It seems hard to believe, but even now there are folks on the right concerned about "death panels." The subject came up at a Paul Ryan event at the University of Central Florida over the weekend.
For those who can't watch clips online, here's a transcript by way of Igor Volsky:
QUESTION: We love you Paul. But I'm getting long in years. Will you address the death panels that we're going to have?
RYAN: The death panels, well! That's not the word I'd choose to use to describe it. It's actually called. It's actually called, so in Medicare, what I refer to as this board of 15 bureaucrats. It's called the Independent Payment Advisory Board. It sounds fairly innocuous.
At which point, Ryan goes to argue that IPAB isn't actually innocuous.
In terms of rhetoric, when Ryan says he's not comfortable with the words "death panel," I'm glad, but it's worth remembering that this isn't about semantics; it's about policy. Those who talk about "death panels" aren't just using the wrong language, they're getting the substance wrong, too.
Asked whether "death panels" are real, the correct answer is, "Of course not." For Ryan, the answer effectively boils down to, "Sort of, but let's call them something else."
Since IPAB questions still come up from time to time, let's do what Ryan did not -- set the record straight.
As Paul Krugman explained a while back, "Arguably the most important thing we can do to limit the growth in health care costs is learning to say no; we cannot afford a system in which Medicare in particular will pay for anything, especially when that's combined with an industry structure that gives providers a strong financial incentive to engage in excessive care."
As we discussed in June, the Obama administration seeks to solve this problem through IPAB -- putting the difficult decisions in the hands of qualified medical and health care professionals, free of the political process on Capitol Hill. And why is this necessary? In large part because Congress has failed so spectacularly in its ability to make these choices on its own.
In theory, Republicans should be delighted, right? After all, we're talking about a panel tasked with cutting entitlement spending and saving money. Why would Republicans say they want to lower costs and cut spending, then oppose a panel that would lower costs and cut spending? It has to do the GOP's larger goal: scrapping Medicare altogether.
Both parties agree that Medicare faces long-term financial difficulties, and that addressing the problem is no easy task. Democrats have proposed measures like IPAB, which will limit unnecessary spending and lower overall Medicare costs, thus shoring up the program's finances.
Republicans have an alternative proposal: scrap Medicare, handing out vouchers that won't keep up with rising costs, and telling seniors to get sick less often.
The GOP opposes IPAB in large part, because they're afraid the Democratic idea might work, and make the Republican goal of Medicare privatization that much less likely to happen. Since scrapping Medicare is the ultimate GOP goal anyway, IPAB's efficacy would be a hindrance, not a benefit.
Besides, it's not like the 15 panelists serving on IPAB have some kind of dictatorial rule over Medicare coverage -- the law not only gives Congress oversight authority over the panel, but it also empowers Congress to replace savings if lawmakers disapprove of what the board comes up with.
The demagoguery surrounding this is ridiculous. It's a shame Ryan is making the confusion worse.
Postscript: If you watch the clip above, you'll notice that there's a running debt clock being used a stage prop. Perhaps it'd be worthwhile to remember that Paul Ryan voted for the Bush tax cuts, two wars, Medicare expansion, and the Wall Street bailout, and put all of the costs -- every penny -- onto the national debt.
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Ryan just doesn't want people to see the word "death panel" in the same sentence as his and Romneys' name. Because people will immediately react by believing that that is exactly what Romney and him will be to the 47%, the death duo. If they were to be elected our fate would literally be in those two bozo's hands. Very scarry thought.
the "deadly duo", it fits
Batsh!t and RobMe?
Of course there are death panels, and there always have been, because the only death panels are made up of the insurance company bureaucrats who deny and ration the health care of Americans, and the Romney/Ryan/Aiken ticket love them and stand behind those death panels 100%
Lyin' Ryan caught lyin' again! What a shock! In other news, the sun set in the west last night at 5:45 pm PDT and rose in the east at 6:15 am PDT.
So, a gov't appointed panel of professionals is less qualified to determine what insurance covers than insurance executives, and yet those same insurance executives are prevented from offering free contraceptives, as part of every standard plan, to everyone because a bunch of gov't bureaucrats get their panties in a twist every time my crotch gets near a church.
Got it.
Bottom line is, some procedures and tests won't be covered by Medicare, but they probably are not currently covered by private insurance--and why? Because they haven't been shown to be effective.
Patients have to deal with insurance companies denying coverage every day. This is no different. Every service provider and every affected patient wants THEIR treatment to be fully covered. Some are worthwhile and some are not--who decides?
Obviously the Ryan plan puts everyone on a private plan, and so the decisions will still be made by some group of people, not the attending physician and not the patient. Instead of the IPAB, it will be a group of insurance execs.
A few years ago at 75, my dad was diagnosed with terminal cancer. Inoperable. He received mountains of treatments, radiation, drugs, operations for other things and then chemotherapy. During several of his hospitalizations, doctors who we had never seen before would come in and ask how he was doing. They were not his doctors but because they came in to check on him, they could then go and bill Medicare. After a year of this and hundreds of thousands of dollars billed to Medicare, a doctor finally came in and asked him, "Why are you having chemo? It's not going to work and you are just making yourself sicker and more miserable." She was the only person in a year to be honest with him. He was a shell of the person he had been and we were all able to talk after and see that there was NO quality of life and all these treatments were doing was prolonging miserably, the inevitable AND giving doctors, the hospital and pharmacy the ability to continue to bill Medicare. He passed away less than 2 weeks after we stopped the useless treatments. There needs to be some controls put in place so that terminally ill patients can die with dignity and not be cash cows to the healthcare industry.
Heartfelt post, redsoxlvr. Thanks.
Actually, we do have controls, there are laws already on the books, and we have a lot of them. What we don't have is the strength to utilize these laws as controls on society's worst.
There isn't a human made program that can't be undercut by some degree of mishandling, abuse, or fraud. Everyone should know this. In fact, that's the current excuse today to get rid of our social safety nets, all this fraud, waste, and abuse, don'tcha know. Well, sorry but that excuse is a lie. It isn't inherent fraud, waste, and abuse, it's the deliberate lack of manpower and budget to get rid of it.
IF federal agencies were allowed to do their assigned jobs, IF these agencies had the prescribed level of manpower and budget, IF a working judicial system were able to act cleanly on the violation cases through to a firm and consistent punishment for violators, our "broken" programs would be cleaned up and functioning far better than they are allowed to today.
Our government has good people in it, it also allows petitioners and lobbyists to work for pet causes, no getting around that, but unfortunately an unlevel playing field allows some "pet causes" to come with a lot more financial backing and influence than others. All causes work to gain the attention of the politicians, the politicians make laws for some of those causes, some laws have loopholes specifically for causes, and of course Congress sets the budgets of the agencies that might, shall we say affect some of those causes, be they medical, environmental, social, etc.
There is no wall, no filter between those who make laws for causes and those who set budgets for agencies having a direct effect on causes. Congress does it all.
Case in point (sorry it isn't a medical one). I watched, as a dismayed liberal during the Bush administration, as his administration zero'd alternative energy budgets, installing his "believers" in key management positions to "rework" federal agency's effectiveness, and work to pull the teeth of those federal agencies whose missions were oversight, regulatory, enforcement.
The Environmental Protection Agency has been hacked to pieces…one would wonder why until one looks up Super Funds sites…we watched severe cut-backs piled on the EPA, diminishing it's case load capability for pollution violators to only the most flagrant, a mere 10 new cases a year, how's that for managing a nation experiencing thousands of small and large polluters. Laws will just sit on the books if there isn't enough manpower to enforce them. And it's not just federal agencies affected, firemen, police, emergencies services all see the same.
The right wants to gut programs that are laden with violators, lack of funding, and overloaded with process, to get rid of them because they promote laziness/mooching, etc. That is Big Government for you, at the very heart of it, sabotaged from within by those who want less regulation on the "free" market, more diversion of tax payer dollars to pet projects, and increased avenues to profit (hence, the protection of Wall street). These are the real violators, the real abusers of the public trust. We need our programs, we need our enforcing bodies, we need Congress to have less impact on so many fronts, because in the end, who regulates their inherent fraud, waste, and abuse?
#redsoxlvr - I'm sorry for the loss of your father, especially under such distressing conditions. Your situation goes on way too often and it is up to each of us to question doctors about recommended treatments, quality of life, other medical personnel involved, etc. We have some control if we have knowledge and are willing to make the tough decisions. God bless you and your family.
#NeedMoreCoffee....Your comments are right on the money! I've long believed that not much will ever change for the better until the way congress does business is changed dramatically. I think it was back in the early 90's that I watched several Congressional hearings about making changes and there were many senior members, former members and even congressional staff that put forth many sensible, fair, simple and common sense ideas......but....the changes would have stepped on those with seniority and egos at stake, so guess what happened.
Lyin Ryan,/Romney is the only death panel we need to fear
"Denial of Service" is George Orwell's term for Death Panel.
"Death panels" isn't that what happened to people when their insurance companies told them NO to services they needed?
The GOP understand there is no point in being a pimp for the insurance companies if they will no longer get their cut.
Who needs death panels if you simply leave medical care to Market Forces ie: Can't afford it you don't get it. Look it aother way...Survival of the fittest.
Obviously Paul Ryan has been to a brain-death panel along with the event's other participants.
And the most amazing thing is, when Sarah Palin created the phrase "death panels" in the context of Obamacare, she wasn't even talking about the IPAB. She was talking about the provision of the law whereby Medicare would have provided payment to healthcare professionals to talk to seniors about end-of-life decisions such as living wills, hospice care, and durable powers of attorney. This was a very important and valuable piece of the bill, IMO, and the fact that we allowed her to kill it by uttering the phrase "death panels" is a crying shame. But the fact that Ryan is tying that term to the IPAB is actually pretty disturbing. It's either another outright lie he's trying to perpetrate, or he simply doesn't understand the history of that law. I'm guessing it's a little of both.
When the hypocrite Palin was half term governor of half baked Alaska, she signed a proclamation saying that everyone should have a living will and advise their doctor of their wishes, and promoting what she later called "death panels".
Ryan, like Cantor, is a fear-mongering ass.
Perfect description...I just can't decide which one of them is the more perfect!!!!!!
Thurston Howell's other son.
On the local news , a woman sued a state run nursing home , her 91 year old mother was put there because she could not take care of her , she was basically in a vegtible state , the grand ma passed away , and in the report about her death , no one indicated they gave her cpr when they found her dead , so this woman sued the state , the insurance company that covers the state paid the settlement without it going to trial , how many things are wrong with that picture ?
My father ended up in the same scenario , we had discussed what to do already , the nursing home sent him to the hospital when he became unstable , the doc started working on him and alls I said was lets just make him comfortable , they looked up and said that was all they needed to hear , having a coherent user friendly system in place for these scenarios is not unreasonable , but the contards will fight it all the way , because They posses zero common sense
Oh Sigh. So by his own admission, a panel will be looking at ways to reduce costs, and politicians are so disconnected from their constituents and lazy that they will just let the panel's decisions ride, rather than come up with something themselves. But, if we don't have the panel, then the politicians will be connected enough to respond to the changes that need to be made? I have never seen free markets benefit the consumer, it just paves the way for collusion. Again, Businesses are in there to MAKE money. If there is another layer of profit to be taken, then we will have to feed that beast too, and I don't know how that could reduce costs without impacting care. It has already been proven that, while we pay more to insurance companies who provide Medicare Advantage programs, some of those providers don't have any better outcome than people who are on Medicare! Changes need to be made, but unilateral decision-making by politicians means our seniors will continue to be fodder. No thanks.
The IPAB is going to use standards for every type of illness or condition to determine what should be the standard treatment and payment for such treatments based on locale. This is the same thing that private insurance companies use named "medical utilization review" units. These units are dedicated to reviewing the diagnosis, treatment, and medical procedures that are used in specific cases. A medical utilization review unit consists of doctors and nurses reviewing cases for the insurance company and making recommendations to allow or disallow payments as well as forcing doctors to recode their billings to a procedure or diagnosis that has lower payments.
I've just started my studies for a degree in Medical Office Administration. The number of bills and acts passed to try to reign in Medicare spending is crazy. Every procedure or treatment has to be documented, every reason for the procedure or treatment has to be documented. Then you have people who do "spot checks" for errors ranging from improper coding, to upcoding, to bundling things that should not or unbundling things that should not be unbundled.
However, all of these acts and bills and regulations are quite simply aimed at controlling costs. Everyone is screaming that Medicare doesn't have enough money.
The take away, for me, is that if a Democrat says we need to lower costs, it's a death panel. If multiple bills and acts are passed through out history, including more than a few under Bush and other Republican president's, it's just called trying to save Medicare.
Asses.
I live in Oregon where we do have a death with dignity law. If you are terminal there is a process where you can end your lie and your suffering. IMO this should be made available to all on medicare. Rationing health care is the only thing that is going to bring down costs and starting with allowing people this, is a good beginning. My mother broke her hip at 88 had a stroke at 89 and lymphoma at 90 all paid by medicare. she is now 95, I think if people at an advanced age need expensive treatments they should have a supplement plan and pay for it themselves. If not, our only option should be to increase the premium and the payroll tax because the system is running a deficit and is not sustainable.
oops, I meant "life" not "lie" lol. That's a little right wing even for me!
OK, this is really simple: Healthcare costs money. There is a very broad range of medical services available, including hardware(technology, medicine, infrastructure, etc.) & software(human services & related services that are not a physical commodity). The actual financial costs of these goods and services is, at best, a guesstimate. The value of a human life falls somewhere within this calculation. That value is based on a variety of factors, including emotional value to family, friends, colleagues, and the relationship of that human to its environment, its productivity on a cost/benefit analysis, or simply that human life has an indefinable value. There are limits to the availability of healthcare services, based on the above factors. At some point, someone has to decide how to allocate the available resources, based on the value of the life of the person in question. Since there is no foo-proof method of evaluating the life, someone has to make the choice. I believe everyone has a stake in the outcome. The ones with the most power (usually a function of dollars) usually prevail. When we vote, we are declaring our values based on the power we choose to recognize. Dollars or human compassion. Romney/Ryan seem to be a vote for dollars. Obama, human compassion. And, neither is an absolute. Each of us still has to live with our vote.
I believe that this statement is misleading. It seems to imply that health care professionals are free of political bias. This couldn't be further from the truth. Just look at the medical cannabis issue. There, the majority of health care professionals fall in line with big pharma's political interests and others, a very small minority, are just trying to treat disease. Clearly there is no easy solutions but health care professionals have just as much self interest as politicians.
I find it ironic that there are those who talk about threats to our freedom while they continue to persuade people to vote against their own self-interest. Please explain the threats to my freedom from Obama. “Hands off my health care.” Pal, there are hands all over your health care, and they're sucking up 20% or more of what we spend on it. That's right. Private insurance companies are already rationing health care, denying treatment, exploiting every loophole not to pay, legal and not so. Maybe it's not such a good idea to let people make tons of money by figuring out ways not to pay, and then give a whole bunch of that money to politicians and lobbyists.
We have the best military in the world, the best air traffic control system, and the list goes on and on. Given a choice between government-run health care and private greedy insurance-run health care, I'll take the government, thank you. But that isn't even the choice. The government doesn't run health care, doctors and hospitals do. Ask doctors who runs health care now, who tells them what they can and can't do. Yep, insurance companies. And by the way, if government health care is so bad, why didn't Republicans get rid of Medicare when they were running the country and had the chance? Instead, they actually expanded it — while handing more money to drug companies at the same time. Why? Because people like Medicare. And I'm guessing that's what Reps are worried about now. Obama gets a victory, in a couple of years it turns out people like ACA, and the Reps look mean and dumb. Kiss the next election goodbye, too.
Canada has had a government funded, physician run, universal single payer health care system nationwide since 1966, The percentage of Canadians who would rather have an American style insurance run health care system is always in the low single digits (5% maximum, 3% average).
Self serving American lie filled propaganda suggests that Canadians commonly go to the US for health care, while the actual fact is that it is Americans who stream to Canada to get the health care they are denied by the decisions of insurance company bureaucrats. Only a small handful of Canadians go to the US for health care reasons and, if it is necessary (and that is very rare), the bills are paid by the provincial government. On the other hand, 500 Americans come to Canada for health care for every Canadian who goes to the US for health care.
The first thing a Canadian who takes sick or is injured while visiting, on vacation, or working in the United States does is not to go to a US physician or US hospital. The first thing a Canadian who takes sick or is injured while visiting, on vacation, or working in the United States does is to buy a plane ticket back to Canada to be seen by a Canadian physician and to go to a Canadian hospital. Not even Canadians who take sick or are injured in the UNITED STATES use American health care, let alone Canadians in Canada would be so stupid as to go to the US for health care when access, quality, and medical outcomes are far better in Canada than they are in the United States.
Speaking of which, I remember I was in a country with universal health care a few years ago. I sustained a minor injury. I found a hospital, walked in, sat around for twenty minutes or so. They asked what was wrong, patched me up. I left. That was it. No ID, no paperwork, no money. Amazing.
A couple of my American cousins who needed medical attention while visiting in Canada found the same thing.
Phuckin Idiot!!!!!!!!!!!!!!!!!
If these two bozos, Romney and Ryan, ever gain control, it will bode only ILL for this Country. And by "ILL" I mean -for starters, everything from a sub rosa, unregulated, Oligarchy -similar to, but more corporate-inclusive than the feckless Bush/Cheney employment under the proprietorship of Exxon/Mobil, to a war with Iran. If the potential consequences of their ever being elected were not so disastrous, their running for office in itself, would be, as they, an absurd and baleful joke. Take heed: "Those who can make you believe absurdities can make you commit atrocities [like getting you to vote for them]."Voltaire(1694 - 1778)
Tom Nass
5th Marine Division - WWII
Nice quote. Didn't know that one. What would the latter-day monarchists call Voltaire today?
I firmly believe that, as the line in a movie goes: [Far too many people, because of cognitive deficiencies] "cannot handle the truth!"
Lies, however, are no problem for the mentally round-shouldered to handle!
That is why so many politicians lie. Because lies stick due to their not requiring any cognitive processing!
Tom Nass
5th Marine Division - WWII
Any time you refuse transplants, treatment, or care because of no money you are a death panel.