2009-12-17

pro-lifer mandate

7.21:
. a major opposition to health care reform
is the concern by pro-lifers
that it may be used as an instrument for
gov-mandated anti-life decisions:
specifically,
the gov' is responding to the fact that
most of a person's health bills
are incurred during the last year of life;
ie,
we are spending a lot of money to bring them very little more life .
. without having read the bill myself,
relying only what pro-lifers are saying about it,
it sounds like the gov' would cap this like so:
if the treatment needed to extend life another x years
was projected to cost more than, say, $45,000 per year,
then that treatment would be replaced by a let-die policy
that would treat only symptoms such as pain, infections, etc .

. back when the church was forming,
we didn't have the sort of medical decisions we face now;
physicians could only say "(first do no harm),
and then let god's renewing death machine
do its work with a minimum of suffering .
. Jesus did make a point of bringing friends back to life,
but he also said children were the highest priority,
and that's where our [elder heroics]-money should go .
(big picture:
"(first do no harm) -- the children need that money
) .

. here again I'm getting the feeling from pro-lifers
that they are full of unfunded mandates:
. while they could be setting an example
with social systems that actually work
instead, they water down their demands to maximize membership .

new testament example:
. in the new testament -- which the church itself built
(tossing many scripts that didn't suit their tastes) --
they include an example of how, because of class diff's
(between the wealth and poor)
communalism just doesn't work .
. well, that's absurd,
it's an obvious call for the future church,
to find some way to make it work .
. we must find communalism
to replace the loss of the extended family
-- a loss imposed on us by the industrial revolution
with its calling for the nuclear family to move out
to that next great job offer .

. when people have a commune backing them up,
they are no longer alone in caring for the unexpected child,
or in taking abuse from the senile elder .
. communalism means communal ownership of children;
making childcare a public concern, not a private nightare .
. when expectant mothers ask our doctors about abortion;
we can ask assuringly:
"( we're the parents,
why would you want to abort our child? ) .

. "(family values) in America is really just
a watered-down, empty version of the extended family;
and a family-values christian
is just running scared from the calling to communalize .

. let's look at how these same christians
are attracting the pro-lifers:

. if we had communes, then we'd be caring for our own,
not by ourselves, but in a collective effort by one's commune .
. without communes,
we are asking tax payers to hire professionals in retirement homes;
away from the children who could ask:
"(what's wrong with grampa .)

"( . grampa was raised in the age of the high-glycemic diet,
full of sugar, flour, ... corn syrup,
and meat raised on grains not grass .
. we'll all go mad like that now -- in a nuclear family
... that will never even know about it .
) .

12.17:
. with communalism, pro-lifers could hardly stand their own choices:
"(
. oh, now we all have to go psychotic caring for the senile,
and give our shirt to million dollar congenital defects .
) .

8.3: pol/health care/cooperating with pro-lifers:
. getting a lot of heat from pro-lifers;
isn't there any way to separate gov funds from controversial treatments?
wouldn't matter anyway, they are even fighting about
not treating the terminally ill and comatose .
-- they are not happy even if you do let god make the choices!
. still, how about no abortion funds for the gov plan,
and then remind the pro-"(lifer)s
that if they want to feed their vegetative cases,
they can do so in their own high-premium private plan ?

8.9:
. members of Congress physically assaulted?
hearsay from from one rep about another at a meet .

. where are the blue dogs w.r.t the pro-lifers?
they are fiscal conservatives:
their main problem is the plan is still too expensive;
pro-lifers would make it more expensive
with their demanding unlimited life-support
for the terminally ill .
. but one way they could get pro-lifer support and still be cheaper
is to ask that the gov stay out it
-- that means saying later to universal coverage .
. this round, just ask for manditory health insurance
and manditory acceptance -- this will make health care cheap .

. apparently the insurers are feeling the pressure of the pro-lifer
and submitting to it while taking losses .
. much easier to nickel-and-dime the non-life cases .
. this is what a seemingly confused woman meant by
"(keep the gov out of medicare);
she was reminded that medicare was already a gov program,
but she was right in knowing that the reform being proposed
would, in fact, fundamentally transform medicare
along with any extension programs
by dictating how much money could be thrown at life-support cases
and make other decisions that would so restrict your own doctor
that being able to choose your own doctor would be meaningless .
. pro-life costs more money,
but esp'ly the people using medicare
would often not be able to afford a private health plan
-- exactly because it was supporting the spendy ways the gov was nixxing .

. the admn should plead open source,
point out the costs,
and ask amer's if they are not about accountability .
. do we pay life-support cases when we don't want to ?
do we pay for abortions when we don't want to ?
how can we respectfully ask for more accountability?






8.12:
. I think they they are confusing 2 issues:
the "(death panel) cries are not talking about the end of life counciling,
rather they are refering to the medical panels being set up
to decide what services are worthwhile,
and one criterion, is that adding a year of life
should cost no more than a certain amount .
. I found various blogs that confirm this and responded to them:

[one reader responds:
that recommendation was made the context of medical ethic principles,
not actual policies coming from the White House.
That juxtaposition is not only dishonest and disingenuous,
but also factually incorrect....
]
June 3, 2009
Indeed, without a serious, sustained effort
to reduce the growth rate of health care costs,
affordable health care coverage will remain out of reach.
So we must attack the root causes of the inflation in health care.
That means promoting the best practices,
not simply the most expensive.
We should ask why places like
the Mayo Clinic in Minnesota, the Cleveland Clinic in Ohio, and other institutions
can offer the highest quality care at costs well below the national norm.
We need to learn from their successes
and replicate those best practices across our country.
That's how we can achieve reform that preserves and strengthens
what's best about our health care system, while fixing what is broken.

I believe if we are going to make people responsible for owning health insurance,
we must make health care affordable. [and provide] a hardship waiver
to exempt Americans who cannot afford it.
In addition, while I believe that employers have a responsibility to support
health insurance for their employees,
small businesses face a number of special challenges
in affording health benefits and should be exempted.

To identify and achieve additional savings,
I am also open to your ideas about giving special consideration to
the recommendations of the Medicare Payment Advisory Commission (MedPAC),
a commission created by a Republican Congress.
Under this approach,
MedPAC's recommendations on cost reductions would be adopted
unless opposed by a joint resolution of the Congress.
This is similar to a process that has been used effectively by
a commission charged with closing military bases,
and could be a valuable tool to help achieve
health care reform in a fiscally responsible way.


While MedPAC currently only makes suggestions regarding Medicare payments and costs,
the Obama proposal [above] would greatly expand MedPAC's power
over a large percentage of the economy
-- and the health and welfare of tens of millions of people --
because MedPAC's actions would have the force of law
without any significant accountability:
The likelihood of a joint resolution of Congress against anything MedPAC did
is so small as to make MedPAC a law unto its own.
MedPAC will become a de facto health care Czar

The analogy of closing military bases
to making health care costs decisions if fallacious.
The base closing commission was a reaction to large excess capacity in military bases,
largely as a result of pork barrel earmarks.
Taking politicians out of the closing process
was the only way to close military bases,
so that politicians would not take the blame.
There is no excess capacity, however, in health care services.

my response: (8.12.2023 -- post not yet approved):

. there is indeed an excess capacity of health care
-- given our limited budget;
pork is relative: if you've got plenty of money,
you can never buy too much military security!
likewise for health care:
no senator wants to do the grizzly job of medical triage;
therefore, a commission is again needed to do the job for them;
so, it was a perfect analogy .




. [one of] Obama's advisors famously frets about
the insistence of American physicians on doing
"everything for the patient regardless of cost."
Thus, stopping such costly interventions will be a
primary mission of the
"Federal Coordinating Council for Effectiveness Research,"
a new hive of health care apparatchiks
created by the infamous "porkulus" bill.
This new bureaucracy is intended to operate like its European counterparts,
meaning that it will assign a monetary value to your life
and deny your care if you contract a malady whose
cost-of-treatment exceeds that amount.

It is called the "quality-adjusted-life-year" (QALY),
and it assigns a numerical value to a year of life.
A year of perfect health, for example, is given a value of 1.0
while a year of sub-optimum health is rated between 0 and 1.
In Great Britain, for example,
the National Institute for Health and Clinical Excellence (NICE)
uses "cost per QALY" to determine if patients should receive
expensive treatment or drugs.
"NICE currently holds that, except in unusual cases,
Britain cannot afford to spend more than about $22,000
to extend a life by six months."


. the reason Obama has not emphasized rationing as an economizer,
is that there have been such fine examples like the Mayo clinic
of getting good results based on prevention
and careful use of resources .
. to insure we have choice,
the commission would be deciding simply what the insur'co would pay;
we can pay for any additional services using our own money,
at the same prices we the insur'co would have to pay .
. I'm sure that's what Obama has in mind;
because he said that if we like our care, we can keep it;
and the one care we do have now
is being able to buy any service we can afford out of pocket .
-- appreciating Michael Moore, usa


Gallup found the approval rating on health care
at 43 percent now approving
and 49 percent disapproving
Meanwhile, Rasmussen found that support for Obama health care
has dropped 6 points in the past two weeks, to 42 percent,
while a 53 percent majority now oppose.

. Obama care doesn't have popular support?
well then I see usa`people hear the gov' saying:
"( medicare is too costly; and, to reduce costs
the gov' will expand services to non-elders?
featuring preventive measures?
) ?!
. elders are now getting whatever they can talk their doctor into;
but with Obama care,
they are going to have their soda's taxed,
and be told they need to go on a Zone diet .
. if only usa`people could see
that the biggest cost-cutter of Obama care is going to be
manditory health insur' purchasing:
why are they even worried about the gov's health plan?
all the other private plans will be affordable too!
. however,
the gov' plan may be even cheaper
and be the only plan reachable by the unemployed;
so, many do indeed feel trapped into Obama care .
. the real venom is coming from
the same place it always has:
the life-vs-choice debate is obvious,
as most of usa's health costs are incurred
during the last year of life;
so, you must know,
the gov' will be sneaking into life-snuffing rationing
of elder and vegatative life supports
as the primary way to ensure costs stay down .
. apparently the other health insur'co's are silently agreeing
there's no profit in bumping into pro-lifer's;
so if the gov' thinks it can do that,
there will be no fair competition;
except of course,
that there will still be the upper class and religious
who will be willing to pay higher premiums
in order to receive special and pro-lifer services .
. also, the gov' will be paying doctors more for
keeping people well rather than per service;
whereas,
the wealthy would rather have more control over their doctors,
using them more for sports and performance than wellness .
. finally, I wonder how much of the opposition
might be thinking they already get free health care
any time they care to sit in the emergency room?
. to them, the Obama care is just another fat tax needle .