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View Diary: Medicare: What can we do about it? (314 comments)

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  •  So long as your panel is optional, then, so be it. (0+ / 0-)

    But I could not disagree with you more that every time the government funds something, it can hang on a condition like abiding by a panel of local medical and ethical experts. (I'm a Progressive Democrat who spent a 35-year career with a highly regulated company, and learned to work reasonably well with regulation even when it was not wise regulation.)

    It's one thing to fund counseling for the terminally ill patient and his or her loved ones. It is quite another to call that counseling "public representation."

    But it sounds like your proposal goes much farther than seeing to it that counseling is part of medical care. I think what you are suggesting is rationing as a condition of accepting Medicare, for example. Is that a correct reading of your idea?

    And if it is, good luck with selling that to the public. Rationing will help kill any health care reform it is a part of, however cost-cutting it may be.

    Obama and strong Democratic majorities in 2012!

    by TRPChicago on Sun Aug 21, 2011 at 10:35:23 AM PDT

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    •  Of course we are going to have to (1+ / 0-)
      Recommended by:
      stitchmd

      ration. We can't spend a million dollars to delay the death of a 90-year old by a month. If you think that the right answer is to pay for every procedure that a person wants, your policy will end up being responsible for the collapse of the entire system. People should be counseled, but those who refuse to accept the inevitability of death cannot be coddled at the expense of our entire system.

      I'm in the I-fucking-love-this-guy wing of the Democratic Party!

      by doc2 on Sun Aug 21, 2011 at 11:33:19 AM PDT

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      •  "Every procedure" and "coddling"? Ooops. (1+ / 0-)
        Recommended by:
        Catte Nappe

        If education and counseling - hopefully beginning well in advance of the event, sustained and available the time when it is called for - about the sense of continued care for the terminally ill is vital to health care reform, right on. The evolution of hospice care makes enormous sense for those in the patient's family and friends who are care-givers, aside from the cost-savings in lieu of huge end-of-life/anything-goes medical services.

        Those are sensible, even vital, aspects of HCR. I think they will care for an increasing number of terminally ill cases as time goes on and people of good will with eyes open to life's experiences understand how thoughtless it is to artificially sustain a patient's life, even though the medical profession can do it.

        But your position - as you've stated it - is beyond public acceptance right now: "People should be counseled, but those who refuse to accept the inevitability of death cannot be coddled at the expense of our entire system."

        Said that way, it sounds too much like meanly expressed cruelty, and very unlikely to persuade anyone to favor your committee approach. I'm in favor of reform, but you lose me on that one!

        Obama and strong Democratic majorities in 2012!

        by TRPChicago on Sun Aug 21, 2011 at 12:53:07 PM PDT

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        •  What I'm saying is that is where (0+ / 0-)

          we will end up. Because as our society ages, we are not going to be able to afford all these procedures. So the public will be faced with painful decisions. And the Congress that will be in charge of making those decisions is going to cut back on end-of-life expensive procedures. It has to happen, there is no real alternative.

          I'm in the I-fucking-love-this-guy wing of the Democratic Party!

          by doc2 on Sun Aug 21, 2011 at 04:15:40 PM PDT

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