Showing posts with label rationing. Show all posts
Showing posts with label rationing. Show all posts

PostHeaderIcon Death & cost of terminal care are still taboo among many patients

8/25/2009 | Posted by mesiamd | Edit Post


The provision of reimbursing time given by physicians to counsel patients on end-of-life issues elicited unease and horror among many Americans. Sen. Sarah Palin spoke against it in terms of “death panels” and others thought the measure was a step towards euthanasia. Such fear is expected. The Obama administration debunked these fears as myths.

The public has been reluctant to talk about advance directives, health proxies, and power of attorneys as “rationing” loomed. If money becomes too tight in the healthcare budget, control on who gets the services may be inevitable in USA.

Not representing the majority of US licensed physicians, the American Medical Association (AMA) believes compensating MDs to discuss options of a terminal patient is OK. It saves on expenses while clarifying voluntarily issues about the death process. Upon request however, free advice on life and the dying has been available in medical care since time immemorial. Why then does the government want to shell in additional money for counseling when it is part of healthcare all along? Obviously, money has something to do with it.

“Studies have shown that the 5% of Medicare patients who die each year account for 30% of Medicare's costs, with 78% of last-year-of-life expenses occurring in the month before death. A March 9 Archives of Internal Medicine study of 603 dying cancer patients at seven hospitals, oncology clinics and hospices found that care for patients who had end-of-life discussions with their physicians cost $1,295, compared with $2,780 for patients who did not have such talks.

Anthony L. Back, MD, professor of oncology at the University of Washington School of Medicine and an oncologist at the Fred Hutchinson Cancer Center,said “encouraging physicians to have extended counseling sessions with their patients through the Medicare system could help patients get the care they want at the end of their lives while saving the health system money.”---AMA News. (08/24/09, O’ Reilly KB)

The counseling supported by AMA may remove barriers and misconceptions in tackling death, but there are practically no rules on what and how the doctor will share his advice. Physicians are inadequately trained on dispensing end-of-life advices. There is a possibility that patients and their relatives may be pressured in their decisions. =0=

RELATED BLOGS: AARP loses 60,000 members in July-August 2009 Posted by mesiamd at 8/18/2009; Sen. Sarah Palin stirs the healthcare debate with her warning of the “death panel” Posted by mesiamd at 8/15/2009

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PostHeaderIcon Legislation stalled: Americans question Obama's healthcare overhaul plan

7/24/2009 | Posted by mesiamd | Edit Post


The attempt of Pres. Barack Obama to hasten the approval of his universal health care plan met significant opposition when Senate majority leader Harry Reid (D-Nev.) announced the floor will take up the contentious matter after the August recess. At the earliest, the legislation will be voted, in September 2009 to allow time for legislators and citizens to think.

“Obama envisions legislation that would, for the first time, require all Americans to be insured. A new government insurance program would compete with private insurers, and insurance companies would be barred from excluding people with pre-existing conditions. The goals are to hold down costs and extend coverage to most of the 50 million uninsured. The price tag: $1 trillion-plus over a decade.”----AP (07/24/09, Werner, E.)



But a growing number of citizens and leaders from both sides of the political aisle are questioning the huge price tag of healthcare overhaul plan----exactly the reason why USA is pushing for a change. Many are resentful, appalled and worried that the reform will lead to rationing of medical services as 47 uninsured will be included. The danger of overtaxing the system is there---leaving doctors, nurses and caregivers overworked, underpaid, and unable to deliver the quality of care America expects.

Taxes which Obama promised to keep low, are likely to rise astronomically to subsidize at least 10 million illegal aliens who will crowd the system. The elderly and disabled may suffer denial or delays of service as the government wants to give the young and socially productive the priority in health services.

Through government machinations planned by a few supposed medical experts, many tests, procedures and treatments are in danger of being denied from the seriously sick, chronically ill, and those who suffer from rare diseases. This practice has begun even in the current system and is expected to be greater when the Obama plan takes effect.

Doctors often complain of being slowed by insurance disapprovals and delays to the detriment of their patients' health. Reimbursements of claim from medical services have been cut or denied on top of over-regulation. People have suddenly realize the creeping interference of government in their lives.

So therefore, it is easy to understand why enough time must be given for study and deliberation before a decision is made. There are reasons to doubt Obama and his contentious plan. As it is, his proposal for reform doesn't fly with the people he wants to serve (53% disapproved vs. 46 approved as one recent poll shows.)(Photo Credit: Reuters/ US Health Politics/ Reed, J; AP/ Burke, LV) =0=

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