I want to know

SarahSmile23 · August 2009

I completely agree with this. *high fives Nugget* i knew we could find some common ground somewhere!

NuggetBrain · August 2009

THE PRESIDENT: So that’s where I think you just get into some very difficult moral issues. But that’s also a huge driver of cost, right? I mean, the chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health care bill out here. NYT: So how do you — how do we deal with it? THE PRESIDENT: Well, I think that there is going to have to be a conversation that is guided by doctors, scientists, ethicists. And then there is going to have to be a very difficult democratic conversation that takes place. It is very difficult to imagine the country making those decisions just through the normal political channels. And that’s part of why you have to have some independent group that can give you guidance. It’s not determinative, but I think has to be able to give you some guidance. And that’s part of what I suspect you’ll see emerging out of the various health care conversations that are taking place on the Hill right now.See, I didn't get any "death panel" idea out of that. I read it as he doesn't want the government to make the sole decision about end of life care, and there would need to be a lot of people involved in the discussion about what to do. But that it would be a discussion, not a final say.

SarahSmile23 · August 2009

See, I didn't get any "death panel" idea out of that. I read it as he doesn't want the government to make the sole decision about end of life care, and there would need to be a lot of people involved in the discussion about what to do. But that it would be a discussion, not a fi nal say.He is acknowledging that decisions will have to be made about how long to extend care to people who are elderly or dying, which was then translated into "death panels." To me, this article is acknowledging that decisions for when to end care will need to be made and is suggesting we need a panel made of an "independent group" to provide such guidance. Regardless, it annoys me because it is removing the focus from the rest of the bill. I wish tthe media would get off the death panels and making fun of town hall attendees and really show us what to expect from this bill.

zippityb · August 2009

I'm going to start watching out for any mention of "death star."

tlv204 · August 2009

I wish tthe media would get off the death panels and making fun of town hall attendees and really show us what to expect from this bill.I definitely agree with that. Too bad it probably won't happen, on any news channel.

ricksang · August 2009

The news is all about the dramatics.

lpstl · August 2009

Sarah, thanks for posting that. It's really interesting that anyone would interpret his answer as a sign that death panels are coming. The way I interpret his answer, is government can't solve the issue of end of life healthcare costs alone. It's a delicate issue and we need to bring together experts from multiple fields to have a discussion. My company is extremely involved in healthcare reform and new trends in the industry. I can tell you the trends are towards practicing medicine in a smarter way by better disease management, physician & patient behavior modification, analytics, and increased visibility into a patient's medical record. Simply slicing benefits and sacrificing quality of care is widely regarded as actions that would get us deeper into trouble, both financially and ethically.

NuggetBrain · August 2009

He is acknowledging that decisions will have to be made about how long to extend care to people who are elderly or dying, which was then translated into "death panels." I work at a health insurance company, and we make those same choices. For example, for my plan they only cover 120 days per year in a nursing home, and it's covered at 95%. That's for "preferred". So if all the preferred ones are crap, and you decide to go out of network, they only cover 70%. And not all nursing homes accept medical insurance - some you have to be a private payer. Hospice is the same way - there are no day limits, but it's covered at 95% inpatient and 70% outpatient. And hospice can run thousands and thousands of dollars a month. Even at 95% coverage, you could still be looking at hundreds out of pocket and for someone on a fixed or limited income, that's very hard to make.

SarahSmile23 · August 2009

The way I interpret his answer, is government can't solve the issue of end of life healthcare costs alone. It's a delicate issue and we need to bring together experts from multiple fields to have a discussion. Exactly. A panel of experts to figure out how to handle end of life situations. And you don't see how that can be simplified and then sensationalized as a "death panel?" I can see how it could be confusing and frightening for people who might be elderly or have family members who are seriously ill and will be effected by this group of experts who will be making these decisions.So no, I don't see mention of death panels in the current bill, but I can see how Obama created that impression in his interviews. It's all a cluster.And to whomever wanted to see the bill, here ya go:http://www.opencongress.org/bill/111-h3200/text?version=ih&nid=t0:ih:1

Keri825 · August 2009

I haven't posted on here for lately but wanted to let you know some of the experience I have. I'm a hospice nurse and we frequently get patients that have private insurance that only pays for 30 days total for hospice care (sometimes less), then our company takes care of them for free. This is very, very costly. I'm glad that they are not denied the care they need because they can't afford it but we are also lucky as a hospice to get a lot of donations from the community. In other areas that do not have a non for profit hospice, families will end up with the bill for the hospice care that the insurance companies would not pay for. I have also had patients that were forced to stop treatment earlier than they would have chosen to on their own because they couldnt afford it and their insurance company would only pay for so much. This is wrong. I'm not sure if the health care reform would fix these types of problems but it is still important to know that the current system isn't working for everyone.

Keri825 · August 2009

*here lately* not sure why I put a for in there. lol. sorry.

lpstl · August 2009

I agree that Obama's response was crap. I understand why he was so vague, but he really should have clarified that they want to find ways to decrease cost without sacrificing quality (or length) of care. Being so deep in the industry can make it difficult to understand the public's perception and interpretation of statements like that. My company runs a medicare advantage plan, and we know funding will be cut and it will affect us. We're working on ways to decrease costs and increase quality of care. Obama is 100% right about chronic conditions accounting for the majority of healthcare costs, but it never occurred to us to just kill the sick people. We, and a lot of leaders in the industry, believe the key to cutting costs is preventing and/or better managing the chronic disease. Take lung cancer for example, most insurance companies won't cover smoking cessation therapies, but they'll pay out thousand and thousands of dollars for chemotherapy. That's just jacked up, and we realize that. We're looking into creating incentive programs like this: You quit smoking using a drug we pay for entirely, once you are successful we reduce your copays, or get rid of them all together. That's a win for the patient and win for the insurance company in terms of financial benefits and quality of care. We actually already cut copays for drugs for the top 10 chronic conditions in order to promote patient adherence, and it's working beautifully. ^ Programsd like that is what obama was talking about, but if you weren't well informed on the trends in the industry you would have no idea. If you're wary about the reform and a little paranoid, I can see how you would jump to a very bad conclusion.

lpstl · August 2009

Side note: Lung cancer was a bad example, that's not a chronic disease. But, I thought it would be an example everyone would get.

timmysgal1 · August 2009

i heard a news story about this today. the "end of life" panels are actually not such a new idea. when someone enrolls in medicaid, they have to fill out some forms about end of life already.and the purpose was to get people thinking waaaaayyyyy before end of life about how to move forward. People are so wary about discussing death that they jump at the idea that someone else is deciding for them. That's not the purpose. the purpose was to educate the insured person about their options (care, DNR, etc) so that they can CHOOSE, not so that someone else can choose for them. This was to be re-reviewed every 5 years, so that people can change their plans, ideas, reevaluate where their health is at. I think the purpose of this has been misconstrued by the angry politicians (on both sides). I don't necessarily agree or disagree with the idea. I think end of life planning is very important so I do think it should be more openly discussed. And I also thought that the panels were OPTIONAL, and not required by the bill?

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