. The hospital wanted a $30,000 deposit, and I knew I could not pay this or for the surgery myself. I had no idea what to do or where to turn. I met a lady who told me you need to call your congressman Joe Barton for help.
[...]
I began going everywhere looking for help, county hospitals, Foundations, agencies. Everywhere I went I was placed on a waiting list. When you have aggressive invasive cancer you have no time to wait as the cancer grows everyday. I went back to the county hospital where they lost my medical records three times. The process was unending searching for help for cancer. I did everything to get help. Everywhere you go takes time. No help was found until Joe Barton and his staff, after working a very long time, got Blue Cross to reinstate my insurance after being diagnosed with aggressive invasive breast cancer in June 2008. I was then placed back on the surgeons list to receive my cancer surgery. I finally was operated on October 2, 2008. My tumor grew from 2 centimeters all the way to 7 centimeters. Also, I had to have both breasts removed and all my lymph nodes due to waiting from June to October for treatment.
Delaying treatment for cancer only worsens the condition, costing more to treat and treatment much more intensive. Also the outcome is not as good. [Prepared testimony of Robin Beaton before the House Energy & Commerce Committee, 6/16/09]
Media reports of people pulling their own teeth. There are media reports of Americans gluing and extracting their own teeth due to the costs of dental care.
There is no way to present this as controversial without lying.
However, the president is on record several times supporting end-of-life counseling, both in the context of the bill and for cost-savings for the system, and it's unreasonable to be nervous that the "guidance" may not always be non-determinant? A doctor doesn't have to say "no" before he/she don't offer care, they just don't get to it.
And has been pointed out previously, rationing does take place now as well. Your statement that rationing cannot be dismissed is entirely accurate, but unfortunately it has become the fulcrum for the panic machine.
The "controversial" end of life counseling of the bill doesn't mandate it or attach any requirements to impose the counselor's recommendations on the person being counseled. It ONLY requires that such counseling be covered if the person wants it.
The most that might have been mandated is that doctors would be required to mention it as an option for patients, and I don't even believe that that is required.
But, I am more curious as to why you would be opposed to this counseling. What is it that you think our doctors are trying to do to us? They secretly are waiting to put us to death against our will?
End-of-life counseling isn't something new, and neither is the advocacy issue that you bring up.
I'm not diving down this dark winding hole of stupid with you today. Find somebody else to torture.
If it was recognized as something well-established, then how would the the "death panel" nonsense be presented at all? Nobody's ever talked about a "death panel" before, so why wouldn't it have been described as such if the idea was previously out there? The nature of the controversy implies that it's a new and radical concept.
I think Clams comment is very much in line with what you said earlier. I'm not sure why you're objecting to it.
What I was focusing on was your argument that the death panels stem from a larger concern about govt. intervention. OK. fine.
If pundits, politicians, and etc. oppose the public option and single payer solution because they think govt. intervention is bad, they should state it as such and give their reasons why instead of using this talking point.
Otherwise they are being disingenuous and relying on fear mongering to get their message across.
don't look at me, see how many faults I can find with the other guy!
Quote:
President Barack Obama said his grandmother’s hip-replacement surgery during the final weeks of her life made him wonder whether expensive procedures for the terminally ill reflect a “sustainable model” for health care.
The president’s grandmother, Madelyn Dunham, had a hip replaced after she was diagnosed with cancer, Obama said in an interview with the New York Times magazine that was published today. Dunham, who lived in Honolulu, died at the age of 86 on Nov. 2, 2008, two days before her grandson’s election victory.
“I don’t know how much that hip replacement cost,” Obama said in the interview. “I would have paid out of pocket for that hip replacement just because she’s my grandmother.”
Obama said “you just get into some very difficult moral issues” when considering whether “to give my grandmother, or everybody else’s aging grandparents or parents, a hip replacement when they’re terminally ill.
“That’s where I think you just get into some very difficult moral issues,” he said in the April 14 interview. “The chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health- care bill out here.”
Again, the provision would require Medicare to pay for any end-of-life counseling. And that counseling would remain voluntary, as it is now. I still fail to see what it is about that that has you spooked.
And, where rightOn, is the earlier link? I cannot find it anywhere on Dex's earlier posts.
I guess my question to you would be, what is the concern here? That we have doctors that are just waiting for the political cover to trick old people into dying sooner? I am missing where this end-of-life counseling has a downside.
"He just did above. Maybe you should read what's here before you comment." - RightOn
Your statement was completley false and your spoon comment really just digs the hole deeper.
Dex shows an address on my screen, which is helpful. But not a link.
Watching you decsend for a rare sane position to full hissy fit, is interesting.
It's been established that people who do go through end of life counseling very often choose, by their own choice based on knowledge, treatments that provide better quality of life at the end, even at the expense of quantity. The fact is that these informed choices coincidentally also cost less, even though that is not generally the reason they are chosen. Project those savings over a few million more people making that informed choice and there are significant cost savings. However, the extraordinary measures approach is still a genuine option for the patient, and there has been no suggestion of removing that choice.
Patients would fight tooth and nail to have any such decision-making taken from them. Their families would fight it. Doctors would fight it. The media would publicize it in spectacular fashion. The public would be outraged and politicians would take action to prevent it, whether through genuine outrage or grandstanding the result would be the same.
Just look at the outrage over the issue when the risks are entirely imaginary. Just imagine what would happen when actual policies were put in place. I really, honestly believe you are imagining a nonexistent risk.
As a paramedic I have encounter many instances where people with terminal illnesses lives were artificially prolonged because someone within their chain of care failed to either suggest such orders or even offer such services. A specific example I can think of is a woman in here late 40's who was diagoised with terminal cervical cancer. The woman was told after surgery that nothing could be done. She wanted to go home and die with dignity in her home. The hospital did not set up any form of hospice care, properly educate the patient or the family as to what her options were or even attempt to execute a DNR with the patient. We were dispatched to a difficulty breathing in the morning when the patient refused to go to the hospital because she wanted to die at home. We were called to a cardiac arrest later in the day, where she was sucessfully resuscitated and lived for 3 days in an ICU before passing in the hospital. This is exactly what she didn't want to happen.
These kind of end of life decision need to be made between a doctor and a patient BEFORE the patient is unable to voice what their choices are. Fact is, they CAN be made right now, but they are too many times not. That however, does not mean legislation is needed. These decisions are too difficult to make in the emotionally charged potential end of someones life. Families should not be forced to make them and patients may not be able to speak for themselve when these dramas are unfolding. BUT, Pres. Obama and those who are defending healthcare have done a very poor job of properly explaining to what extent their version of end of life counseling would entail. This is what I believe to be the biggest problem in this debate. If Pres. Obama want to convince me that this is a good bill, I need details, which have been few and far between. I have actually read the entire bill, but there are far too few details and far too much is simply left up to the "commissioner." It's unfortunate that good parts of this bill are probably going to fall be the wayside because of all the junk!
If Pres. Obama truly wants healthcare reform, there needs to be more specific details and less of the political feel good rhetoric that I heard from his townhall meeting today.
Then you must have missed the fact that, under all of the proposed legislation, you will be able to keep your over-priced, under-covered, for-profit, ceo-salary-subsidized health care plan. Time to put away your tin-foil hat.
That however, does not mean legislation is needed.
You're a dolt. All the legislation mandated was that the government would PAY for this counseling.
If Pres. Obama truly wants healthcare reform, there needs to be more specific details
The details are there, as much as can be there without an ACTUAL BILL. Use the google.
Which Bill, Fog?
Your employer can switch plans NOW.
And if you lose your job today, guess what, you have NO health care.
As far as which bill, you're right, there is no bill. That doesn't mean people have to lie about what's in the PROPOSED bills.
Don't forget your bumper sticker:
PROFITS OVER PEOPLE
DISEDENCE IS PATRIOTIC
Oh, I forgot, that's only if your a democrat. If your a conservative then you were organized by special interests and you are just a mindless zombie who can't think for yourself and just does what Rush says.
Your right. Your employer can switch you coverage now. But under HR 3200 your employer will be charged an 8% tax if they don't provide insurance. I just got a benefit statement from my employer and they said they pay 11% of my salary to insurance. So my math may be a little rusty, but if after year 3 (they can't drop it until then), your employer can drop the insurance and put you on the public option and make and extra 3% profit. Now remember the public option already has a competetive advantage because it doesn't have to make a profit and therefore doesn't have to worry about it's medical loss ratio so it can either be way cheaper or offer more coverage. So, people in the exchange will most likely pick the cheaper or better coverage of the public option. That is just speculation of course. People may want to pay more or get less coverage. Who knows. So you put the two together and that perfect storm will certainly lay the ground work for the end of private insurance and the beginning of a....say it with me in a happy happy joy joy voice...single payer system.
I have no healthcare until I get another job. I'm not saying we shouldn't have something in place for those who dont' have benefits or cannot be insured. Don't take away my right to determine my coverage just because you want to cover others. You know that's what you're doing.
If you had read page 16 of HR 3200 Sec 102 para (a) then you would clearly see that you can keep your current insurance IF, then it adds several qualifications for you to keep your current coverage. Under government run healthcare the government will decide exactly what the benefits an QHBP (qualified health benefit plan) provides. So you will be able to keep your insurance it has jumped though all of the government hoops. Essentially, all insurance will be forced to provide the same coverage.
Except the public options. It will more than likely be better because it doesn't have to make a profit. Heck, it can even go in the hole. After all, it's the government. Then there is something called the medical loss ration. This is the pecentage of premiums that go to actual healthcare. The closer to 100, the less profitable. 75 to 80 is what most insurance companies shoot for. Well the "commissioner" is going to set an "acceptable" ratio and anything below that will have to rebated to consumers. Sounds great. Except that, because the public option doesn't have to make a profit, it will be able to offer better coverage. It can keep it's ratio as close to 100 as the "comissioner" wants. That's not competion. It's on page 24.
Finally, end of life counseling is something a doctor can do RIGHT NOW. We do not need legislation to make doctors talk to patients about living wills and DNRs. They should do it anyway.
Hmm. That would imply that conservatives and people of other ideological bents don't stoop to the same level from time to time...which is complete BS.
As for the whole govt. takeover of healthcare, I personally wouldn't mind if it's done right. It seems to work pretty well in places like Sweden, Norway, Denmark, France, Canada, etc.
Well, here's some more name calling because you deserve it: You're an idiot. That's right, I'm calling you an IDIOT.
You may have read one of the bills (even though I find that claim highly questionable). Nothing in any of the bills requires any "end of life counseling".
YOU ARE AN IDIOT.
All the proposed legislation mandates is to have the govt. PAY for these consultations.
Wrong. This was your point:
We do not need legislation to make doctors talk to patients about living wills and DNRs.
So right there, you have proven that you either haven't read the proposed bill or you did read it and was unable to understand it.
There was nothing, repeat, NOTHING in any of the proposed bills that would MAKE doctors do any such thing.
You remain an idiot AND a moron.
You give us this horror story, which I do personally empathize with, but then you talk about people being forced to make these decisions. Who's talking about that? If you recognize that it's not mandated, then why even say that? What is supposedly unclear in the bill that troubles you about this counseling, exactly?
You're not doing a very good job of making yourself clear, honestly. You say that we shouldn't have to pay for it because doctors should already do it, but then you also say that it doesn't happen often enough. In other words, not enough doctors are doing it.
Why is the law in Texas relevant? We're talking on a national level here. That's like saying we don't need a Constitutional Amendment for prohibition because your county is dry already. Do you like this law or not? If you do, then the concern that the same thing might happen on a national level is very strange, especially since you say that counseling is not mandated.
It all seems muddled and inconsistent. Clarification would be appreciated.
And, yes, it is unreasonable to think that doctors are wanting to put old people down against their will. It is even more unreasonable to think that there is political cover for this kind of thing. I never supported G-Dub, but I would never be so partisan as to think that he is secretly plotting to kill old people. Stop listening to Rush Limbaugh!
That was my exact point from the start, but apparently the concrete thinkers couldn't get their minds around the way I expressed it. And then we still never got an answer out of any of the naysayers. What exactly has them so spooked about this provision? Once you debunk all the lies, their fears makes absolutely no sense.
If passed, Medicare would pay for voluntary end-of-life counseling. That's it. And that's somehow worse than letting the patient/family pay for it out of pocket.
Aren't those things incredibly obvious anyway? Of course most costs come at the end and counseling would reduce some of them. So what? As long as it's voluntary, I don't see what anyone is concerned about. Does Obama have to refrain from making perfectly understandable statements because opponents will intentionally misrepresent them, or what?
Man, where you guys when I was being jumped on for saying that at the beginning of the thread?