On good days I wake up with a clear idea for Morning Feature, usually because I spent a lot of the day before thinking and talking with Herself and the Springoffs about that idea. On bad days, I wake up with no clear idea in mind, often because what I'd thought was a clear idea fell apart in the discussions with Herself and the Springoffs.
Then there are days like today, when I wake up with a whole bunch of ideas, none of them all that clear. They're tidbits of ideas, none of which says "Hey, I'm a good idea for an essay." In fact, they say: "Who me? Umm, it's that other idea's turn."
More below the fold....
Some Tidbits
In another diary this morning, rrouda suggests Obama Should Issue Veto Threat over "Death Panel" Provision. On the one hand, I agree that "this provision can be misinterpreted" is a weak reason to remove it, especially when in this case misinterpreted translates to lied about. The provision isn't ambiguous. A health care industry flack just made up a lie about it and, with well-organized and well-funded support, that lie went viral. If we start removing provisions that can be successfully lied about, that's a bottomless pit of "this provision can be misinterpreted."
On the other hand, were President Obama to issue a veto threat, he simply raises the stakes. His veto threat wouldn't change opinion or better inform a discussion on whether end of life care consultations should be reimbursable under Medicare. It would more likely harden opinions where they are, and make an already (if falsely) controversial minor provision into the make-or-break issue for the entire bill.
Much as some wonder if President Obama has the temperament to stare down the GOP - and sometimes I wonder that also - I'm not sure if this is the issue on which I want him to prove that. But I'm not sure it's not the issue either.
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Much of the reaction to yesterday's Morning Feature about The Tangled Skein of End of Life Care focused on living wills and other advanced directives. And I replied in several comments that while living wills are useful and we all should have one, this issue isn't entirely about living wills. In most end of life care cases, a living will doesn't apply because the patient is still able to speak for him/herself, and care is governed by the will of the living, not the living will.
So these end of life care consultations are often needed even when the patient already has a living will, because a conscious and aware patient is not bound by an advanced directive. Often such consultations include the patient's loved ones, because the patient wants their input. Such conversations often take more than a few minutes, because the doctor must lay out the medical facts and the alternatives, and answer the patient's and family members' questions.
A surprising amount of the cost of end of life care comes in the form of confirmatory procedures to rule out other possible diagnoses, diagnoses the doctor suspected or even knew were not correct but must disprove, because the patient and family want the peace of mind of having left no stone unturned. These confirmatory procedures can total tens or hundreds of thousands of dollars, and most of the time the patient and loved ones find themselves right back where they started days or weeks before: with the original diagnosis and a terminal prognosis.
But sometimes there's a triumphal and joyous House, M.D. moment ... the doctor discovers the original diagnosis was wrong and the patient actually has a treatable condition. That happens often enough that it's impossible to blithely declare: "We must limit these redundant tests, as they usually do nothing but increase the cost of dying." Even when the tests confirm the original diagnosis, they've done something: given the patient and his/her loved ones some peace of mind. How much is that peace of mind worth?
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I had a minor epiphany while watching Ed Schultz last night. The transcript isn't up yet, but one of his panel guests was a GOP strategist who reminded me of why I hated junior high school. She said (quoting from memory): "President Obama is going to sell out the left and give up on the public option in order to get a bill passed."
She reminded me of junior high school because most of us probably heard something similar from a 'friend' during those years, usually involving someone we both found attractive: "He/she doesn't really like you. I heard he/she really likes someone else."
In my day - the Mesozoic Era - we called that behavior "a snake in the grass." At least on the Ed Show she was identified as a GOP strategist, so I could question whether this was an assessment based on observed behavior or just a cynical attempt to discourage progressives. Here on DailyKos, we can't always be sure.
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Ahh, but the stars always know ... sort of:
Leo - Despite what you've heard, tids don't actually bite. In fact there are no tids.
Virgo - Tads don't usually bite either, but they do conduct public opinion research.
Libra - Your intelligence helps you understand veiled puns. Oh wait, that was the Scorpios.
Scorpio - So you get to explain tad polls to the Libras.
Sagittarius - Please don't pull the plug on Chuck Grassley's grandma.
Capricorn - Not even if Chuck Grassley's grandma is already dead.
Aquarius - Your Kossascope was deleted because it could be easily misinterpreted.
Pisces - Max Baucus promises you'll have this weekend's Kossascope by next year.
Aries - Newt Gingrich insists you can't trust government Kossascope programs.
Taurus - Sarah Palin insists your Kossascope may be a secret plot to kill Glenn Beck.
Gemini - Lou Dobbs says your stars came over the horizon without a green card.
Cancer - Rush Limbaugh says your constellation looks suspiciously like a swastika.
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Happy Friday!