Help Wanted: Qualified Death Panelists

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    Jan 30, 2013 4:43 PM GMT
    http://blogs.the-american-interest.com/wrm/2013/01/29/help-wanted-qualified-death-panelists/

    It isn’t hard to see why nobody is clamoring to take a job that offers low pay and lots of regulations and will make everyone in the country hate you.

    But it’s been clear from the beginning that this is the kind of thing you get with a massive, centralized health care “fix” like Obamacare: 15 unhappy people in a room making enormously important but impossible to predict decisions affecting a broad and diverse industry (not to mention the lives and health of millions). It’s hard to imagine a centralized approach getting all the nuances of health care right—and we certainly haven’t stumbled onto the miracle cure here.

    If you go for the job, though, try not to dwell on how impossible and unpopular and low-paying your work will be. Instead, think about the fact that you’ll be able to tell your grandkids that you were one of the first death panelists.
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    Jan 30, 2013 4:55 PM GMT
    So, I take it all your family is fleeing Canada because there must be death panels?

    Death panels have been alive and flourishing in the private insurance business since its inception. It's only recently that congress intervened with rules about pre-existing conditions for example.

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  • shutoman

    Posts: 505

    Jan 30, 2013 4:57 PM GMT
    riddler78It’s hard to imagine a centralized approach getting all the nuances of health care right


    It is indeed - but it doesn't have to. It just has to put cost/benefit of pharmaceuticals to public scrutiny in order to do a valuable service.

    Other healthcare providers will still be able to use whatever drugs they want.

    First, surprise surprise. It isn't actually called a death panel. And despite regular contributions on this and other sites talking of 'peath panels' elsewhere, they don't actually exist do they? Using trashy language doesn't exactly bolster a point.

    Second, we have an organisation in the UK called The National Institute of Clinical Excellence. It is, as you point out, extremely unpopular. But it's work is essential protecting the public purse against all sorts of unsubstantiated claims from Pharmaceutical giants who, of course, don't have to release their negative results and who are happy to pay for pages of copy to go into the public domain saying how many lives their, in many cases, unproven but certainly expensive, products will save.

    My guess is you'd be quite keen on public scrutiny of expenditure elsewhere. Why give this industry a free pass? Isn't this exactly the sort of thing the US government should be doing in any case with the existing medicare/medicaid packages?
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    Jan 30, 2013 5:11 PM GMT


    Here's something by a person who was on a private insurer's death panel.


    http://www.opednews.com/articles/Confessions-Of-A-Real-Deat-by-Jillian-Barclay-110720-69.html
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    Jan 30, 2013 7:44 PM GMT
    shutoman said
    riddler78It’s hard to imagine a centralized approach getting all the nuances of health care right


    It is indeed - but it doesn't have to. It just has to put cost/benefit of pharmaceuticals to public scrutiny in order to do a valuable service.

    Other healthcare providers will still be able to use whatever drugs they want.

    First, surprise surprise. It isn't actually called a death panel. And despite regular contributions on this and other sites talking of 'peath panels' elsewhere, they don't actually exist do they? Using trashy language doesn't exactly bolster a point.

    Second, we have an organisation in the UK called The National Institute of Clinical Excellence. It is, as you point out, extremely unpopular. But it's work is essential protecting the public purse against all sorts of unsubstantiated claims from Pharmaceutical giants who, of course, don't have to release their negative results and who are happy to pay for pages of copy to go into the public domain saying how many lives their, in many cases, unproven but certainly expensive, products will save.

    My guess is you'd be quite keen on public scrutiny of expenditure elsewhere. Why give this industry a free pass? Isn't this exactly the sort of thing the US government should be doing in any case with the existing medicare/medicaid packages?


    Of course it isn't called a death panel. But that's effectively what it is. It's different if you give individuals a choice between providers versus forcing them to use the government and being given only one alternative as is the case in for instance Canada. But this is also what you get in the UK -

    http://www.dailymail.co.uk/news/article-2240075/Now-sick-babies-death-pathway-Doctors-haunting-testimony-reveals-children-end-life-plan.html

    How civilized is that?

    I don't give a pass to industry - but this is hardly a real market in the US that works through this convoluted system that fights transparency and competition at every turn. meninlove would have you believe that there is real competition or a free market in healthcare in the US when it is anything but. I don't doubt that change is needed - but what the US is getting is hardly positive change.
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    Jan 30, 2013 8:36 PM GMT
    I love love it when Riddler pulls stuff out of his ass and says 'meninlove would have you believe blah blah blah' in his pompous typing. icon_lol.gif
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    Jan 30, 2013 9:05 PM GMT
    meninlove said

    Here's something by a person who was on a private insurer's death panel.


    http://www.opednews.com/articles/Confessions-Of-A-Real-Deat-by-Jillian-Barclay-110720-69.html


    I don't think he gets it. Not very bright, eh?
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    Jan 31, 2013 12:16 AM GMT
    meninlove said I love love it when Riddler pulls stuff out of his ass and says 'meninlove would have you believe blah blah blah' in his pompous typing. icon_lol.gif


    Except you always seem to enjoy proving me right - thanks for being my foil icon_wink.gif
  • shutoman

    Posts: 505

    Jan 31, 2013 12:27 AM GMT
    riddler78Of course it isn't called a death panel. But that's effectively what it is. It's different if you give individuals a choice between providers versus forcing them to use the government and being given only one alternative as is the case in for instance Canada. But this is also what you get in the UK

    http://www.dailymail.co.uk/news/article-2240075/Now-sick-babies-death-pathway-Doctors-haunting-testimony-reveals-children-end-life-plan.html

    How civilized is that?

    I don't give a pass to industry - but this is hardly a real market in the US that works through this convoluted system that fights transparency and competition at every turn. meninlove would have you believe that there is real competition or a free market in healthcare in the US when it is anything but.



    It always helps if you read the article you're citing, doesn't it?

    What is described here is the practice adopted by certain doctors to allow babies to die 'at home or in hospices' or withdrawing treatment. That has nothing to do with approval of treatment by a government panel. Indeed, the article states that government ministers have ordered an inquiry.

    Guess what? You can, at any stage, elect for you or your child to be treated privately in the UK.Since its inception, there has always been a thriving free market in private healthcare in the UK.

    So what are you saying? That there is no market in the UK (false). That the National Institute for Clinical Excellence approves this treatment - even that it has reviewed this treatment? (also false). That this US panel will have the power to order deaths (false).

    Tell me that private doctors in the US never withhold treatment to dying patients?

    And, crucially, the examples in this article refer only to children whose parents have consented to the withdrawal of treatment.

    The quotation from the top of the inset panel states "They wish for their baby to go quickly. But I know, as they can't, the unique horror of watching a child shrink and die"

    In other words: the problem with this treatment is that children are not dying as quickly as their parents wish.

    How, in fact, does the article you cited relate to your opening question (not at all)?
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    Jan 31, 2013 12:53 AM GMT
    riddler78 saidhttp://blogs.the-american-interest.com/wrm/2013/01/29/help-wanted-qualified-death-panelists/




    Dude, I just have to say your "source" is completely laughable. Right wing much icon_rolleyes.gif
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    Jan 31, 2013 12:57 AM GMT
    Being a Republican is being a death panelist, since they promote death to gays.
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    Jan 31, 2013 2:42 AM GMT
    dudewithabeard said
    riddler78 saidhttp://blogs.the-american-interest.com/wrm/2013/01/29/help-wanted-qualified-death-panelists/




    Dude, I just have to say your "source" is completely laughable. Right wing much icon_rolleyes.gif


    Walter Russel Mead is a Democrat - so laugh away:
    http://en.wikipedia.org/wiki/Walter_Russell_Mead

    Shutoman - my reference was more to the attempts at cost control. Sorry I was not more precise. At least with private industry you can have competition but the way the industry is structured in the US, yes you do have industry death panels. I don't think anyone is denying that the way the US healthcare system is, is remotely ideal.

    The idea though that you have hospitals and doctors seeking to achieve cost containment by putting people and babies on death pathways is appalling - and that's the issue. The issue here is whether or not parents were encouraged to provide consent in order that the hospitals achieve their budgetary constraints.
  • shutoman

    Posts: 505

    Jan 31, 2013 12:49 PM GMT
    riddler78The idea though that you have hospitals and doctors seeking to achieve cost containment by putting people and babies on death pathways is appalling - and that's the issue. The issue here is whether or not parents were encouraged to provide consent in order that the hospitals achieve their budgetary constraints.


    You cannot put babies or anyone else on 'death pathways' in this country. You can, however, withhold treatment if there is no prospect of recovery but, of course, it is the parents and/or relatives who have to give informed consent.

    The investigation here is that parents and relatives have not been informed. That is potentially a crime at common law, certainly a civil suit and also a breach of the Code of Practice under the Mental Capacity Act. Do we have one example in this article of someone who said 'I didn't want my baby to die, but they encouraged me to save costs' No.

    But, speaking as an insurance lawyer in the UK Life & Health sector. I can tell you that a free market CANNOT protect against this practice happening.

    If it is in an insurer's interests to reduce costs by endorsing a treatment such as this then they have an incentive to do so. It is not an incentive to which they should pay attention but - on a rational economic basis - they have good reason to make this encouragement. The market here works against the interests of the vulnerable patient.

    This is an area about which I know something up close and personal, and I have recently also completed a Masters in Medical Ethics and Law. I am not remotely suggesting that this makes my view any more valid than yours; but my experience tells me that this is an area where a "free market -v- state provision" slog out rarely covers the detail.

    May I ask you to consider carefully whether the use of death panel here is appropriate? This panel will only be approving, after all, treatment which many people in the US have simply not been able to receive until now.
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    Jan 31, 2013 1:57 PM GMT
    Of course it's not appropriate.

    http://en.wikipedia.org/wiki/IPABIPAB was created as a strengthened version of the Medicare Payment Advisory Commission (MedPAC), a body with no regulatory power that solely advises Congress, but can not enact regulations in and of itself. Since 1997, MedPAC had recommended cuts totaling "hundreds of billions of dollars" to Medicare that were ignored by Congress.[2] Also, Congress has pressured Medicare administrators to cover "ineffective or needlessly costly methods of care", while Medicare's founding legislation says "Nothing in this title shall be construed to authorize any Federal officer or employee to exercise any supervision or control over the practice of medicine".[3] Henry J. Aaron, a health care expert at the Brookings Institution, says that many observers see that some in Congress are "in thrall to campaign contributors and producers and suppliers of medical services" and most are not well enough informed to wisely use Medicare's buying power to reform health care.[3] The idea behind the IPAB was to take power away from Congress (and special interests[4]) in order to give it to those knowledgeable in health care policy.


    Where are these savings going to come from?

    http://www.washingtonpost.com/blogs/wonkblog/wp/2013/01/30/how-to-cut-9-4-trillion-from-medicare-in-150-easy-steps/For health policy wonks, the list of options won’t be terribly surprising. The approaches break down into five broad categories: Eligibility, doctor payments, delivery system reform, program structure and, last but not least, administration.
  • shutoman

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    Jan 31, 2013 5:45 PM GMT
    Thanks Q1W2E3 - useful.
  • GQjock

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    Feb 01, 2013 1:25 PM GMT
    Qualified death panelists?

    I don't know if they are qualified or not but my little clueless friend we have them now

    What do you think happens now when a physician or a hospital tells a patient that this treatment or that is not covered?
    Do you think that the money just appears out of the benevolence of the community ..... or the patient who cannot afford the treatment becomes sicker and/or eventually dies?

    No what this Heathcare Act will do is take the monetary portion of this decision making and place it into the hands of healthcare professions who will determine the correct choice of treatment or if treatment is no longer possible.... something that is being done every single day every day of the week already in hospitals across the country ...... it's called hospice care
  • musclmed

    Posts: 3271

    Feb 01, 2013 3:32 PM GMT
    [quote][cite]shutoman said[/cite]
    riddler78The idea though that you have hospitals and doctors seeking to achieve cost containment by putting people and babies on death pathways is appalling - and that's the issue. The issue here is whether or not parents were encouraged to provide consent in order that the hospitals achieve their budgetary constraints.


    I am curious why does the UK need a Health insurance Lawyer? who do you represent patients or the government?

    In the U.S in general decisions made by the government or bureaucrats are exempt from legal causes of action.
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    Feb 01, 2013 4:38 PM GMT
    shutoman said
    riddler78The idea though that you have hospitals and doctors seeking to achieve cost containment by putting people and babies on death pathways is appalling - and that's the issue. The issue here is whether or not parents were encouraged to provide consent in order that the hospitals achieve their budgetary constraints.


    You cannot put babies or anyone else on 'death pathways' in this country. You can, however, withhold treatment if there is no prospect of recovery but, of course, it is the parents and/or relatives who have to give informed consent.

    The investigation here is that parents and relatives have not been informed. That is potentially a crime at common law, certainly a civil suit and also a breach of the Code of Practice under the Mental Capacity Act. Do we have one example in this article of someone who said 'I didn't want my baby to die, but they encouraged me to save costs' No.

    But, speaking as an insurance lawyer in the UK Life & Health sector. I can tell you that a free market CANNOT protect against this practice happening.

    If it is in an insurer's interests to reduce costs by endorsing a treatment such as this then they have an incentive to do so. It is not an incentive to which they should pay attention but - on a rational economic basis - they have good reason to make this encouragement. The market here works against the interests of the vulnerable patient.

    This is an area about which I know something up close and personal, and I have recently also completed a Masters in Medical Ethics and Law. I am not remotely suggesting that this makes my view any more valid than yours; but my experience tells me that this is an area where a "free market -v- state provision" slog out rarely covers the detail.

    May I ask you to consider carefully whether the use of death panel here is appropriate? This panel will only be approving, after all, treatment which many people in the US have simply not been able to receive until now.


    Doctors and hospitals are in the position as experts and authorities in advising parents as to what the best available options are. Do you deny this? If you don't then how can you not see that it is a plausible scenario that some were guided down this path in order that the doctors/hospitals meet certain targets? That's what this article suggests.

    In a competitive market, there's at least the choice that is made with transparency. Insurers can cater to different segments of the market and you tend to get more of what you pay for - while in a public scheme, it is a one sized fits all provider. You seem to equate your existing standard with a free market - and while I am not knowledgeable of the specifics of the NHS, there's a large body of articles on its failings quite easily googled.

    As for the use of the death panel in the US? Yes - given that the public options are one size fits all and there are specific standards that are being regulated with an eye towards cost containment and removing consumer choice - yes. What's worse is that it is not likely that Obamacare will even make it cheaper for healthcare in the US - in fact, the opposite as has been predicted and appears to be developing already as it gets implemented.

    And are these treatments that the panel is approving ones that "many people in the US have simply not been able to receive until now"? Yes and no.

    Death panels seems like the appropriate name for the bureaucracy that decides whether or not treatments should be approved with an eye towards cost containment:
    http://www.usnews.com/opinion/articles/2012/12/10/the-truth-behind-obamacares-death-panels
  • shutoman

    Posts: 505

    Feb 02, 2013 9:44 PM GMT
    musclmedI am curious why does the UK need a Health insurance Lawyer? who do you represent patients or the government?

    In the U.S in general decisions made by the government or bureaucrats are exempt from legal causes of action.


    As I said above, there is a thriving market in health insurance in the UK and there always has been. Health insurance is usually taken out in the UK to cover elective surgery (the waiting list is much shorter for private cases) and because some people want to be treated in private hospitals where, for instance, you will certainly get a private room. Speed of treatment is the overwhelming reason.

    From the beginning of the NHS 'Consultants', the most senior grade of doctor, have been permitted to balance private work alongside their NHS obligations.

    I work for insurers. But I am still supportive of the NHS, as are nearly all the Life & Health insurers I know. That's not to say that it should be immune to change; but I read some of the online stuff about social medical provision generally and the NHS in particular and I not only do not recognise it, I am staggered at the misrepresentation and the highly selective debate. The citing in the US of 'NHS death panels' is precisely the sort of shoddy debate that bemuses those of us in Canada, UK, NZ, Australia and the other places which have these systems.
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    Feb 02, 2013 9:57 PM GMT
    shutoman said, "I am staggered at the misrepresentation and the highly selective debate. The citing in the US of 'NHS death panels' is precisely the sort of shoddy debate that bemuses those of us in Canada, UK, NZ, Australia and the other places which have these systems."

    I was as well, but not after getting to understand the agendas of those that promulgate those shoddy debates.

    Two things to consider when reading their posts:

    "I got mine, fuck you" attitude cleverly hidden by concern for economics.
    "Health care is a privilege and a status symbol" cleverly hidden by claims the poor are poor out of laziness etc.

    ...another thing to consider is that they may very well have shares in the for-profit-in-ever-greater-and-endless-amounts private system of insurers.

    icon_wink.gif


    PS Had Obamacare been implemented by a Republican gov't, these guys would have no posts decrying it. For example, our Conservative majority gov't has stated it is committed to Universal Healthcare and not a peep or topic out of Riddler.
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    Feb 02, 2013 10:12 PM GMT
    yourname2000 saidCan't we all just vote to kill Riddler and be done with all this shite?? icon_confused.gif


    rolf, no.

    I suggest we wait til the inevitable day comes when he needs those 'entitlements' he sneers at. Now that will be an interesting day. icon_lol.gif
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    Feb 02, 2013 10:17 PM GMT
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  • coolarmydude

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    Feb 02, 2013 10:58 PM GMT
    yourname2000 said
    meninlove said
    yourname2000 saidCan't we all just vote to kill Riddler and be done with all this shite?? icon_confused.gif


    rolf, no.

    I suggest we wait til the inevitable day comes when he needs those 'entitlements' he sneers at. Now that will be an interesting day. icon_lol.gif

    Does China have entitlements? icon_confused.gif


    icon_lol.gif
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    Feb 03, 2013 4:20 AM GMT
    meninlove said shutoman said, "I am staggered at the misrepresentation and the highly selective debate. The citing in the US of 'NHS death panels' is precisely the sort of shoddy debate that bemuses those of us in Canada, UK, NZ, Australia and the other places which have these systems."

    I was as well, but not after getting to understand the agendas of those that promulgate those shoddy debates.

    Two things to consider when reading their posts:

    "I got mine, fuck you" attitude cleverly hidden by concern for economics.
    "Health care is a privilege and a status symbol" cleverly hidden by claims the poor are poor out of laziness etc.

    ...another thing to consider is that they may very well have shares in the for-profit-in-ever-greater-and-endless-amounts private system of insurers.

    icon_wink.gif


    PS Had Obamacare been implemented by a Republican gov't, these guys would have no posts decrying it. For example, our Conservative majority gov't has stated it is committed to Universal Healthcare and not a peep or topic out of Riddler.


    Good point. It was a REPUBLICAN-controlled White House and a REPUBLICAN-controlled House and Senate that gave us Medicare Part D, the prescription benefit (without paying for it of course despite today's claims that they are the party of fiscal responsibility) in 2003. Where were all the right wingers' concerns and outrage then??
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    Feb 03, 2013 4:51 AM GMT
    To sfbayguy, just imagine the thunderous roar of outrage had Sir Bush NOT implemented that part D plan and then later Obama does. icon_lol.gificon_lol.gificon_lol.gif

    Another example: If the Obama gov't stated that immortality with perfect health had been discovered and that everyone could get a one time pill, the Right on here would scream that it was a trick to get you all to pay taxes forever. icon_lol.gif