Death Panel: a reality or fiction?

topic posted Tue, August 11, 2009 - 6:45 AM by  melissa
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"The news from Barbara Wagner's doctor was bad, but the rejection letter from her insurance company was crushing. The 64-year-old Oregon woman, whose lung cancer had been in remission, learned the disease had returned and would likely kill her. Her last hope was a $4,000-a-month drug that her doctor prescribed for her, but the insurance company refused to pay. What the Oregon Health Plan did agree to cover, however, were drugs for a physician-assisted death. Those drugs would cost about $50.
www.drudge.com/news/12395...regon"

That is exactly what is meant by the term "death panel"


""It was horrible," Wagner told ABCNews.com. "I got a letter in the mail that basically said if you want to take the pills, we will help you get that from the doctor and we will stand there and watch you die. But we won't give you the medication to live."

Critics of Oregon's decade-old Death With Dignity Law -- the only one of its kind in the nation -- have been up in arms over the indignity of her unsigned rejection letter. Even those who support Oregon's liberal law were upset. "


www.healthcare-blog.com/2008/d...oregon/

How can you call it anything else when a bureaucratic body is doling out medicine according to some formula?
posted by:
melissa
Chicago
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  • Re: Death Panel: a reality or fiction?

    Tue, August 11, 2009 - 6:51 AM
    It's a dark and frightening thing.

    This has to be exactly what people are talking about when they speak of concern that government will be in between them and their doctor.

    Obama says it won't happen. He says a lot of things won't happen but he is not willing to put plain language to that effect in the bill. No one is. All of the supporters of this bill will only offer assurances but the language to back up all those assurances is not being put into the bills.


    I wouldn't take a car dealer's word on a guarantee unless he put it in writing.
    Why would I take a government's? Governments do not have a history of keeping the lightly given word of legislators.
    Fact is Government is not bound by the promises of the legislators . Government is bound only by the words that are written into law.

    If the legislators and Obama are unwilling to put their promises into written plain language law then why should I trust them?
  • Re: Death Panel: a reality or fiction?

    Tue, August 11, 2009 - 6:55 AM
    The Oregon Experience

    Members of a British House of Lords Committee traveled to Oregon seeking information regarding Oregon's assisted-suicide law for use in their deliberations about a similar proposal currently under consideration in Parliament.

    After hearing witnesses claim that there have been no complications associated with more than 200 assisted-suicide deaths, committee member Lord McColl of Dulwich, a surgeon, said, "If any surgeon or physician had told me that he did 200 procedures without any complications I knew that he possibly needed counseling and had no insight. We come here and I am told there are no complications
    There is something strange going on." (1)

    Although the experience with assisted suicide in Oregon is generally portrayed as a complication-free practice with careful safeguards, operating under strict scrutiny, the reality is different. None of the individuals quoted below are opponents of Oregon's law.

    "Safeguards" are disregarded and no one has been disciplined

    * Referring to assisted suicide cases that were in violation of the law – where only one of the required two witnesses signed the request or where doctors prescribed the lethal drugs without waiting for 15 days as the law requires – Dr. Katrina Hedberg who has been the lead author of Oregon's official reports said, "[T]here have been a number over the years." (
    2)

    * Kathleen Haley, Executive Director of the Oregon Board of Medical Examiners, said four such cases, one involving multiple patients, (
    3) were reported to the Board of Medical Examiners. This resulted in issuance of two "letters of concern" that are considered "letters of advice." She explained that the letters "are not public and they are not official disciplinary actions." (4)

    Complications are not investigated or reported

    * "[W]e are not given the resources to investigate," Hedberg said. "[N]ot only do we not have the resources to do it, but we do not have any legal authority to insert ourselves." (
    5)

    * David Hopkins, Data Analyst for Oregon's Center for Health Statistics, said, "We do not report to the Board of Medical Examiners if complications occur; no, it is not required by the law and it is not part of our duty." (
    6)

    * Jim Kronenberg, the Oregon Medical Associations' (OMA) Chief Operating Officer, explained that "the way the law is set up there is really no way to determine that [complications occurred] unless there is some kind of disaster." "[P]ersonally I have never had a report where there was a true disaster," he said. "Certainly that does not mean that you should infer there has not been, I just do not know." (
    7)

    Patient's judgment may be impaired at the time the lethal drugs are taken

    * Hedberg acknowledged that there is no assessment of patients after the prescription is written. "Our job is to make sure that all the steps happened up to the point the prescription was written," she said.(
    8) "In fact, after they write the prescription the physician may not keep track of that patient....[T]he law itself only provides for writing the prescription, not what happens afterwards." (9)

    No way to track the drugs once they are received

    * "[W]e do not have a way to track if there was a big bottle [of lethal drugs] sitting in somebody's medicine cabinet and they died whether or not somebody else chose to use it," explained Hedberg. (1
    0)

    Self-administration is very broadly interpreted

    * Dr. Peter Rasmussen who has been involved in Oregon assisted-suicide deaths numbering into double digits explained that, in one case, he opened 90 capsules – a lethal dose – of barbiturates and poured the white powder into a bowl of chocolate pudding. He gave the mixture to the woman's son who spooned the mixture into his mother's mouth. Another son gave her sips of water to wash the solution down. The woman died twelve hours later.
    (11)
    * According to Sue Davidson of the Oregon Nurses Association (ONA), a 2002 survey found that nurses were very actively involved in the process and that "some indicated that they had assisted [patients] in the taking of it [the lethal dose]."(
    12)

    Lethal drugs do not need to be taken orally

    * Barbara Glidewell who educates Oregon Health & Science University (OHSU) patients and their families about "the need for a dying plan and to rehearse the plan"
    (13) said that patients who cannot swallow would "need to have an NG tube or G tube placement."(14) Then, they could "express the medication through a large bore syringe that would go into their G tube."(15)

    * Oregon's 2005 Guidebook for Health Care Professionals states, "It remains unclear whether the Oregon Death with Dignity Act allows an attending physician to prescribe an injectable drug for the patient to self-administer for the purpose of ending life."
    (16)

    * Discussing a case in which a man said he helped his brother-in-law take the drugs, Hedberg said that "we do not know exactly how he helped this person swallow, whether it was putting a feed tube down or whatever, but he was not prosecuted...." (
    17)

    Required six months prognosis is considered unrealistic or unimportant

    * Kronenberg of the OMA said most physicians have told him that trying to predict that a patient has less than six months to live "is a stretch." "Two hours, a day, yes, but six months is difficult to do," he explained." (
    18)

    * Rasmussen said life expectancy predictions for a person entering the final phase of life are inaccurate. He dismissed this, saying, "Admittedly, we are inaccurate in prognosticating the time of death under those circumstances, we can easily be 100 percent off, but I do not think that is a problem. If we say a patient has six months to live and we are off by 100 percent and it is really three months or even 12 months, I do not think the patient is harmed in any way...." (
    19)

    Pain control has become increasingly inadequate

    * As of 2004, nurses reported that the inadequacy of meeting patients' pain needs had increased "up to 50 percent even though the emphasis on pain management has remained the same or is slightly more vigorous...Most of the small hospitals in the state do not have pain consultation teams at all," Davidson of the ONA said. (
    20)

    Data for reports is based on self-reporting by doctors who prescribe lethal drugs

    * Asked if there is any systematic way of finding out and recording complications, Hedberg replied, "Not other than asking physicians."
    (21)

    * Dr. Melvin Kohn, Oregon State Epidemiologist and Administrator of the department that oversees the annual reports about Oregon's law, explained that, in every case that they hear about, "it is the self-report, if you will, of the physician involved."
    (22)

    Records used in annual reports are destroyed

    * Hedberg said, "After we issue the annual report, we destroy the records."
    (23)

    Doctors decide what "residency" means

    * Under Oregon's law, a patient must be a resident of Oregon. Residency can be demonstrated by means that include [but are not limited to] a driver's license or a voter registration but, according to Hedberg, "It is up to the doctor to decide" whether the person is a resident. There is no time element during which one must have lived in Oregon. "If somebody really wanted to participate, they could move from their home state," she said. "I do not think it happens very much...."(2
    4)

    Assisted-suicide advocacy group facilitates most of Oregon's assisted suicides

    * According to Dr. Elizabeth Goy of OHSU, Compassion in Dying (now called Compassion and Choices
    (25)) sees "almost 90 percent of requesting Oregonians...." (26)

    * Barbara Farmer of the Visiting Nurses Association said, if a person's own doctor doesn't want to participate, "we have advised them to work with Compassion in Dying...." (2
    7)

    The state pays for assisted-suicide drugs for the poor

    * Ann Jackson, Executive Director and primary spokesperson of the Oregon Hospice Association, explained, "The State of Oregon, under the Oregon Health Plan, will buy the medications....The drugs are very inexpensive." (2
    8)

    www.internationaltaskforce.org/orexp.htm
  • An End to Healthcar rationing

    Tue, August 11, 2009 - 7:35 AM
    Health Insurance Reform will end current forms of rationing, not expand it.

    First, there is widespread rationing in today’s system. Right now, decisions about what doctor you can see and what treatment you can receive are made by insurance companies, which routinely deny coverage because of cost or the insurance company rules. Health reform will do away with many of those rules that result in rationing today.

    Health Insurance Reform will prevent insurance companies from denying coverage because you have a pre-existing condition; prevent them for canceling coverage because you get sick; ban annual and lifetime limits on coverage, which often force people to pay huge sums out of pocket if they develop a serious illness; and prevent discrimination based on gender.

    With health insurance reform, we will also put treatment decisions back into the hands of doctors in consultation with their patients.

    One of the reasons we spend too much on health care today is that our incentives are perverse: Doctors are paid by the procedure, rather than for quality. We want reform that rewards quality of care not quantity of procedures. Having dozens of procedures doesn’t necessarily make you better. In fact they can make you worse. Right now roughly 100,000 Americans die every year from medical errors, which, in many cases, were the result of treatments that were wrong for them. We want to reduce preventable hospital re-admissions that are frequently caused because patients are not getting the right care in the first place. We want to give doctors the ability to make the best treatment decisions for you and your family.
    www.whitehouse.gov/realitycheck/faq#r1
    • Re: An End to Healthcar rationing

      Tue, August 11, 2009 - 9:26 AM
      ************Health Insurance Reform will end current forms of rationing, not expand it. ****************

      That's the sort of think they are saying
      I put that in the same place as their rosy predictions of the bill being able to generate surpluses that some congressman was touting.

      So anyways Blue I went to your web page.
      There is nothing at all there that has any foundation in substance. It's all rosy promises and crap.

      When you see the legislators putting plain language that says things like that in the bill then you can tell me that they are at least serious about it. Otherwise Blue, it is all just one more empty promise by a politician.

      How can you take them at their world when they don't have the decency to put it in writing in the law ?

    • Re: An End to Healthcar rationing

      Tue, August 11, 2009 - 9:39 AM
      ***************One of the reasons we spend too much on health care today is that our incentives are perverse: Doctors are paid by the procedure, rather than for quality.*************

      So you only want to pay when you obtain the desired result?
      That's not a problem. Just cut that deal when you start the relationship


      If you are buying into the presidents disgusting accusations that America's doctors are defaulting to the expensive procedure instead of trying to help the patient you are believing in lies told by the nation's best fear monger.

      While it may be true that some doctors have scammed their patients and the system it is largely a thing of the past given how all State Medical Boards are all wired up electronically and procedures that are unnecessary pop out like sore thumbs and get review real fast. Insurance companies are also monitoring doctor's making sure that the things they do are not unwarranted.
      So doctors and hospitals are double watched.

      Then there is the fact that the vast super majority of Physicians have never engaged in such conduct.

      Which all puts LIE to the words of Saddam Hussein Barak.
  • Re: Death Panel: a reality or fiction?

    Tue, August 11, 2009 - 10:27 AM
    "the insurance company refused to pay"

    Seems like the "death panels" are working for the insurance companies at present . . . inspiring a total lack of outrage from "conservatives" . . . killing your granny just to make a buck is free enterprise, it seems . . . not like "government rationed health care," which is totally evil . . . it's SO much nicer dying of cancer when you know you're contributing to corporate dividends . . . I'm sure you would be proud to die for the sake of Blue Cross, as many aleady have:

    articles.latimes.com/2008/ap...insure18

    articles.latimes.com/2009/ju...escind17

    www.fiercehealthcare.com/story...-02-12

    www.consumerwatchdog.org/patie...icles/
    • Re: Death Panel: a reality or fiction?

      Tue, August 11, 2009 - 1:19 PM
      I am sure Forrest that there will always be instances of problems with insurance companies.
      Nothing is going to be perfect - especially anything run by a government.

      That's hardly reason to throw the baby out wit h the bathwater.
      • Re: Death Panel: a reality or fiction?

        Tue, August 11, 2009 - 1:47 PM
        "Nothing is going to be perfect - especially anything run by a government. "

        So that's why you want to abolish Medicare?


        By the way, I live in Oregon. The Oregon Health Plan does not cover assisted suicide. Sorry.

        www.oregon.gov/OHPPR/HSC/...09PList.pdf
        • Re: Death Panel: a reality or fiction?

          Tue, August 11, 2009 - 1:51 PM
          I don't "want" to abolish Medicare at all. It's just that the underlying fiscal realities will not even support it as it is right now. The only way you will be able to finance these entitlement programs is to take back a large chunk of all that dough that has been sucked from the economy into the hands of the upper class. Even that would probably not be enough. So much money has been pissed away in derivative tomfoolery that basically no one can make any sense at all of accounting. The wheels have come off.
        • Re: Death Panel: a reality or fiction?

          Tue, August 11, 2009 - 2:15 PM
          ***********So that's why you want to abolish Medicare? **************

          No I want the government to but the fuck out.
          I want the Fed to stay out of things They are already too much involved.

          I am for this:
          uspolitics.tribe.net/thread/...f0ec0a67
          Which does not have government becoming a massive octopus BUT does make care available to every one o9n a sliding scale down to No fee for the indigent.
          • Re: Death Panel: a reality or fiction?

            Tue, August 11, 2009 - 2:22 PM
            "No I want the government to but the fuck out."

            You want Medicare WITHOUT government? How would that work, exactly?
            • Re: Death Panel: a reality or fiction?

              Tue, August 11, 2009 - 2:32 PM
              **************You want Medicare WITHOUT government? How would that work, exactly? *****************
              I saw where you were going the first time around.
              It is a weak and specious argument to trot out medicare - a near total failure of fiscal mismanagement for the purposes you have in mind.

              How about instead you go read that bill instead of quoting liars.



              Or would that be an galactic success of fiscal mismanagement.
              Either way it's a disaster and it's all because the fucking Feds are running it

              Did I ever link you to the laundry list of Federal Trust funds that Clinton had to raid into bankruptcy to create the fiction that he balanced the budget?
              I'm sure it's on this tribe somewhere.
        • Re: Death Panel: a reality or fiction?

          Tue, August 11, 2009 - 2:26 PM
          *********By the way, I live in Oregon. The Oregon Health Plan does not cover assisted suicide. Sorry.
          www.oregon.gov/OHPPR/HSC/.....df***********

          It is not called assisted Suicide in Oregon it's called "Death With Dignity" and they will help you go die.
          www.oregon.gov/DHS/ph/pas/faqs.shtml




          Barbara Wagner, who is covered through the state of Oregon's government health care plan, was denied an important cancer drug she requested and instead was offered a drug for assisted suicide. Below is an excerpt from the KATU.com article:

          --------------

          Her doctor offered hope in the new chemotherapy drug Tarceva, but the Oregon Health Plan sent her a letter telling her the cancer treatment was not approved.

          Instead, the letter said, the plan would pay for comfort care, including "physician aid in dying," better known as assisted suicide.

          "I told them, I said, 'Who do you guys think you are?' You know, to say that you'll pay for my dying, but you won't pay to help me possibly live longer?' " Wagner said.
          www.wral.com/golo/blogpost/5755842/
          hotair.com/archives/200...not-cure-you/
          www.lifesitenews.com/ldn/200...402.html
          wizbangblog.com/content/20...-life-1.php
          disabilitymatters.blogspot.com/20...tml

          I can't find a local news paper story on it so all I have are links like those.
          Whether they are all repeating each other and spreading a falsehood or if they are correct I can't say.
          It does raise the specter of State sponsored suicide in Oregon.
          and then there is this
          www.oregon.gov/DHS/ph/pas/faqs.shtml
          They call it "Death with Dignity "
          "A: The Death with Dignity Act (the Act) allows terminally-ill Oregonians to end their lives through the voluntary self-administration of lethal medications, expressly prescribed by a physician for that purpose."

          Which sort of puts some teeth in the Barbara Wagner tale.

          • Re: Death Panel: a reality or fiction?

            Tue, August 11, 2009 - 3:01 PM
            "Death With Dignity" is not on the list of procedures approved under the Oregon Health Plan. In any case, it is never offered to a patient, as Wagner claims, you have to request it. And it is only available when the patient is terminal:

            "Only terminally-ill patients who are diagnosed with six months or less to live may request to use the law to hasten their deaths -- and typically only as a last resort as each day becomes increasingly unbearable. The primary physician's diagnosis must also be certified by a consulting physician, which ensures an accurate prognosis and helps prevent mis-diagnoses."

            www.deathwithdignity.org/histo...ns.asp

            Possibly, Wagner had a lower chance than 5% of survival with treatment, and she wanted the treatment anyway. Oregon does not cover such cases.

            www.oregon.gov/OHPPR/HSC/...09PList.pdf

            Possibly, she would have been eligible under Medicaid, if her income were low. For this purpose, many people declare bankruptcy.

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