Medicare to Cover End-of-Life Planning Talks By Emily P. Walker, Washington Correspondent, MedPage Today
WASHINGTON -- Starting Jan. 1, Medicare will reimburse physician discussions with patients about end-of-life treatment options -- a provision Democrats had to drop to get healthcare reform passed.
The new regulation requires only that Medicare cover end-of-life consultations for patients who want it. The "voluntary advance care planning" language was included in a regulation issued in early December that deals with annual wellness visits.
The regulation was issued quietly, the New York Times reported, in hopes of avoiding the hue and cry raised early in the reform debate when opponents claimed such counseling would create "death panels."
The new Medicare rule will pay for elective annual discussions about end-of-life plans, which can, in turn, be used to prepare an advance directive stating what treatments a patient would want and treatments they would not want.
In contrast, the provision that ignited the firestorm of rhetoric in 2009 would have paid for such consultations every five years.
House Minority Leader John Boehner (R-Ohio) chimed in a week later, saying the bill would "start us down a treacherous path toward government-encouraged euthanasia if enacted into law."
The "death panel" label was given to such counseling sessions by former Alaska governor and Republican vice presidential candidate Sarah Palin who alleged they would pass judgment not only on older people's right to healthcare, but on others' as well.
-------- Who to believe, who to believe. Is this the initiation of "death panels" and government encouraged euthanasia - or - is it an act of magnanimous politicians because they love and respect us so darn much.
I lean toward the former, and Palin is correct, end-of-life won't be just for seniors. End of Life Planning will eventually cover everyone insured by Big Daddy Government. Big D sees the coming tsunami of much younger folks in poor health. Those younger folk afflicted with major disabling lifelong health problems due to obesity, drugs, alcohol, promiscuity, craziness, laziness, bad backs and mood disorders. "Disability" like so many social programs has fast become a career, a generational lifestyle. One in 19 Americans today, give it another decade. The trend now is not only ill health for yourself - but for all the kids in the family. Bipolar babies. It's not hard to find physicians who go along with it.
There will be no shortage of healthcare professionals willing to counsel the space wasters that they really should die sooner rather than later. Not that bluntly of course. And if you think HMO physicians liked those end-of-year bonuses for cutting costs, just wait until Big Daddy rewards physician performance.
Will Big Daddy really want to cover a kidney or heart transplant for 30-somethings who weigh 300+ pounds, having already spent a small fortune on years of medical care for hypertension, hyperlipidemia, diabetes, depression, insomnia, asthma, knee replacements. Will Big D want to spend a million dollars on medical care for the 40-year-old Neanderthal who was badly burned when his meth lab exploded? Will Big D continue to spend millions on preemies or trauma victims who's future will be decades of drooling on an air mattress in front of the TV?
"Palliative" or comfort care options will be a burgeoning field. Keep you high 'til you die. And you will call it the best in modern medicine. I call it one helluva an undignified and unnatural method to cull the herd of the deadbeats, the stupid, the poor, the unproductive. Pols and pundits are con artists. Swindlers, exploiting the confidence of their victims. Death panel is ominous so I'm curious as to what warm fuzzy phrase will be used to describe your SOL options.
The current bill contains a "utilization review program" which on the surface sounds protective of patient's rights. But basically, and this is already SOP, what it means is the utilization review department, the medical staff, and the hospital/government administrative bodies will work in close harmony to survive these trying economical times, and ... oh, yes, serve your healthcare needs, and in that order. (Name one government program that has not been perverted from its original intent.)
Tuesday, December 28, 2010
Medicare to Cover End-of-Life Planning Talks By Emily P. Walker, Washington Correspondent, MedPage Today
Monday, December 20, 2010
Alan Bock: Things we shouldn't have had to learn from WikiLeaks. December 17, 2010|By ALAN BOCK
"There have been expressions of alarm over the possibility that the release of diplomatic cables by WikiLeaks could endanger Americans and others, notably human-rights activists in other countries, leaving WikiLeaks founder Julian Assange "with blood on his hands." To date, however, the government has not described a single instance of a life being endangered, or even of a diplomatic initiative threatened, by the document dumps – which you know it would do if it had a credible example.
I'm not saying there aren't a number of things the government justifiably should keep secret, but I've come to believe it's a fraction of what is actually classified. When I worked in the nation's capital in the 1970s, including three years as a congressional aide with limited access to classified material, I got the distinct impression that a significant reason for classifying so much information was to give those with access a boost in self-esteem; yes, they were entrusted with facts about the nation's business that were so vital, only they could know. I can't tell you how many times at cocktail parties staff members, state department workers and others would explain that if we knew what they knew, but which, unfortunately, they couldn't tell us, we wouldn't be questioning policies or actions so vigorously. Out of curiosity I tracked down a few such boasts and found them to be bogus or bravado."
----- Ever notice when someone wants to sound knowledgeable on secret government stuff they always mention they worked X number of years in government, etc. etc.
Of course the amount of material that is classified is much larger than what should be, but not to boost the self-esteem of low level staffers and diplomats so they can feel important at cocktail parties. It's done our of sheer laziness. It's easier to stamp classified or confidential on most everything than to actually make an honest determination and accept responsibility.
If the Assange supporters are correct and the leaks endanger no one - then basically Assange is a dufus, boasting like a puffed up government employee at a D.C. cocktail party, but letting us know the secrets he knows.
According to WaPo Wikileaks "unveiling" of State Department cables exposes the inner workings of U.S. diplomacy. Oh my. Putin is described as an alpha-dog. Karzai is driven by paranoia. Angela Merkel allegedly "avoids risk and is rarely creative." Silvio Berlusconi is "Putin's mouthpiece" after receiving "lavish gifts."
Classified gossip, opinions, or assessments that should remain out of the public realm? Death to diplomacy? Would you want to have a sit down with someone who thinks you're a bit cowardly and uncreative, or a mouthpiece, or a paranoid.
Bock writes: "To date, however, the government has not described a single instance of a life being endangered, or even of a diplomatic initiative threatened, by the document dumps – which you know it would do if it had a credible example."
You know, wikileaks began redacting heavily after its initial leaking. (The military was in the process of notifying some 300 Iraqis whose names were in the documents. You think all 300 dodged that bullet?)
I can think of a couple of reasons the government has not given a single instance. One, the dumps are petty ... crappola ... making Assange yet another among many bogus heroes. Or two, the government, being slow and incompetent, will have a credible "instance" in the future but by that time it will matter only to the person it directly effected - as the crappolistas will be busy unveiling the newest peoples' hero to fill the chattering lives of on-line forum fighters who haven't a clue to what is going on under their nose.
Hopefully, Assange will wikileak those secrets from Russia and China that he claims access to. Although he may end up eating polonium if he does.
Posted by Kate-A at 11:44 PM
Sunday, December 05, 2010
It is amazing how quickly the months pass when giving only cursory attention to the world outside my window. After 5 years of blogging it is pretty much the same ol' same ol' as far as politics and society are concerned. Same reelection of the same corrupt unethical pols, same "outing" of the "truth" by the same old and new players who "speak truth to power." Yawn. Same cinematic reruns.
But, let us hope that we are not subjected to a second term of Reverend Obama the Impotent, or worse yet, a 4 year stint of the rather empty-headed nasal twanging Palin. Both who's stars have burnt, flashed in the pan, but who likely will have lifelong careers in the public limelight - if media moguls deem it so.
Are Palin and Newt the Gingrich the best the republicans have to offer? Who in their right mind would recycle the check kiting Newt, who is as unethical as his democratic counterpart Charlie Rangel, both reelected term after term no matter how many times they are smacked on the wrist. Although granted, Newt is a major producer of conservative Christian propaganda and contracts on America, while Charlie is just your typical pimp and porker working hard for "monuments named after me", cleaning up the Harlem that is never cleaned up, supporting Israel, etc.
What the heck - like all pols, nothing is a disgrace anymore - unethical and immoral is merely an error of omission, a lapse in judgment. Folks don't lie anymore - they misspeak. Folks don't get caught with their hand in the till anymore - they thought the till was their legal personal fund. Folks don't bribe, coerce, or extort anymore - they schmooze for the good of all mankind.
And for those folks who cannot squirm out of trouble, are caught red-handed, have to admit wrong doing, whatever their income bracket, society has an excuse - they couldn't help themselves (insert a syndrome). They're not really evil or dastardly - you just failed to give them universal healthcare to repair their heads being screwed on wrong.
News programs, most evenings, a pundit will mention that "republicans and democrats must come together." That line, as so many others, is so worn out. They are working together - to their own elitist benefit.
Also on a quarterly or annual basis, the crypt keepers Poppa and Barb Bush issue sound bytes of supposed wisdom and warm nostalgia. As does Bill Clinton with his W.C. Fields nose, and the up and coming statesman George Junior Bush who may finally have faked sobriety so long that he really is sober, or perhaps slick Willie has coached Dubya on how to be a highly functioning drunk skunk.
I still shake my head at the level of stupid that is displayed in the media, socially and politically. Movies, music, television, print. For me, it's similar to watching a horror show - I don't like it and don't go out of my way to see it, hear it, or read it, but I usually cringe through to the end. Then swear for wasting my time.
The phoniest shows are labeled "reality" TV. Ghost hunters are taken seriously when they catch a blur or crackle on film or audio, haunted houses and ghosts of animals are real. Jesse Ventura theories are taken seriously - why not, Jesse once fought the predator with governor Arnie of California. Meathead entertainers turned politicians.
And who knew there were so many women who didn't know they were pregnant until the newborn dropped in the toilet? Who knew that 16 and pregnant would get your 15 minutes. Who knew fame could come from shopping, ho'ing, petty drama and cat fights, or being bored housewives.
Who would have thought that sleazy skanky folks with no talent could be nipped and tucked into celebrityhood. Or worse, the fat, the bony, the inked up who are Revlon-ed and Cover Girled, and sold as having the talent and bravery to be repo men and women, or chasing bad guys around their mama's house.
How many episodes can anyone really watch of Dog Chapman stalking meth heads and petty thieves. How many episodes of the greasy Kardashians - and now, god help us, David Hasselhoff, the slobbering cheeseburger eater. Commercials for the "Hoff" have a toddler running along the beach with a hairy chest - an oddly perverse way to claim that "some people are born awesome" - seems most folks think the ad is "cool" and "funny" but that's to be expected from a public with a spiraling double-digit I.Q.
Who knew that so many would be so famous for so little.
You know, as cynical as I may appear I did have hope for the Republic, but I can only conclude that folks who pay more than a little attention to anything going on today are either under the influence or were dropped on their heads in childhood. If the garbage that fills the media is a reflection of our political and social ideals - then abandon hope all ye.
Posted by Kate-A at 9:18 AM
Thursday, December 02, 2010
Juke joint (or jook joint) is the vernacular term for an informal establishment featuring music, dancing, gambling, and drinking, primarily operated by Blacks. The term "juke" is believed to derive from the Gullah word joog, meaning rowdy or disorderly. It could also derive from the Irish language "deoch dionta" (drinking roofed place). Classic juke joints found, for example, at rural crossroads, catered to the rural work force that began to emerge after the emancipation. Plantations workers and sharecroppers needed a place to relax and socialize following a hard week, particularly since they were barred from most white establishments by Jim Crow laws. Set up on the outskirts of town, often in ramshackle buildings or private houses, juke joints offered food, drink, dancing and gambling for weary workers. Owners made extra money selling groceries or moonshine to patrons, or providing cheap room and board. (Wiki)
Minnie Memphis - Kissin' in the Dark
It Was You Baby
Posted by Kate-A at 11:01 PM