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Tracking the next pandemic: Avian Flu Talk

The Death Panels - Realities of Obamacare

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Medclinician2013 View Drop Down
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    Posted: November 09 2013 at 8:45am
After going through considerable portions of the actual bill passed and being implemented the concept of doctors deciding a person is not worth treating because of age and life expectancy is a reality to come, it was a very disturbing and depressing thought. As a post-op open heart 3-way bypass and heart reconstruction with various surgeries needed to keep me alive, my prognosis even to live to see 2014 are not all that great.

http://www.usnews.com/opinion/articles/2012/12/10/the-truth-behind-obamacares-death-panels

The concept of counseling people while planning to deny medical treatment is chilling. It reminds me of a Stanford doctor at the VA coming towards me and stopping to say -

"Your father is dead. His kidneys were failing. It would have been a hardship for him to come for dialysis versus allowing him to pass away. At 86 he had a long life and it was his time."

It was the doctor's decision to let him die.

If the elderly are denied health care because they are elderly and are not, as determined by a Death Panel, worth saving, millions will die in a very short period.

The rich will continue to receive health care, even if they are old.  Although ranting about Death Panels is one of Sarah Palin's mantras and she was laughed off the stage for predicting what would happen after reading the health care bill.

http://www.breitbart.com/Big-Government/2013/11/06/Sarah-Palin-knew-a-death-panel-when-she-saw-one

With a possible H7N9 Pandemic approaching, and new data  on triage deciding who will share the few respirators out of thousands who may need them, the issue may become a moot point if the health care system collapses.

A patient may have the right to die as they become old and have expensive health problems, but should not have the obligation to do so to help cut healthcare costs. 

Medclinician
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Satori Quote  Post ReplyReply Direct Link To This Post Posted: November 09 2013 at 9:04am

you raise a lot of hard questions


Health Care Costs in the Last Week of Life: Associations with End of Life Conversations

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2862687/


"U.S. health care expenditures exceeded $2 trillion in 2006 and are expected to rise rapidly over the next decade.1 A disproportionate share is spent at the end of life (EOL): 30% of Medicare expenditures are attributable to the 5% of beneficiaries who die each year;2 about one third of the expenditures in the last year of life is spent in the last month.3 Previous studies have found that most of these costs result from life-sustaining care (e.g. ventilator use and resuscitation), with acute care during the final 30 days of life accounting for 78% of costs incurred during the final year of life."


How Much Do We Spend on End-of-Life Care?

http://www.thirteen.org/bid/sb-howmuch.html


"Medicare, the health insurance program for the elderly, spends nearly 30 percent of its budget on beneficiaries in their final year of life. Slightly more than half of Medicare dollars are spent on patients who die within two months."


does spending MASSIVE amounts of money

that we do not have

make sense in these situations ???


would I want to bankrupt my family

by futile spending in my last few days ???


SOMEONE has to pay

is society willing to see serious increases in taxes to pay for

care that will fail ???


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Post Options Post Options   Thanks (0) Thanks(0)   Quote Elver Quote  Post ReplyReply Direct Link To This Post Posted: November 09 2013 at 10:32pm
My mother was hospitalized 4 times during the last 3 years of her life.  She had a broken hip which required pins to be put in.  She suffered from carbon dioxide buildup in her lungs due to her COPD.  She had an aorta aneurysm repair. And she had to be intubated for pneumonia just 5 months prior to her death.  Each hospital charged in excess of $90,000 for each of the 4 weeks that she stayed there.  She was also hospitalized 8 years prior to her death for colon cancer.  All of these bills in total were absolutely huge!
 
My mother-in-law was recently hospitalized twice.  The first time was after having several strokes.  The second time was for extremely high blood pressure.  She spent 6 weeks in rehab twice for these two events or 12 weeks of total rehab.  She's had countless doctor visits since last April for blood pressure, thick blood requiring blood thinners, disk issues in her back, etc.  In fact, she's been to a doctor every single week since 4/15! 
 
The costs of elder care during not just the last year of life, but several years of life are exorbitant.  Instead of letting people suffer prior to death because our government doesn't want to expend the money treating them, then we should offer euthanasia for the sick elderly.  However, when your own life is on the line I'm not sure many people would opt for this.
 
1980's Colorado Governor Richard Lamm said this years ago.
Elderly people who are terminally ill have a ''duty to die and get out of the way'' instead of trying to prolong their lives by artificial means.
 
''You've got a duty to die and get out of the way,'' said the 48-year-old Governor. ''Let the other society, our kids, build a reasonable life.''
 
I think our ex governor would be about 78 about now.  I wonder if he feels the same way.
 
The problem with our government deciding our fate for us is that nobody can predict just how long someone would live after a major medical event.  My mom's colon cancer surgery was 8 years before her death.  She was 79, past the Obamacare age limit of 75.  If they denied her cancer surgery back then she would not have lived the remaining 8 years. 
 
The problem as I see it is not really how many medical treatments one receives in the last years of life, but the $90,000 hospital bills for each week they are there.  These bills are absoluely ridiculous and until they do something about what hospitals and doctors charge we're all screwed when we get old.  How could any hospital justify a $90,000 bill for an aorta aneurysm repair surgery lasting 1.5 hours, 2 days of instensive care and 5 days of laying in a semi-private room?  NOTHING!
 
What justifies a $5,000 hospital bill for spending no more than 3 hours in an emergency room to get fluids following a blood pressure drop?  NOTHING!  $5,000 for 3 hours in a hospital getting fluids is absolutely RIDICULOUS!!!
 
What justifies a $200 doctor bill for a 15 minutes visit to be weighed and have your BP and sugar level checked?  NOTHING! 
 
While it's true that some elderly, such as my own mother, have several hospital visits during her final years of life, there is NOTHING THAT JUSTIFIES WHAT DOCTORS AND HOSPITALS ARE CHARGING!  GREED IS RUINING OUR HEALTHCARE SYSTEM.
 
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Those high costs are due to liability issues caused by to many greedy lawyers and outlandish awards by juries.
 
 
He died and was resurrected on the third day
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That is another distortion of the facts.  Liability costs are high but the major cost driver in medical care.  It is cost shifting (uninsured costs get passed to insured).  In the profit and fee for service system, hospitals are rewarded for over testing and procedures.  I was having chest pain and when to the emergency room.  I received very good care over the 20 hours I was there, but the cost was $15,000.  Had I have known the cost before going in, I would have waited longer.   In the 20 hours if I measured the labor costs, I would say there were about 10 hours of actual face time with everyone involved.  At $200 per hour that would be $2,000.  Other variable cost clothing, food, IV's were probably $1,500 assuming super expensive saline, tubing, chest pads, aspirin, linens etc.  If the fixed costs are spread over the variable costs that means  15,000/3500 =  428% OH on variable costs.  There is either terrible fixed cost control, or under utilized fixed assets.  I think it is probably both.     
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Who said the rich will live and all others will die is correct. Wait a year or two and good doctors will be concierge doctors. You will have to pay 2K a year just to see a doctor. But you will see a doctor in time.

Hospitals will go that way too. If you can't pay 5-10 K to be a concierge patient to get your operation you will wait a year or two and may die waiting.

It is the middle class that elected Obama that will be most effected by Obamacare. They elected him and they will have family die because of their vote. People get what they deserve.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Satori Quote  Post ReplyReply Direct Link To This Post Posted: November 15 2013 at 10:58am

very good end of life article


The true cost of end-of-life care


http://americablog.com/2013/11/true-cost-end-life-care.html


I've seen this scenario play out a thousand times

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Medclinician2013 Quote  Post ReplyReply Direct Link To This Post Posted: December 29 2013 at 7:07am
http://www.cnn.com/2013/12/28/health/life-support-ethics/index.html?hpt=hp_t3

And so a part of Obama care not well publicized but in the plan nudges closer to reality as we near January 1, 2014 -- The Death Panel

Long ago I posted online of Terri Schiavo and talked to her relatives. It was a widely publicized case

Both these situations are distinct from brain death -- according to the Uniform Determination of Death Act, an individual is dead when he or she "has sustained either (1) irreversible cessation of circulatory and respiratory functions, or (2) irreversible cessation of all functions of the entire brain, including the brain stem."

"It seems like there seems to continue to be confusion about what it means to die using neurologic criteria," said Cynda Hylton Rushton, professor of clinical ethics at Johns Hopkins University.

Rushton suggests, in fact, that this phrase "die using neurological criteria" be used instead of "brain death," to emphasize what it means.

http://www.catholicapologetics.info/morality/medicalethics/brain.htm


The real issue here behind the scenes is not the morals or correctness of cessation of life support. It is the harvesting of organs and extension of costly medical care expensive to individuals who show little promise of recovery and when the value of human life is less than the value of the cost to prolong it.

Now this becomes a reality as the implementation of the hammer of Obamacare nears New Year'ss.

http://www.mercurynews.com/opinion/ci_24803245/mercury-news-editorial-no-one-recovers-from-being


Having worked in the medical profession for 30 years, I have seen up close and personal, a brain dead person.  Under my care as a medclinician, in ICU, was a young man who had truly gone into a body that was disfigured and a wrenching situation for the relatives who came everyday to talk to and be with this person. Mercifully, at that time, the person died after two months on life support.

However, the realities of the cost of human life versus termination of that life are the very hint of what is to come.

So the question for readers and posters is --  hidden in this law are there provisions that people with less than five years life expectancy--  be given medical treatment and where will the dividing line fall?

It was predicted that the baby boomers who be some of the first to age and find themselves in a world of declining health care with shades of Soylent Green.

http://www.medicalnewstoday.com/articles/182951.php

It isn't the implementation of euthanasia that is the real issue. It is the continuing reduction of medical care for those determined not worth attempting to save and the panels that will make this determination.  For some, who may not this, it becomes up closer and personal.

The reality --

http://www.usnews.com/opinion/articles/2012/12/10/the-truth-behind-obamacares-death-panels


Do we near the final line of the much quoted  the A.A.  line"and the wisdom to know the difference"? Perhaps. we have.

Will the youth of America rally support the old who to many seem to have lost their ability to contribute and be part of life, versus their right to die in peace and dignity ?  This is the topic for debate. Have we reached points of no return in American health care as we near New Year's?

Begging the question?

What of those hit by Flu during a possible Pandemic and the triage under a health care system with extreme triaging and stalling of medical treatment? It's not like I have not been here before.  I have.

http://scienceblogs.com/effectmeasure/2009/09/09/the-depressing-math-of-swine-f/

Four years ago as the Flu swept through the world.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Johnray1 Quote  Post ReplyReply Direct Link To This Post Posted: December 29 2013 at 12:32pm
Med,I am glad that you brought up about the "Death Panels". Even most if not all of the Dr.s that I know have not believed that the Death Panels were part of the Obamaheathcare plan.They are called a different name.Some people call them "End of Life Counselors". But they are one and the same. These people are so anxious to go to work,that they started having secret meetings last summer. They were not suppose to start having meetings until after the 1st of the year. They really want to get started with their work. Johnray1
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Post Options Post Options   Thanks (0) Thanks(0)   Quote cobber Quote  Post ReplyReply Direct Link To This Post Posted: December 29 2013 at 5:54pm
death panels!! what a load of garbage.

I dont know where to start, so i wont. This is alarmist bullcrap. 

Australia has had this type of system for a long time and this is a non issue!
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When you factor in the baby boomers I do not believe it is a non issue. They (me included) will put a strain on the medical dollars and services that will be available, and I believe that they will ration the health care to those that are productive in society or have the potential to be productive (younger ones)
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I agree Cobber, this is rhetoric BS.  
The US already has death panels as defined in the law. 

The panels currently in place before the ACA, are boards in insurance companies that determine what care private health policies will cover. This is determined by a board who's soul purpose is to maximize insurance company profits.  If you think these boards cared one bit about health outcomes over profits your nuts and delusional.  I will take my chances with physicians who's soul purpose is to define what  care at the end of life is reasonable with the best quality of life outcome based on current  science.  Science versus accountants.      
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I have a few more real life end of life stories for you. 

My 93 year old grandmother, had ovarian cancer and was in a coma, and they preformed a hip replacement.  She died 1 week later the hip replacement cost $30K to medicare she never walked on it.  

My mother was in late stage Alzheimers and she received a $10K interferon shot for leukemia once every 2 weeks up until she could not remember how to swallow.  And a $70K coli-cure implant for hearing, the second one a year before she died.  She never was able to use the first $70K one 5 years before because of short term memory loss but the first one was worth a shot. 

My father had stage 4 small cell lung carcinoma,  They were going to do Chemotherapy, he asked him how much longer he would live and they figured a month.  He asked would he ever feel better then he did right then, and they said absolutely not.  His answer was then what is the point?  
He died 7 days later.  

There are worth outcomes then dieing just saying.       
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Johnray1 Quote  Post ReplyReply Direct Link To This Post Posted: December 29 2013 at 7:16pm
Taxman,I believe everything that you say here. Because I have seen it done for years and it costs many millions or billions of dollars each year. I have even worked with Dr.s who were so good that they knew approximately when their patients were going to die. They Dr.s would schedule the patients high dollars procedures,in the order that they were going to die and they were usually correct and the procedures were unnecessary and just plain stealing, in my opinion,. This made me sick when I first saw it and then I started seeing it everywhere. I do not know how to teach Drs. ethical behavior and you stop what I consider to be criminal behavior in many cases. But just because the Drs. and the HOSPITALS need to be taught ethical behavior ,and yes the HOSPITALS are 100% for this kind of behavior because if the hospitals equipment and rooms are being used,the hospitals are making far more money than the Dr.s. are. But  with all of this,that does not mean that the Government is going to do a better job. When the government steps and starts making the decisions,there will be people dieing,that should not be dieing yet,because the government agents will make sure that the patient dies when they are suppose to. Johnray1
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Seawolfe Quote  Post ReplyReply Direct Link To This Post Posted: December 29 2013 at 8:18pm
All who bring "profit" into the discussion are absolutely correct. Medicine AND Insurance are businesses engaged in ventures just like the Defense Contractors I use to work with. When we negotiated a contract, the Contractors set aside about 16 to 20 percent as profit not to be touched. No profit, no contract. I know there are good Doctors and Heath Care Workers involved who care about patient well being above profit; however, profit is still a factor. If a hospital is not profitable it goes out of business. Anybody ever heard of an insurance company not making a profit? It all comes down to Return On Investment. Good ROI comes from keeping cost low an revenue high. So now fit that into the discussions.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: December 29 2013 at 8:27pm
I am sorry I do not want someone else to determine if I get health care no matter how old I am. What happens when a child has leukemia for a 4th time and the Death Panel determine it is not worth chemo for them again!

This is a death panel and the USA is now a Communistic country! It is all ok until it is your family member this Death Panel decides will die due to lack of care!

If you want to get rid of Obamacare and Death Panels you had better vote for any and all Republicans in the next two elections.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Mahshadin Quote  Post ReplyReply Direct Link To This Post Posted: December 30 2013 at 4:45am
Flumom

Your little story is a perfect example of what it was before the ACA. Of course they called them Quality assurance departments or something similar but in the example you gave the corp would sick this little panel on the case looking for anything to save the corp money with no regard for the child. The favorite little technicality was pre existing conditions and had the parents made one mistake in filling out the long medical history forms well that was reason enough and (DENIED). This has been dealt with in ACA and this no longer happens

Now I am not sure where your getting your information but I challenge you to show me where the ACA will be reviewing and making decisions on individuals and treatments case by case.

Tip-- don't waste your time because that is not part of the law never was and the death panel BS was just a big fear mongering campaign based in fiction.
"In a time of universal deceit, telling the truth is a revolutionary act."   G Orwell
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Taxman speaketh the truth. 

Even if the health care system fails in Australia you have the option to pay for it yourself. I did it for a knee reconstruction. On public i had a three month wait. I wanted it fixed before so i opted to pay.

The thing you will find with the new system is the opposite. "Death panel doctors" will be approving stuff that shouldn't be done to protect their arses. 

Flumom your from New Zealand your health care system is the same anyway. ??? 

"Death panel doctors" is just good marketing spin for those opposed to Obamacare


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Post Options Post Options   Thanks (1) Thanks(1)   Quote jacksdad Quote  Post ReplyReply Direct Link To This Post Posted: December 30 2013 at 10:12am
When the insurance companies had a complete stranglehold on healthcare pre-ACA, did we not see people sent home to die when their plan didn't cover the treatment or medications they needed, children included? And weren't they also legally allowed to deny coverage, increase premiums or drop people altogether if they had the audacity to get sick enough to impact their profit margin? We've had death panels for years but they used to be called insurance company accountants back in the day, and I'm not sure why anyone would get teary eyed and sentimental about the way they were allowed to protect the interests of shareholders over patients.
The US healthcare system had higher administrative costs compared to other countries because it had one thing many of them didn't have - buildings full of people who's only purpose in life was to find reasons to limit or deny care in order to keep heathcare profitable.
"Buy it cheap. Stack it deep"
"Any community that fails to prepare, with the expectation that the federal government will come to the rescue, will be tragically wrong." Michael Leavitt, HHS Secretary.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Medclinician2013 Quote  Post ReplyReply Direct Link To This Post Posted: December 30 2013 at 10:56am
Several observations here -- clearly if a person is within a month of death, it is not wise to perform heroic non-productive measures to save a life that is a huge expenditure of funds better used to care for thousands of other patients. However, if a person may have five years, and with our ever changing healthcare system, live  for another 20, if health care is provided, a Death Panel could refuse to approve the health care and effectively murder them.

The philosophy that 75 years old is enough for a social security system that may be moved to 70 would only  give retirees 5 years more to live.

Some of us are in that group; I, being one of them. How many out there are as 65 or older as well?   We are still mentally clear and all too aware of a changing attitude in the U.S. concerning the the poor, elderly, and homeless. 

It is projected that by 2020, 50 million Americans will  be over 65.  That would be one in six people in the United States.  Do we set up a health care that system that would systematically eliminate them? Do they have a voice? Do they need a voice? Are they being represented by those they put in office. Do they have a choice. Yes, they do. In 2014, if they live that long, remove those responsible for this horrific health care plan.  They can stop electing a congress who is deaf to those who put them in office with  the poorest health care plan in history and passing bills to eliminate their pensions and quality health care. Health care may be affordable, but it can certainly be worthless. A plan that cannot be implemented by the current insurance and existing medical system is a myth is not a plan.

http://www.agingstats.gov/Main_Site/Data/2012_Documents/Population.aspx

The chilly ring to the phrase "feeders" as applied to the disabled and elderly seems to be addressed in the current legislation. One can argue that many old people have  made huge contributions in every field and some of the best literature and not a few inventions were created by those with lifetimes of experience and a perspective not known to those who are young or even middle aged.

Throughout thousands of years, civilization has respected and revered its elderly as the keepers of wisdom as opposed to simply intellect.  The advisers of kings were not classically those under 30.

We see what can happen as the young assume positions as the leaders of nations. North Korea is a glaring example of a 30 year old inebriated person with either current or future control to launch an attack with a nuclear bomb on South Korea and start a world war. One who is currently poised to do so and unstable enough to launch when even operating a car, is very  dangerous.

A nation which abandons those who have served in the military and  fought to protect it, have given their lives in some instances or have paid great amounts of money for security in their golden years, is not the nation which has for centuries protected its citizens and their rights. Even current soldiers, will find themselves as they grow old or end their military carriers, short changed.  The price of Liberty is considered secondary to political agendas and the creation of administrative power which violates the basic Constitutional rights and foundations of the United States can  only lead to the loss of what we hold so dear -- Freedom.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Pixie Quote  Post ReplyReply Direct Link To This Post Posted: December 30 2013 at 2:01pm


The salvage of human life ought to be placed above barter and exchange ~ Louis Harris, 1918

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Post Options Post Options   Thanks (1) Thanks(1)   Quote Mahshadin Quote  Post ReplyReply Direct Link To This Post Posted: December 30 2013 at 4:03pm
Originally posted by jacksdad jacksdad wrote:

When the insurance companies had a complete stranglehold on healthcare pre-ACA, did we not see people sent home to die when their plan didn't cover the treatment or medications they needed, children included? And weren't they also legally allowed to deny coverage, increase premiums or drop people altogether if they had the audacity to get sick enough to impact their profit margin? We've had death panels for years but they used to be called insurance company accountants back in the day, and I'm not sure why anyone would get teary eyed and sentimental about the way they were allowed to protect the interests of shareholders over patients.
The US healthcare system had higher administrative costs compared to other countries because it had one thing many of them didn't have - buildings full of people who's only purpose in life was to find reasons to limit or deny care in order to keep heathcare profitable.


A voice of Sanity in a Sea Of BS

Exactly right jacksdad, I experienced this with a good friend who got cut off at the knees while in the hospital because of a box they checked at one doctor but missed at another (Completely unrelated) but enough to give the Corp the right to Deny. By the time he appealed and got it overturned (Months) it was to late.

Now That's a Death Panel

The rest of whats getting posted in here out of Political Intolerance or just outright ignorance is SHAMEFUL.
"In a time of universal deceit, telling the truth is a revolutionary act."   G Orwell
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Johnray1 Quote  Post ReplyReply Direct Link To This Post Posted: December 30 2013 at 4:37pm
Mahshanin,you are exactly right.But I do not think that any of us are ready for the scale of what we are about to see. Johnray1
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Post Options Post Options   Thanks (0) Thanks(0)   Quote jacksdad Quote  Post ReplyReply Direct Link To This Post Posted: December 30 2013 at 4:42pm
The misinformation is so thick on the ground that you can't help stepping in it - it's little wonder that people are so fearful of the ACA. Check this one out,

http://www.addictinginfo.org/2013/12/05/cornelius-kelly-fox-obamacare-baby/

"Buy it cheap. Stack it deep"
"Any community that fails to prepare, with the expectation that the federal government will come to the rescue, will be tragically wrong." Michael Leavitt, HHS Secretary.
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Post Options Post Options   Thanks (1) Thanks(1)   Quote Satori Quote  Post ReplyReply Direct Link To This Post Posted: January 02 2014 at 7:09pm

things that make ya go hmmm

NY Times: Obamacare was conceived at the Heritage Foundation, a conservative think tank, and birthed in Massachusetts


http://www.blacklistednews.com/NY_Times%3A_Obamacare_was_conceived_at_the_Heritage_Foundation%2C_a_conservative_think_tank%2C_and_birthed_in_Massachusetts/31688/0/38/38/Y/M.html


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Post Options Post Options   Thanks (0) Thanks(0)   Quote Taxman Quote  Post ReplyReply Direct Link To This Post Posted: January 02 2014 at 8:17pm
The "personal responsibility" insurance mandate was the conservative portion of the plan. To in effect force poor and middle class people to buy insurance instead of burdening the system with unrecoverable medical expenses.    
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Medclinician2013 Quote  Post ReplyReply Direct Link To This Post Posted: January 09 2014 at 8:47am
http://www.foxnews.com/health/2014/01/09/calif-teen-declared-brain-dead-gets-feeding-breathing-tubes/?intcmp=latestnews

The subtle escape of one from the death panel.

OAKLAND, Calif. –  A 13-year-old California girl who was declared brain dead after suffering complications from sleep apnea surgery has been given the feeding and breathing tubes that her family had been trying to obtain for weeks.

Christopher Dolan, the attorney for the girl's family, said doctors inserted the gastric tube and tracheostomy tube Wednesday at the undisclosed facility where Jahi McMath was taken Jan. 5.

The procedure was a success, Dolan said, and Jahi is getting the treatment that her family believes she should have gotten 28 days ago, when doctors at Children's Hospital Oakland first declared her brain dead.

comment: It would appear that however subtly, some of the mandates pronounced as final for January 1, 2014, are not that final and may be reversed over time.  Perhaps, it is economically impractical to keep those pronounced brain dead alive, but in this case, it still was left to the family to make that decision and not the government. 



Medclinician - not if but when - original
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