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Obamacare to limit our health care choices

December 29, 2010 by B. Daniel Blatt

Talk to a British émigré friend of mine whose octogenarian parents still live in the UK and have to deal with their National Health Service (NHS) and he loses his temper.  Talk to my septuagenarian parents who have each had health difficulties over the past year and you hear of the challenges of aging and the choices available to them.

When each has had to consult a physician for care, they have often asked friends and family members (in the medical profession) if the course of action that health care profession recommended was the best option — and to learn what else (if anything) they could do.  In some cases, they, like many Americans, have sought a second opinion.  

As government extends the reach of its tentacles into our health care system, many fear that it will limit the number of choices available to patients.  Taking issue with the use of the term “death panel” to describe the new Medicare regulations I blogged about here, calling such criticism “misplaced“, the editors of the Washington Examiner find the term

. . . entirely justified when used in reference to another provision of Obamacare — the Independent Payment Advisory Board — whose members will attempt to save money by making one-size-fits-all recommendations for skimping on care protocols and treatment regimes, particularly for older patients.

Unelected bureaucrats will soon be set the standards for the treatment doctors can offer, unelected bureaucrats who won’t be able to judge on a case-by-case basis, thus unable to define treatments which address the particular circumstances of individual patients.

Read the entire piece to see why the editors object to the manner in which the Administration is enacting the Medicare regulation in question, seeing it as “part of a broad pattern of opacity and deception” in the current Administration.

That said, let’s also bear in mind just how the various bureaucracies created by Obamacare will intrude ever further in the treatment health care professionals can offer and insurance companies can pay for.

Some might point out that today many insurance companies deny certain treatments.  And they will be right.  But, there is not now one standard for the industry.  As long as companies compete to offer services, we have a choice.

Instead of the Democrats’ overhaul fixing this problem, it exacerbated it, reducing choices rather than increasing them (as they would have done had they enacted reforms which made the market for health care insurance more competitive).  Yes, reform was needed (and is needed even more than it was before Obamacare); the “reform” enacted only made the problem worse.

Where faceless private sector bureaucrats limited the services their companies would pay for, soon faceless government bureaucrats will limit them even further.

But, as my doctor friends have informed me, you can argue with private sector officials — and often win, trying though the experience may be.

Filed Under: Big Government Follies, Obama Health Care (ACA / Obamacare)

Comments

  1. ThatGayConservative says

    December 29, 2010 at 2:51 am - December 29, 2010

    Chairman Obama, who plays a doctor on TV (inhalator?), says “just take a pill”.

  2. Auntie Dogma says

    December 29, 2010 at 8:03 am - December 29, 2010

    >>>Some might point out that today many insurance companies deny certain treatments. And they will be right. But, there is not now one standard for the industry. As long as companies compete to offer services, we have a choice.

    Put down that magic wand and straighten up the tiara, honey. Once you’re turned down for a procedure, you’re uninsurable. You’re out of options. In some cases, your death panel just ordered your termination.

    Further: Specifically, how have your choices been reduced? Was your insurance company put out of business? The only choice that’s been eliminated is being uninsured.

    That aside, ObamaCare sucks, but not for any reason you’ve ever mentioned.

  3. The_Livewire says

    December 29, 2010 at 8:15 am - December 29, 2010

    Look, another fact free rant from Grannie Goodness.

    Now the reality is, that different companies do offer different services based on guidelines. For example, Medicare doesn’t cover compression hose. However, if you have a private insurer they may/will cover the DME. That’s one example of Grannie Goodness being wrong.

    Another example would cover things like Bariatric surgery and mammoplasty. BCBS makes the later extremely difficult to get approved, while our process is a bit easier. Likewise Bariatric surgery is a rider for our policies, meaning that if you work for company A, it would be denied, but if you went to work for company B, and they choose to include it, you can be covered.

    As to how choices have been reduced, low benefit health plans, like those McDonalds offers, have been outlawed by the Obama plan. Well unless you suck up to the the Great and Powerful Oz Kathleen Sebelius and get a waiver.

    These facts have been brought to you by The Livewire, who works for an insurance company but sure as hell doesn’t speak for them.

  4. Heliotrope says

    December 29, 2010 at 10:09 am - December 29, 2010

    Dogma Auntie,

    For all intents and purposes, Medicare chased private insurance for the population served by Medicare out of the market. Along with Medicare came the reality that doctors may choose to limit their number of Medicare patients or not take them at all.

    Over the years, the medical world has learned how to “adjust” to Medicare by billing the privately insured patients higher amounts to supplement the losses of the Medicare reimbursements. The insurance companies played along because they need the doctors and the hospitals for their clients. The biggest cause of increase in health care premiums is due to Medicare/Medicaid underpayment.

    A doctor has a lot of latitude under Medicare that is not available under private insurance. Hip and knee replacements, for example, are expensive and a private insurance company would price its policies based on actuary tables so that they would not get clobbered. Medicare just ponies up for the replacement.

    If the 65 and over population had to buy private insurance and Medicare was not available, there would be a world of insurance policies premiums that would have riders for every conceivable geriatric reality.

    The truth is, the cost of health care at the end of life is enormous if you have the means to stave off the inevitable. Medicare has given the aged almost a blank check.

    England has dealt with this by ruling that a whole host of medical procedures will not be available to people over 55.

    Health care can get very expensive, very quickly. Cancer is one disease that can eat up your private assets in no time at all. But, under Medicare, the treatments are “free” and private wealth is not touched. However, if the person needs to go into a nursing care facility, then Medicare does not help until the private assets are burned up. (Not entirely the case, but good enough for this discussion.)

    Medicare is broke and going broker. The United States treasury is broke and going broker. So, the Obamacare solution is to make everybody buy healthcare insurance. This is, in fact, a tax that on paper, at least, refills the coffers of Medicare/Medicaid and expands the umbrella of health care. Private insurance companied are mandated to accept pre-existing conditions and accept other requirements that are not actuarially sound. That means that many insurance companies will simply get out of the business. So, who will fill the void? Why the “single-payer” entity of course. This “single-payer” will be the government acting as a corporation like the US Post Office or Amtrak.

    The single-payer government corporation will “discover” the enormous cost of end-of-life health care and they will write regulations to control the cost. People will continue to “need” expensive end-of-life health care, but they will not get started on it and soon they won’t “need” it because they will be dead.

    Dr. Ezekial Mengele Emanuel has already worked out how the socialist state should systematically handle disposing of end-of-life problems. He has an efficient and clear eye on the bottom line and it is hard to find someone who is so precise in handling the final solution to the extreme cost of dying in a state that finances open ended treatment.

    Now you leftist egalitarians do not like the idea that an illegal alien should be shut out of limitless health care. You want all the population treated to the same very high level of health care enjoyed by those who “can afford” it. You will tax anything and anyone to bring aid and comfort to the afflicted. Your heart swells with pride and you feel almost charitable.

    But, when you run up the credit card to the point where there is no more cash available and your ability to pay is crashing like a lead balloon you immediately start yelling at those who leave the country to get on firmer footing.

    Years ago, Colorado Governor Lamm recognized that keeping the aged alive on Medicare was too heavy a burden on the state. He suggested that the elderly just buck up and die. Bad career move.

    Obamacare knows that Lamm had the right formula and the wrong message. So, “death panels” will meet in regulatory board rooms and decide the rules and regulations surrounding end-of-life treatment. They will pour over actuary table and cost analysis sheets and they will work out many of the same “formulas” the insurance companies have used and they will radically cut the cost of end-of-life healthcare. They may even offer euthanasia, like the Dutch do.

    Your turn.

  5. AJ says

    December 29, 2010 at 10:21 am - December 29, 2010

    Its funny because these “Death Panels”, by law, can’t ration healthcare or restrict benefits already in place. They were charged with cutting spending in a way that doesn’t affect the quality of care that patients are already receiving. Congress can also change or completely veto the proposals.

    Here is how these “death panels” are limited:

    “The effects of the IPAB’s proposals, however, may not be to “ration health care,” raise costs to beneficiaries, restrict benefits, or modify eligibility criteria. Proposals may not, before 2020, target the rates of particular providers — primarily hospitals and hospices — that are already singled out by the ACA for extraordinary cuts. ”

    http://healthpolicyandreform.nejm.org/?p=3478

    People still haven’t shown how this law created anything close to something resembling panels or bureaucracies that will end up rationing healthcare or forcefully denying people coverage. The bill may have it’s flaws, and many may disagree with it, but death panels have not been created it seems. I could be wrong though, and if they do, I would really appreciate someone showing me where and how this bill specifically creates them.

  6. Heliotrope says

    December 29, 2010 at 10:41 am - December 29, 2010

    AJ,

    The New England Journal of Medicine is not the go-to authority on Obamacare. It is one liberal source. So, here is a more conservative look:

    http://online.wsj.com/article/SB10001424052748704756804575609001831141096.html

    And here is a discussion on the Independent Payment Advisory Board (IPAB) which you reference.

    Your TalkinPointsMemos bomb bursts only serve to make you look uninformed. The gobbeldygook legalese sandwich supposedly outlawing “rationing” is nothing more than hit and run claptrap.

  7. The_Livewire says

    December 29, 2010 at 10:58 am - December 29, 2010

    Wow, AJ’s link is all shiny. Too bad it was already shredded. By itself.

    “Proposals may not, before 2020, (Afterwards, sure) target the rates of particular providers — primarily hospitals and hospices — that are already singled out by the ACA for extraordinary cuts.(since we’re already cutting them and restricting services) ”

    Congratulations AJ. Any more quotes you’d like to post undermining your argument?

  8. Heliotrope says

    December 29, 2010 at 11:04 am - December 29, 2010

    AJ brings us language that is supposedly in the Obamacare law, but in fact is editorial language from the New England Journal of Medicine. He has provided a link to that source. Here are key paragraphs from the link AJ relies upon:

    The IPAB will have 15 members appointed by the President for 6-year terms, supplemented by 3 officials representing the Department of Health and Human Services (DHHS). IPAB members are supposed to be nationally recognized experts in health finance, payment, economics, actuarial science, or health facility and health plan management and to represent providers, consumers, and payers.

    (IPAB stands for Independent Payment Advisory Board.)

    The board is charged with developing specific detailed proposals to reduce per capita Medicare spending in years when spending is expected to exceed target levels, beginning with 2015.

    (In the box above, I have underlined and put in bold two issues that are contradictory to what follows.)

    The effects of the IPAB’s proposals, however, may not be to “ration health care,” raise costs to beneficiaries, restrict benefits, or modify eligibility criteria. Proposals may not, before 2020, target the rates of particular providers — primarily hospitals and hospices — that are already singled out by the ACA for extraordinary cuts. The board is not prohibited from cutting payments for physicians, but its powers may be limited if a permanent fix for the sustainable growth rate — the formula that determines increases or decreases in Medicare’s physician payments — is passed.

    This final box is not language from Obamacare, but editorial language provided by the New England Journal of Medicine. Taken as a whole, the IPAB is to act like the Congressional Budget Office and “score” to reach the desired result by fiddling the numbers. IPAB is the Draconian sword wielder that provides cover for Congress and the President. A “blue-ribbon panel” or a panel of a different name. Perhaps it could be called the “End-of-Life Quality Assurance Board.” (You will get the very best care we accord you.)

  9. The_Livewire says

    December 29, 2010 at 11:06 am - December 29, 2010

    *high fives heliotrope*

  10. AJ says

    December 29, 2010 at 11:09 am - December 29, 2010

    Heliotrope, it’s not an opinion, liberal or conservative, it’s the law.

    “The proposal shall not include any recommendation to ration health care, raise revenues or
    Medicare beneficiary premiums under section 1818,
    1818A, or 1839, increase Medicare beneficiary cost-
    sharing (including deductibles, coinsurance, and copayments), or otherwise restrict benefits or modify eligibility criteria”

    http://democrats.senate.gov/reform/patient-protection-affordable-care-act-as-passed.pdf

    Congress has power over what the board suggests and the law requires that this board not ration or restrict benefits. They are charged with finding ways to reduce wasteful spending that does not ration or reduce healthcare benefits. If you’re claiming that you believe they will break this law, then that again is your opinion on where things will lead. The healthcare bill, however, takes steps to ensure that this panel not restrict or ration benefits. It’s plain as day.

  11. Adriane says

    December 29, 2010 at 11:10 am - December 29, 2010

    …What The Hill’s Jason Millman forgot to mention in his article was that President Bush VETOED the 2008 bill and the Democrats, along with some “good-willed” Republicans OVERRODE Bush’s veto forcing him to sign the legislation into law. The bill dealt with doctors’ reimbursements and more, but the Democrats slipped in the end-of-life planning by opening up the Social Security Act, which I have stated many times is dangerous, because once changed, it is difficult to amend again and allows for tinkering with the Medicare fee schedule and covered services definitions and requirements. …

    The fact that the Obama Administration claimed that the Bush Administration supported the end of life provision is a complete lie.
    – Gateway Pundit, (citation in italics via Redstate)

  12. Heliotrope says

    December 29, 2010 at 11:12 am - December 29, 2010

    Thanks! The_Livewire, now I have to go scrape my boots. The cats hate the smell of bullcrap mixed with vanilla lattes.

  13. AJ says

    December 29, 2010 at 11:18 am - December 29, 2010

    thelivewire, Controlling how much doctors and hospitals receive under Medicare has always been determined by the government. The part of the law you quoted doesn’t change that. For better or worse Medicare has cut doctors fees numerous times and they still have that power. How is that a new power the government enjoys?

    Fact is the board can’t ration healthcare or restrict benefits, it can, however, continue to do what the government has done for years. What’s your point?

  14. The_Livewire says

    December 29, 2010 at 11:41 am - December 29, 2010

    I suppose then banning services wouldn’t be something new since, that’s just cutting rates to zero?

    Fact is, Heliotrop showed what is legal language, and what isn’t. Fact is that the only way medicare can ‘cut costs’ is to cut services. Avastin is just the start. (It works AJ, it’s ‘too expensive’)

    “I am very concerned about people who are receiving the drug and may feel threatened that they may not be able to receive it,” said the Dana-Farber Cancer Institute’s Winer, who is also chief scientific officer for Susan G. Komen for the Cure, a breast cancer patient advocacy group. “This is not a worthless drug by any means. There is almost certainly a group of women who get a big benefit. “

    Breasts today legs tomorrow.

  15. Heliotrope says

    December 29, 2010 at 11:43 am - December 29, 2010

    AJ,

    When the government writes a regulation, does it raise the limits or lower them? Does a regulation encourage a doctor to charge more? Does a regulation encourage the hospital to spend more time and money? Does the regulation require the hospital to make home visits and transport patients?

    Or —- do regulations set the minimum standards and cap the number of services and set the pay scale and determine the procedures that will be reimbursed? Medicare does not pay for most cosmetic surgery or botox or hearing aids. Would you not say this is a current example of rationing health care?

    Do you recall that Congress wrote rules for the Congressional Budget Office that they had to follow in “scoring” Obamacare? Under those rosy scenario rules, Obamacare did not increase the deficit. Under the rules of mathematics, Obamacare is a deficit flood.

    You, sir, are going to be s-o-o-o-o shocked, SHOCKED, I tell you, when you discover there is gambling going on in Casablanca.

    Your little piety dance to the gods of naivete lacks charm and grace.

    You do not need 2000+ pages to say the following:

    In no manner, shape or form will Obamacare raise costs to beneficiaries, restrict benefits, modify eligibility criteria or engage in any activity that has the merest hint of rationing health care. Any person caught trying to negatively affect the pure and perfect care of any human being under this act will be imprisoned at hard labor for the remainder of his life, but he will get top-notch medical care.

    In fact, why doesn’t Obamacare just send everyone a medical ATM card and you just go get your treatment and stuff and charge it straight to Obamacare?

    Why do we have a debt ceiling? Isn’t that rationing? Why don’t we have hospital suites for all patients? Why don’t we send a taxi with the ambulance in case some one wants to ride along? Why a taxi? Why not a limo? Shouldn’t patients get ethnic foods served to them? Are we touchy about reimbursing witch doctors and providing chickens for voo-doo sacrifices? Talk to me about rationing.

  16. North Dallas Thirty says

    December 29, 2010 at 11:57 am - December 29, 2010

    Medicare does not pay for most cosmetic surgery or botox or hearing aids. Would you not say this is a current example of rationing health care?

    Actually, AJ supports the government denying these because unelected bureaucrats have said they’re “unnecessary”.

    However, as we see with Obamacare waivers, what is “unnecessary” in one situation becomes “necessary” in another when it would financially benefit an Obama donor.

    So what becomes immediately obvious is that, when AJ and his fellow liberals get their wet dream of government-controlled health care for everyone, what is “necessary” and therefore covered will be determined primarily by your donations to the Obama Party and whether or not you criticize Barack Obama.

    In the private market today, if one insurer declines to cover you or one provider declines to treat you, the option exists to shop others. In Obamacare, as we already see, the government is your only option, and if you’re declined, you’re not getting anything.

  17. North Dallas Thirty says

    December 29, 2010 at 11:57 am - December 29, 2010

    Medicare does not pay for most cosmetic surgery or botox or hearing aids. Would you not say this is a current example of rationing health care?

    Actually, AJ supports the government denying these because unelected bureaucrats have said they’re “unnecessary”.

    However, as we see with Obamacare waivers, what is “unnecessary” in one situation becomes “necessary” in another when it would financially benefit an Obama donor.

    So what becomes immediately obvious is that, when AJ and his fellow liberals get their wet dream of government-controlled health care for everyone, what is “necessary” and therefore covered will be determined primarily by your donations to the Obama Party and whether or not you criticize Barack Obama.

    In the private market today, if one insurer declines to cover you or one provider declines to treat you, the option exists to shop others. In Obamacare, as we already see, the government is your only option, and if you’re declined, you’re not getting anything.

  18. AJ says

    December 29, 2010 at 12:05 pm - December 29, 2010

    thelivewire, here’s another quote from that washington post article:

    “An FDA advisory committee voted 12 to 1 on July 20 to withdraw Avastin’s authorization for advanced breast cancer based on two new studies that the advisers concluded had not shown that the drug extends life. Not only that, the committee concluded that the studies indicated the drug slowed tumor growth for even less time — perhaps as little as about a month. “The vast majority opinion of the committee was that the drug was not doing very much, and what it was doing was more than offset by the negative,” said Wyndham Wilson of the National Cancer Institute, who chaired the committee. Avastin can cause a variety of potentially serious side effects, including blood clots, bleeding and heart failure. “In our best judgment, we did not feel this drug was safe to give relative to its benefits,” Wilson said.

    The recommendation has been praised by many cancer experts and by advocates for breast cancer patients.

    “The FDA should never have approved Avastin for breast cancer to begin with,” said Fran Visco of the National Breast Cancer Coalition. “We don’t see evidence of benefit, but we do see evidence of harm.”

    http://www.washingtonpost.com/wp-dyn/content/article/2010/08/15/AR2010081503466.html?hpid=topnews

    Sounds to me like they’re just doing their job. But Hot Air didn’t quote that part of the article, just the small part of it that has one person objecting. Guess it didn’t fit their narrative.

    And this is legal language. Legal language saying they can’t restrict benefits. What’s so hard to understand about that.

    The proposal shall not include any recommendation to ration health care, raise revenues or
    Medicare beneficiary premiums under section 1818,
    1818A, or 1839, increase Medicare beneficiary cost-
    sharing (including deductibles, coinsurance, and copayments), or otherwise restrict benefits or modify eligibility criteria”

    http://democrats.senate.gov/reform/patient-protection-affordable-care-act-as-passed.pdf

    How can they be death panels if they can’t legally restrict or ration healthcare. Isn’t that what these so called death panels do?

    And Heliotrope, for the billionth time, I am not saying the healthcare bill is flawless or even good! In fact many of the worries expressed over it are valid. I’m saying that the concern of new death panels being created is one that is not based on anything actually in the bill. Just overall fear that the government is too big in general. Nothing in the bill gives the government power to restrict or ration healthcare. If you read the law you find that the exact opposite is the case.

  19. The_Livewire says

    December 29, 2010 at 12:10 pm - December 29, 2010

    And AJ ignores the qualifiers in his quote, again. Heck it even says “that are already singled out by the ACA for extraordinary cuts”

    Clarification, I was mistaken that the wording given was not part of the legal language.

    Given that the Obamamation already will cut medicare rates, to below the amount hundreds of doctors can afford, it restricts care. If they keep passing the ‘doc fix’ the CBO numbers go out the window. So again, the government is set to ration care.

  20. AJ says

    December 29, 2010 at 12:13 pm - December 29, 2010

    Another quote from the article about Avastin. Sounds like they’re doing there job pretty thoroughly for a change. Darn those government agencies for following through with their jobs.

    “The FDA endorsed Avastin for advanced breast cancer in 2008 despite divided opinion about its usefulness for that purpose. Only one study had found that the drug appeared to delay an advanced breast tumor from growing by about five months. It remained unclear whether patients lived longer or experienced an improved quality of life.

    But the FDA approved Avastin under a special program designed to make new treatments available as quickly as possible, with the caveat that pharmaceutical companies conduct follow-up studies validating their drug’s effectiveness. The agency has been criticized for not adequately reviewing such approvals. Only one of at least 90 drugs that have received accelerated approval has been pulled.”

  21. AJ says

    December 29, 2010 at 12:19 pm - December 29, 2010

    If you read Heliotropes article, you see that the hospitals actually discussed with congress to arrive at that conclusion. They approved the cut and are in favor of the result.

    “Hospitals and pharmaceutical companies last year struck deals with the White House to reduce their costs and swallow payment cuts in exchange for winning certain protections in the health law. Drug makers agreed to kick in $80 billion over a decade, mostly by covering a greater portion of drug costs through Medicare, while hospitals agreed to $155 billion in payment cuts through Medicare and Medicaid.

    “Any more reductions on top of that could be very problematic for our members,” said Tom Nickels, senior vice president at the American Hospital Association, an industry trade group that helped strike the White House deal.

    The health-care law created an Independent Payment Advisory Board that can recommend Medicare spending cuts to Congress, except for cuts directly to hospital payments. The commission’s draft report calls for strengthening the board’s powers and stripping hospitals of the exemption. That proposal hasn’t gone over well with hospitals and drug makers, which have been working to weaken or to eliminate the board.”

    So looks like they struck that deal knowing they could handle the cuts and in order to help slow the rising medical costs.

    But again, Medicare and Medicaid have always had the rates determined by the government. Where has the outrage over death panels been if thats what you believe they are? How are Obama and this bill creating them? That’s what has been argued but not backed up with evidence.

  22. AJ says

    December 29, 2010 at 12:26 pm - December 29, 2010

    I think the issue is that this bill extended coverage under Medicare and Medicaid, programs you strongly dislike, to millions of more Americans. And you believe that it has exacerbated a problem that already exists and will just make things worse. (not trying to put words in your mouth, but that’s the general gist of what I’ve gotten from you. Correct me if I’m wrong)

    That’s fine and I’m not necessarily disagreeing with you. I’m just saying it’s not a factual statement to say this bill created death panels or bureaucracies that restrict or ration healthcare when the law, in plain English, says they cannot do so.

  23. North Dallas Thirty says

    December 29, 2010 at 12:29 pm - December 29, 2010

    But again, Medicare and Medicaid have always had the rates determined by the government. Where has the outrage over death panels been if thats what you believe they are?

    Everyone knows that Medicare and Medicaid routinely deny care, with unelected government bureaucrats stating that peoples’ procedures are not “medically necessary” — or, as in the case of Obama Party-dominated Oregon, paying for assisted suicide instead of chemotherapy.

    However, Medicaid and Medicare do not have mandatory participation. If you don’t want to be covered by either, you don’t have to be; you can purchase private insurance instead, and thus sidestep the death panels that AJ’s Obama Party supports and endorses.

    Under Obamacare, all health insurance must be run according to Medicare and Medicaid’s standards, including rates set by unelected government bureaucrats, death panels, and all. Obamacare empowers the Federal government to determine what is and isn’t necessary and order insurance plans to, like Medicaid and Medicare, pay for assisted suicide instead of chemotherapy.

  24. North Dallas Thirty says

    December 29, 2010 at 12:32 pm - December 29, 2010

    23.I think the issue is that this bill extended coverage under Medicare and Medicaid, programs you strongly dislike, to millions of more Americans.

    Which means the government imposed death panels on millions of more Americans.

    Isn’t that funny, AJ? You and yours insisted that Medicare and Medicaid had “death panels” when you were trying to smear Bush, but then all of a sudden, when defending your Obama Party, you try to insist that Medicare and Medicaid don’t.

    Again, the only consistency in your argument is that everything the government and the Obama Party does is right and any criticism of it must be wrong.

  25. North Dallas Thirty says

    December 29, 2010 at 12:41 pm - December 29, 2010

    I’m just saying it’s not a factual statement to say this bill created death panels or bureaucracies that restrict or ration healthcare when the law, in plain English, says they cannot do so.

    Your contradictions and spin just get more and more hilarious, AJ.

    After all, yesterday, you were arguing that the Federal bureaucracy will restrict and ration health care when it’s not “necessary”. Who determines necessary? As I cited, your Barack Obama and Obama bureaucrats like Nancy DeParle and Kathleen Sebelius were already screaming that rate increases were not necessary and would punish health insurance companies who said otherwise.

    Also, your assertion yesterday was that, if a person has to pay for health insurance, they are denied access to health care. You insisted that “30 million Americans” had no access to health care because they didn’t pay for health insurance. Now today you’re arguing that people having to pay for health insurance is NOT denial of access to health care.

  26. AJ says

    December 29, 2010 at 12:42 pm - December 29, 2010

    NDT, i never insisted Medicare had death panels, so please don’t say so. I’ve said that “if they do”, as people here seem to be implying, then this bill didn’t create anything new. These death panels have been around for a while and Obama didn’t create them as many want to imply.

    And as far as I know, in the actual healthcare law, the government doesn’t say what insurance companies can’t cover, only minimum coverage requirements. I could be wrong, but I’d be curious to see what section and language in the healthcare bill gives the government the right to say that private insurance companies can’t cover something like chemotherapy and must do an assisted suicide, or something to that nature?

  27. Heliotrope says

    December 29, 2010 at 12:44 pm - December 29, 2010

    AJ,

    I’m saying that the concern of new death panels being created is one that is not based on anything actually in the bill.

    WHO SAID IT WAS? The Commerce Clause in Article 1, section 8 has been stretched and pulled and shoved and manipulated to cover darn near anything you want it to mean.

    You have deigned to come here saying that health care rationing can not take place because the bill specifically prohibits it. You say “death panels” are impossible because the bill specifically prohibit any such thing. You ignore the fact that millions of regulations are yet to be written and that cost containment is specifically directed by the bill. You ignore that rationing of health care already exists in Medicare/Medicaid and the process is an on-going one. You ignore that the “Independent Payment Advisory Board” is essentially a cost containment entity. You ignore that end-of-life treatment is the single largest chunk of all health care costs. You ignore that we MUST deal with reality and “death panels” are in our future no matter what happens. (You liberals got tarred and feathered with “right to life” and you are fighting like crazy to avoid being tagged with “death panels.” Either the health care system does everything it can to sustain life, or it doesn’t. The choice not to help sustain life results in a series of specific criteria that either appear magically on stone tablets or from the directives of ……. a death panel.)

    You play coy and show your fanny at the same time.

    Had the Democrats had the guts to hold open hearings and talk this thing out in the daylight, end-of-life health care would have been a huge topic with lots of give and take.

    I am well aware of the ethical swamp that has to be waded in this topic. Frankly, Medicare has created the dilemma. You do not see donation canisters on the 7-11 counter to help some old woman get cancer treatment because Medicare has given her a blank check. At some point, if she is alert and willing she will choose hospice and die in peace and the high medical costs will cease. Or, if you get a Dr. Ezekiel Mengele Emanuel type, she will get shifted into the hospice camp. Maybe she will meet Dr. Kevorkian and make room in the hospice camp. Who knows?

    As long as the terms are filed in 2000+ pages of ugga-bugga-yoyo legal language that refers to tens of thousands of sections of parallel and authorizing additional ugga-bugga-yoyo legal language in other legislation and oceans of regulations are yet to be written by little covens of alphabet groups of “others” …… we have no idea what this Frankenstein’s monster will look like or do. And, that includes you.

    Your simpering is all for naught. You can not offer any iron clad proof. You can only say neener-neener it is not written in so many words in the bill.

  28. AJ says

    December 29, 2010 at 12:48 pm - December 29, 2010

    It was denial to access because they couldn’t afford it, not because they didn’t pay for it. If you can afford insurance, but choose not to, then you pay the fine. If you can’t afford it, the government will help subsidize it so you can.

    So for clarification, someone below the poverty line, can’t afford insurance, they didn’t have access. Someone making $100,000 a year, chooses not to buy healthcare insurance they can afford, they chose to not be covered. Under the new bill, they can’t be denied for a preexiting condition, so they aren’t being denied, they are choosing not to participate and to pay a fine. You may not like or agree with it, but that’s the way the debate was framed in congress and that’s what I was referring to.

  29. AJ says

    December 29, 2010 at 12:51 pm - December 29, 2010

    WHO SAID IT WAS? The Commerce Clause in Article 1, section 8 has been stretched and pulled and shoved and manipulated to cover darn near anything you want it to mean.

    Sara Palin and the two posts that I’ve been commenting on have said so as well, which is why I’m discussing them. Thank you for finally arriving at the debate. Under the bill currently, congress does not have the power to institute death panels. I didn’t say it was impossible or would never happen, just that this bill didn’t create them, so I don’t know why you would be implying that I did.

    Again, what it comes down to is that you don’t like the legislation, and that’s fine. It has issues and people have many valid concerns. The fact that it has created death panels is not one of them. Maybe congress will do some in 20 years, who knows. But this bill doesn’t create them as has been stated by many conservatives.

  30. V the K says

    December 29, 2010 at 1:06 pm - December 29, 2010

    Yeah, just spent all morning at the hospital for my son’s surgery. I’ve been spending a lot of time at hospitals lately, and one thing that is brutally obvious is that most of the people using the system are elderly, and it’s a situation that will only grow worse as the Baby Boom — the most self-centered, entitlement-demanding generation in history — gets older.

  31. North Dallas Thirty says

    December 29, 2010 at 1:17 pm - December 29, 2010

    29.It was denial to access because they couldn’t afford it, not because they didn’t pay for it.

    Really?

    Please provide proof that every single one of the people you mentioned could not afford insurance, including the definition of what “afford” constitutes.

    Also, please provide proof that every single one of the people you mentioned was categorically denied access to health care because they chose not to purchase insurance.

    The hilarity of people like yourself who have never lived outside of the bubble is immense, AJ. You honestly believe that you cannot pay cash to doctors. You honestly believe that you cannot use your own money to purchase prescriptions. You have this entertaining disconnect from reality in which you shriek that out of pocket costs constitute denial of health care, but then turn around and explain that requiring you to pay out of your own pocket for services that Obamacare denies you isn’t denial of health care.

  32. North Dallas Thirty says

    December 29, 2010 at 1:24 pm - December 29, 2010

    So for clarification, someone below the poverty line, can’t afford insurance, they didn’t have access.

    BWAHAHAHA!

    If a person is “below the poverty line”, they already have access to Medicaid.

    This just shows how ignorant and uninformed talking-points repeaters like AJ are. These fools really, truly believed that they needed to pass Obamacare to cover “the poor”. No one with half an understanding of current Federal insurance programs would fall for that one, but as we see, AJ and his ilk are not informed.

  33. V the K says

    December 29, 2010 at 1:27 pm - December 29, 2010

    There are far too many people steeped in the culture of, “If I want something but I don’t want to pay for it, I’ll declare that it is my right to have it and demand someone else pay for it.”

    It is not a sustainable philosophy.

  34. Heliotrope says

    December 29, 2010 at 2:22 pm - December 29, 2010

    Sara Palin and the two posts that I’ve been commenting on have said so as well…

    SHOW ME THE WORDS where Sarah Palin said “DEATH PANELS ARE SPELLED OUT IN OBAMACARE.”

    You can’t. She didn’t. You keep popping up with what your “point” is and then you come rolling back with yet another slippery point.

    Here are Sarah Palin’s words:

    The Democrats promise that a government health care system will reduce the cost of health care, but as the economist Thomas Sowell has pointed out, government health care will not reduce the cost; it will simply refuse to pay the cost. And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care. Such a system is downright evil.

    The words in bold are the words you have taken from TalkingPointsMemo while leaving the context for those words to vanish. I have included them for full disclosure.

    Then you insist that Sarah Palin in clearly stating that the Obama “death panels” appear in the language of the bill …. no ifs, ands or buts.

    So, you put your words in Palin’s mouth, refuse to deal with the New York Times assessment about “death panels” reappearing in the hands of regulation writers and off you go screaming about your only point of the moment.

    But wait! There’s more! AJ will be right back with his next only point he is making.

  35. AJ says

    December 29, 2010 at 4:32 pm - December 29, 2010

    Heliotrope, Actually, here is the quote in it’s entirety. And mind you, the post is titled “Statement on the Current Health Care Debate”

    “As more Americans delve into the disturbing details of the nationalized health care plan that the current administration is rushing through Congress, our collective jaw is dropping, and we’re saying not just no, but hell no!

    The Democrats promise that a government health care system will reduce the cost of health care, but as the economist Thomas Sowell has pointed out, government health care will not reduce the cost; it will simply refuse to pay the cost. And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care. Such a system is downright evil.

    Health care by definition involves life and death decisions. Human rights and human dignity must be at the center of any health care discussion.

    Rep. Michele Bachmann highlighted the Orwellian thinking of the president’s health care advisor, Dr. Ezekiel Emanuel, the brother of the White House chief of staff, in a floor speech to the House of Representatives. I commend her for being a voice for the most precious members of our society, our children and our seniors.

    We must step up and engage in this most crucial debate. Nationalizing our health care system is a point of no return for government interference in the lives of its citizens. If we go down this path, there will be no turning back. Ronald Reagan once wrote, “Government programs, once launched, never disappear. Actually, a government bureau is the nearest thing to eternal life we’ll ever see on this earth.” Let’s stop and think and make our voices heard before it’s too late.”

    http://www.facebook.com/note.php?note_id=113851103434

    The title of the post and the reference to the current health care debate make it clear she was speaking in reference to the health care bill. She didn’t entitle the post, “Statement on the future possibilities or theories of health care.”

    I didn’t claim that language explicitly saying “death panels” is in the bill or that she said that. What I’ve claimed is that nothing is in the bill that rations care as she claims death panels would. Especially since the bill makes it illegal.

  36. V the K says

    December 29, 2010 at 6:00 pm - December 29, 2010

    It strikes me that liberals get caught up in the semantics of argument (“What Sarah Palin said isn’t literally true if you deconstruct it a certain way”) whereas conservatives prefer to argue the practical, real-world application of the concepts communicated by the words. (“ObamaCare as it has implemented is likely to have the following negative ramifications.”)

    This is what makes it difficult. We argue the real world, they argue over the words used to describe it.

  37. Heliotrope says

    December 29, 2010 at 6:00 pm - December 29, 2010

    AJ,

    This is tiresome. You say death panels and health care rationing are not explicitly stated in the bill. I agreed with you on this.

    I pointed out (along with the New York Times) that so much in the bill is left up to regulations yet to be written that “death panels” and health care rationing are not off the table.

    You come back and say the bill makes “death panels” and healthcare rationing illegal.

    That pretty much ends it. Doesn’t it? In 2,000+ pages and gazillions of words of legalese and regulation yet to be written, the American public can rest assured that nothing the government does will consider the costs of end-of-life health care or deny any patient any form of medical assistance.

    Now, this is entirely ridiculous. We know NIH, FDA, CDC all engage in regulating what the government will fund and use. But, according to your iron-clad assurance, nothing whatsoever in any way in Obamacare can curtail health care in any way because it is illegal and is loudly, proudly stated as such in the bill.

    You see, AJ, you are taking the stand that no rationing under any guise can occur. You are taking the stand that no last effort, end-of-life foray into medical manipulation will ever be denied.

    On the other hand, when we discover, as we surely will, that a commission has regulated a fair amount of possible medical care off limits, you will just shrug and say: it’s illegal.

    You can buy incredible insurance for incredible amounts of money. When the government dictates what insurance companies must cover, it can not possibly include the exotic, mega-costly procedures for every man, woman, child and illegal alien in the US. So some rationing and some denial has to come into play.

    If you believe that a doctor can help a patient decide to selflessly lie down and die for the good of society, you are more naive than previously imagined.

    This whole Obamacare is structured to end-up as a single-payer system and Obama has said as much. That single-payer will be a government run corporation like Amtrak, Fannie Mae, Freddie Mac, the Post Office, etc. Sooner than later, they will blow up the economy in what will be called the “health care bubble.”

    Thanks for your unshakable belief that Congress and the President always adhere to the Constitution and never, ever would fudge. Certainly, if Obamacare says rationing and end-of-life management are illegal, why it must absolutely be something you can bet the family farm on.

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