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Letters to the Editor

Divisive debate

August 16, 2009

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To the editor:

As a physician I have talked with people about how they want to be treated at the end of their lives. If they knew they were dying, how much would they want done? Would they want to be at home or at a hospital or in a nursing or hospice facility? How much chemotherapy, resuscitation, diagnostic tests, feeding tubes, etc., would they want? At some point would they just want to be kept from suffering?

I also want to be able to have this sort of conversation for myself. I want eventually to be allowed to die with dignity and peace and without a great deal of medical intervention intended just to forestall death for a few more days or weeks. Some of these things need to be decided before the fact; otherwise medical personnel may be required to give us a lot more “treatment” than we might want.

This sort of discussion is what is included in the current House version of health insurance reform, and it is a far cry from the notion of “death panels” that ex-Gov. Palin and others are screeching about in a cynical and manipulative way. I look forward to the day when we the people no longer tolerate extremist politics and instead demand the kind of rational debate a true democracy requires. We can’t afford to let health care reform be derailed by this sort of divisive foolishness.

Comments

SettingTheRecordStraight 5 years, 4 months ago

Thankfully we have the good doctor to tell us what is "rational debate" and what "a true democracy requires." We're fortunate to have Joe tell delineate "divisive foolishness," "screeching," and "extremist politics" from genuine "health insurance reform."

Arrogance.

SettingTheRecordStraight 5 years, 4 months ago

And Joe, we've all read the polling. Health "insurance" reform polls better than health "care" reform, so please, continue using the terminology of Move On and the Daily Kos. We're not too dumb to know when you're demonizing an industry for selfish political gain. Right.

jonas_opines 5 years, 4 months ago

"We're not too dumb to know when you're demonizing an industry for selfish political gain."

Oh?

scott3460 5 years, 4 months ago

"I look forward to the day when we the people no longer tolerate extremist politics and instead demand the kind of rational debate a true democracy requires."

The public had its say after the Terry Schiavo fiasco & will pass judgment on the current tactics of the pay or die insurance industry and their supporters.

Richard Heckler 5 years, 4 months ago

4 substantial reasons why Medicare Insurance for All should be the choice for all in america

  1. *Eliminates Politicians as shareholders: http://www.washingtonpost.com/wp-dyn/content/article/2009/06/12/AR2009061204075.html

  2. *Eliminates Paying More Getting Less http://www.dollarsandsense.org/archives/2008/0508harrison.html

  3. *Eliminates Leading Cause Of Bankruptcy http://www.consumeraffairs.com/news04/2005/bankruptcy_study.html#ixzz0IQKZLHHh&C

Why use Medicare? It eliminates reinventing the wheel therefore saves a big bundle of money and time = efficient use of existing resources.

Medicare is in place therefore it is ready to roll which is convenient. The only major change necessary is reimbursement numbers which the author and the 87 cosigners are perfectly aware. They are also very much aware of what the inefficient insurance companies pay out on invoices which is never full invoice. Insurance companies usually pay out about 50%-60%.

The USA needs to STOP being be the most expensive insurance/health care of the industrialized nations if americans want jobs back.

HR 676 Medicare for All insurance coverage is key to creating new wealth for america. The most expensive health insurance in the world is not the answer for keeping business costs down and keeping our cost of living somewhat in check.

lippydog 5 years, 4 months ago

I can have an end-of-life consultation right now if I want to. I don't need or want the government's permission or insistence that I do so.

It'll be a cold day in he!! when I allow a member of the party of death to make decisions about my health and my medical treatments.

All the freeloaders in this country who can't wipe their own butts without the government holding their hands ARE NOT ENTITLED TO ANYBODY ELSE'S MONEY.

jonas_opines 5 years, 4 months ago

Haha, the "party of death" (!)
That's one I hadn't heard before.

These should be the real names now. The Party of Death and The Party of War. Then we could call the Green Party The Party of Famine and the Libertarians The Party of Pestilence, and we'd have all four.

staff04 5 years, 4 months ago

"I can have an end-of-life consultation right now if I want to. I don't need or want the government's permission or insistence that I do so.

It'll be a cold day in he!! when I allow a member of the party of death to make decisions about my health and my medical treatments."

I just don't understand the persistent refusal to even attempt to understand what the end-of-life consultation language in the health reform debate means. I'll try to explain: what the language in question states is that should a patient CHOOSE to have a discussion about the end of their life with their physician, then the insurance coverage they CHOOSE will, as long as it is an exchange qualifying plan, be required to pay the doctor for that service.

It's a freaking coverage mandate. Not a requirement, no government insistence, no party of death involvement whatsoever.

If you want to have the discussion with your doctor, you will not have to pay out of pocket for it. Your insurance provider (public, medicare, medicaid, private exchange policies) will pay for it. How that has been twisted into the unashamed lies that we're persistently hearing I simply cannot understand.

I suppose that isn't as sexy as death squads--I also suppose expecting supporters of the status quo to in honest dialogue is too much.

jaywalker 5 years, 4 months ago

jonas' is on a roll! You're makin' me laugh out loud and my dog doesn't know what's goin' on, man!

lippydog 5 years, 4 months ago

To staff04....

I don't have to pay for it now and I don't want the government's nose any farther out of it's boundaries and into my life. It's been way outside them for too long.

And I don't understand the persistent refusal to understand that the majority of Americans don't want more government intrusion so that freeloaders can get "their fair share" of someone elses income.

jonas_opines 5 years, 4 months ago

jaywalker: I'm probably going stir-crazy.

notajayhawk 5 years, 4 months ago

scott3460 (Anonymous) says…

"The public had its say after the Terry Schiavo fiasco & will pass judgment on the current tactics of the pay or die insurance industry and their supporters."

Pay or die - great rhetoric, little one.

Actually, Scottie, the isurance companies are 'pay-or-bear-the-financial-risk-yourself.' It's fine humanitarians like our good LTE writer who introduce the part of the equation that says 'no-pay-no-treatment.'

notajayhawk 5 years, 4 months ago

"Divisive debate."

Pretty much sums it up. The highly divisive and politicized nature of this constant bickering points out exactly why politicians should not be put in charge of our healthcare decisions.

funkdog1 5 years, 4 months ago

Liberty_One (Anonymous) says…

Dr. Douglas makes a good point, but comes to the wrong conclusion. End of life decisions should be discussed—but only between patient and doctor. Why does the government need to be involved in such decisions?

What? So you think Joe Biden is gonna be in the room? It has never been stated that the government will be involved in end of life decisions. The government is simply stating that if you're at the end of your life and your medical care is being paid for by Medicare, it RECOMMENDS that you have a discussion with your doctor about end of life care. That's all. Nothing more, nothing less.

notajayhawk 5 years, 4 months ago

"The government is simply stating that if you're at the end of your life and your medical care is being paid for by Medicare, it recommends that you have a discussion with your doctor about end of life care."

Then why can't we call it a discussion about "continuation of life care?"

funkdog1 5 years, 4 months ago

notajayhawk (Anonymous) says…

“The government is simply stating that if you're at the end of your life and your medical care is being paid for by Medicare, it recommends that you have a discussion with your doctor about end of life care.”

Then why can't we call it a discussion about “continuation of life care?”

Okay, seriously. Can the people on the right at least attempt to think and behave like grownups? Because of the great quality of medical care in this country, there gets to be a point in many Americans' lives when the doctors CAN keep a person alive for another day, another week, another month, but it's doing nothing but prolonging the inevitable. Most people at some point are going to need to make some serious decisions: Do I keep taking chemo treatments that keep me in agonizing hell but keep me from dying for another two weeks or do I give up on the treatments and end the suffering? There are a million such scenarios as this one. I won't try to list them all.

Have you ever actually watched a person die? Have you sat with a loved one and seen them wither and suffer? Have you seen (and smelled) a person's body literally start to rot away before they've even died? These things are real.

What if a person slips into a coma and they haven't put in writing what measures they'd like taken or not taken at the end of their life? Should you just depend on your family members to make such important decisions for you? Wouldn't you want the opportunity to discuss with a doctor yourself what you'd like to have happen at the end of your life?

That's all anybody's saying. Everyone should have this discussion with his or her doctor. To try to pretend that this issue is anything else is childish.

notajayhawk 5 years, 4 months ago

porch_person (Anonymous) says…

"The usual idiots show up"

Yes, porchie, we were waiting for you. Kind of like locusts, although expected, your arrival brings about as much good cheer.

And about as much intelligence.


funkdog1 (Anonymous) says…

notajayhawk (Anonymous) says…

"Okay, seriously. Can the people on the right at least attempt to think and behave like grownups?"

Dunno. When are such fine folks as yourself on the left going to start?

"Because of the great quality of medical care in this country, there gets to be a point in many Americans' lives when the doctors CAN keep a person alive for another day, another week, another month, but it's doing nothing but prolonging the inevitable. Most people at some point are going to need to make some serious decisions: Do I keep taking chemo treatments that keep me in agonizing hell but keep me from dying for another two weeks or do I give up on the treatments and end the suffering?"

And I need my doctor to tell me what I want to do in that situation, funkie? On the government's dime? I think not, thank you. (Oh, and by the way, keeping someone alive for another 50 years is still 'prolonging the inevitable.')

"Everyone should have this discussion with his or her doctor."

Or perhaps their spouse. Or children. Or minister. Or friends and confidants.

A doctor's role is to present the facts and the medical options. It is a personal decision to make the choice. Neither I, nor anyone else, needs to be "counseled" by a physician on what would be the best choice to make based on their opinion.

And I notice neither you or porchie tried to answer my question. Why that particular choice of terminology, funk? If modern medicine can keep a person alive, and the only goal of this 'counseling' is to help the person come to a decision on whether or not they want that to happen, then why is it called "end of life" counseling?

jaywalker 5 years, 4 months ago

"Notajayhawk, people die. You'll come to that point, I'll come to that point, everyone comes to that point."

Anyone who was confused on that point can now thank porch, Purveyor of the Extraordinarily Obvious, for clearing it up.

"What's disgusting is that you guys will hasten the process by fighting for a status quo where Americans will come to that end faster than citizens of other countries just so executives at health insurance companies can enjoy insane profits."

So many fallacies, so little time.....

  • "you guys": gross over-generalization and in the context of his 'argument', incredibly false.

  • "fighting for a status quo": has there been a huge call for things to stay exactly the same? From anyone? Nope, I haven't heard that either. Porch must be hearing voices again.

  • "Americans will come their end faster than citizens of other countries": because THE problem is that foreigners are living .2 years longer on average, and this IS a competition you know! I mean, it's incredibly important that we live longer than Albanians, why can't we prioritize?!

  • "just so executives at health insurance companies can enjoy insane profits.": sooooooo..... (titter)..millions of Americans..(chortle)... are opposed to these proposals (guffaw).... "just so" a hundred or two can benefit????!!!! (laughter) (laughter!) (roflmaoroflmaoroflmaoroflmaoroflmaoroflmaoroflmao!!!!!)

That's comedy gold, porch! Well done! I hope for safety's sake you have someone tie your shoes for ya.

notajayhawk 5 years, 4 months ago

porch_person (Anonymous) says…

"No wonder you don't like it when I show up."

No, just that this message board was already over quota with morons, porchie.

"An idiot who doesn't know that the DNR decision is totally in the hands of the patient (and can be revoked at any moment) is unlikely to enjoy being corrected before the entire Internet."

Would you be that idiot, porchie? 'Cause the rest of us knew that. One of the reasons we don't need any 'end-of-life' counseling courtesy of Uncle Sammie.

But hey, if it hastens your decision any, where do I vote?

(BTW, porchie, your own incredible ignorance is astounding - it's not quite true that a Do-Not-Resuscitate order "can be revoked at any moment," is it? After all, the one "moment" it can not be revoked is at the time it's actually being implemented, which is the only moment it has any usefulness at all.)

jaywalker 5 years, 4 months ago

"Denial of the necessity to make decisions at the end of life fuels the rhetoric..."

Typical pp fabrication. Noone's said it's not necessary, just that the guv need not be involved.

"Only a moron would argue for a shorter life for Americans just be contradictory to another blogger"

Typical pp spin. Pretend someone's line means what it does not. You ARE that kind of moron.

"The public relations campaign being run by the insurance companies through companies like DCI and ..."

Typical pp attempt to clarify a previously ignorant assertion. Perhaps the above is true to some extent, but that's not what you said. You said everyone's protesting just to make some exectutives rich, and they're already doing it knowingly. Yes, you are that kind of moron.

"I wouldn't be laughing at anyone, not with a documented history like that."

Typical 9 year old ...er......pp debate strategy. When all else fails, bring up something way off topic and lie through your teeth.
And laughing at you is uncontrollable, porch. Reading your posts is kinda like watching the Stooges; it's really dumb and simple-minded, but one can't help but chuckle at the idiocy of it all.

Preview of coming attractions: porch will respond with all or some combination of the same "typical" techniques displayed above.
-99.9% chance it will all be repetitive. -99.9% chance it will contain at least one lie -99.9% chance it will contain (laughter)

funkdog1 5 years, 4 months ago

notajayhawk (Anonymous) says… A doctor's role is to present the facts and the medical options. It is a personal decision to make the choice. Neither I, nor anyone else, needs to be “counseled” by a physician on what would be the best choice to make based on their opinion.

And I notice neither you or porchie tried to answer my question.

Wow. Now you're just being purposefully obtuse. I absolutely answered your question. "Continuation of care"? Is this just about a semantics pi$$ing match? Okay, we'll call it "Continuation of Care Counseling" instead of "End of Life" counseling when one finally discusses with his or her doctor that he or she would please no longer like to take chemo treatments as he or she is in agonizing pain and has zero quality of life left and would just like to die, please. Continuation of Care it is. (Eye rolling.)

Really? You don't need to be counseled by a doctor? Is that because you have a medical degree? You know every single treatment, medication and option that's open to you in every single medical situation? You can write yourself prescriptions? Maybe you'd like a doctor's advice because he or she has seen your condition before and kinda has an idea as to how it will progress. Maybe you'd like to tap into that experience and knowledge.

We're talking about a DISCUSSION that YOU have with YOUR doctor about YOUR options. We're not talking about doctors telling you what to do. That's what counseling is. A discussion between a professional and a layperson.

ksdivakat 5 years, 4 months ago

This argument is ridiculous anyway, they took the "death panel" out of the bill on Friday, so its a non-issue. Besides, it was a non-issue anway, as we already have these discussions, DNR's, living wills, hospice, there are plenty of "end of life discussions" that go on with people right now. But everyone talking about "rhetoric" on here are the same people calling names? That makes no sense to me...please explain? How do we move forward with the discussion if everyone is name calling and slinging trash??

jaywalker 5 years, 4 months ago

Make that 100% across the board.

Typical.

jonas_opines 5 years, 4 months ago

ksdivakat "But everyone talking about “rhetoric” on here are the same people calling names? That makes no sense to me…"

That's just hitting you? You've been here a long time!

"please explain? How do we move forward with the discussion if everyone is name calling and slinging trash??"

I think. . . . we don't.

jimmyjms 5 years, 4 months ago

"This argument is ridiculous anyway, they took the “death panel” out of the bill on Friday, so its a non-issue."

smashing computer against face

THERE WAS NEVER ANY SUCH THING AS DEATH PANELS!!!!

Jesus!

jimmyjms 5 years, 4 months ago

P_P, I know, it just gets tiresome when the same 4 or 5 people on here keep repeating the drivel.

jimmyjms 5 years, 4 months ago

I'm pretty sure that's above ksdivakat's pay grade.

ksdivakat 5 years, 4 months ago

well, say what you like, I coined the phrase "death panel" after reading it numerous times on here. I choose not to talk trash on anyone, as obviously, it doesnt fix anything, and I can see by the comments that the left doesnt want to fix it, by conversation, so its a non-issue for me, do what you want, say what you want, makes no difference to me. Geez, you guys are testy...just so you know, you can kick back, sip a glass of wine or coffee, whatever you prefer, and put on some soft classical music,light a candle,chill out, and that will cure that nastiness that Jonas and jimmy seem to have anytime someone doesnt agree with them, or uses a word they dont like.

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