This whole back and forth about whether the "Death Panels" really exist with no one showing proof that they don't is tiring. Below is the section of the Healthcare Bill that addresses the, well as they like to call it, "Advanced care planning". What I want you to pay attention to is what they are REALLY saying. Don't let all the wording slip you up and remember, you are reading a document created by government officials who HAVE NO CARE OR CONCERN about you or your family!
As well, they are clever in word choice to not openly state what they REALLY mean. It is up to us to determine what is and what is not. Just one other thing to note, physicians and other healthcare professionals already consult with patients about Living Wills and Medical Power of Attorneys. We already advocate for them to establish such for THEIR safety because unlike the government, we actually do care about our patients and their families! (Despite what Obama thinks about us, coming from an attorney it is quite comical to question the motives of healthcare professionals). Also note, insurance companies do NOT deny care based on stage of life or disease. If you have coverage you are covered until your last breath regardless of your condition!
SEC. 1233. ADVANCE CARE PLANNING CONSULTATION.
6 (a) MEDICARE.—
7 (1) IN GENERAL.—Section 1861 of the Social
8 Security Act (42 U.S.C. 1395x) is amended (A) in subsection (s)(2)—
10 (i) by striking ‘‘and’’ at the end of subparagraph (DD);
12 (ii) by adding ‘‘and’’ at the end of subparagraph (EE); and
14 (iii) by adding at the end the following new subparagraph:
16 ‘‘(FF) advance care planning consultation (as defined in subsection (hhh)(1));’’; and (B) by adding at the end the following new subsection:
20 ‘‘Advance Care Planning Consultation
21 ‘‘(hhh)(1) Subject to paragraphs (3) and (4), the term ‘advance care planning consultation’ means a consultation between the individual and a practitioner described in paragraph (2) regarding advance care planning, if, subject to paragraph (3), the individual involved has not had such a consultation within the last 5 years. Such consultation shall include the following:
3 ‘‘(A) An explanation by the practitioner of advance care planning, including key questions and5 considerations, important steps, and suggested people to talk to.
7 ‘‘(B) An explanation by the practitioner of advance directives, including living wills and durable powers of attorney, and their uses.
10 ‘‘(C) An explanation by the practitioner of the role and responsibilities of a health care proxy.
12 ‘‘(D) The provision by the practitioner of a list of national and State-specific resources to assist consumers and their families with advance care planning, including the national toll-free hotline, the advance care planning clearinghouses, and State legal service organizations (including those funded through the Older Americans Act of 1965).
19 ‘‘(E) An explanation by the practitioner of the continuum of end-of-life services and supports available, including palliative care and hospice, and benefits for such services and supports that are available under this title.
(What they mean: Doctors will inform you of all aspects of advanced care planning. This is already done and yes, it doesn't sound bad because being informed is important...but keep in mind those who are advising Obama that believe in healthcare rationing and the Complete Lives Cycle or Eugenics. Also remember they are referring to those who are terminal or have life threatening conditions. With the thought of healthcare rationing and Eugenics it makes a clear concern for what the government is wanting to accomplish with "requiring" advanced care planning- or discussing when enough is enough and you should just go ahead and die.)
1 ‘‘(F)(i) Subject to clause (ii), an explanation of orders regarding life sustaining treatment or similar orders, which shall include—
4 ‘‘(I) the reasons why the development of such an order is beneficial to the individual and the individual’s family and the reasons why such an order should be updated periodically as the health of the individual changes;
9 ‘‘(II) the information needed for an individual or legal surrogate to make informed decisions regarding the completion of such an order; and
13 ‘‘(III) the identification of resources that an individual may use to determine the requirements of the State in which such individual resides so that the treatment wishes of that individual will be carried out if the individual is unable to communicate those wishes, including requirements regarding the designation of a surrogate decision maker (also known as a health
21 care proxy).
(continuing with things that are already done by physicians and healthcare professionals...)
22 ‘‘(ii) The Secretary shall limit the requirement for explanations under clause (i) to consultations furnished in a State—
1 ‘‘(I) in which all legal barriers have been addressed for enabling orders for life sustaining treatment to constitute a set of medical orders respected across all care settings; and
5 ‘‘(II) that has in effect a program for orders for life sustaining treatment described in clause (iii).
8 ‘‘(iii) A program for orders for life sustaining treatment for a States described in this clause is a program that—
11 ‘‘(I) ensures such orders are standardized and uniquely identifiable throughout the State;
13 ‘‘(II) distributes or makes accessible such orders to physicians and other health professionals that (acting within the scope of the professional’s authority under State law) may sign orders for life sustaining treatment;
18 ‘‘(III) provides training for health care professionals across the continuum of care about the goals and use of orders for life sustaining treatment; and
22 ‘‘(IV) is guided by a coalition of stakeholders includes representatives from emergency medical services, emergency department physicians or nurses, state long-term care association, state medical association, state surveyors, agency responsible for senior services, state department of health, state hospital association, home health association, state bar association, and state hospice association.
6 ‘‘(2) A practitioner described in this paragraph is— ‘‘(A) a physician (as defined in subsection
8 (r)(1)); and
9 ‘‘(B) a nurse practitioner or physician’s assistant who has the authority under State law to sign orders for life sustaining treatments.
12 ‘‘(3)(A) An initial preventive physical examination under subsection (WW), including any related discussion during such examination, shall not be considered an advance care planning consultation for purposes of applying the 5-year limitation under paragraph (1).
17 ‘‘(B) An advance care planning consultation with respect to an individual may be conducted more frequently than provided under paragraph (1) if there is a significant change in the health condition of the individual, including diagnosis of a chronic, progressive, life-limiting disease, a life-threatening or terminal diagnosis or life-threatening injury, or upon admission to a skilled nursing facility, a long-term care facility (as defined by the Secretary), or a hospice program.
1 ‘‘(4) A consultation under this subsection may include the formulation of an order regarding life sustaining treatment or a similar order.
4 ‘‘(5)(A) For purposes of this section, the term ‘order regarding life sustaining treatment’ means, with respect to an individual, an actionable medical order relating to the treatment of that individual that—
8 ‘‘(i) is signed and dated by a physician (as defined in subsection (r)(1)) or another health care professional (as specified by the Secretary and who is acting within the scope of the professional’s authority under State law in signing such an order, including a nurse practitioner or physician assistant) and is in a form that permits it to stay with the individual and be followed by health care professionals and providers across the continuum of care;
17 ‘‘(ii) effectively communicates the individual’s preferences regarding life sustaining treatment, including an indication of the treatment and care desired by the individual;
21 ‘‘(iii) is uniquely identifiable and standardized within a given locality, region, or State (as identified by the Secretary); and
1 ‘‘(iv) may incorporate any advance directive (as defined in section 1866(f)(3)) if executed by the individual.
(What they mean: the physician is required to do this "planning" session with you and is required to do it every 5yrs or more often if indicated. So, the government will know when you are at a stage of care that is terminal or life-threatening, and thus considering the breakdown of healthcare rationing already discussed will be in charge of determining what care you will receive. This doesn't seem to mesh well with individual privacy. Why does the government need to know what condition you are in if not to determine whether you need further care of whether you should just go ahead and die? It is no one's business what stage you are at other then you and your physician. The government has stated they want to decrease costs and what better way then to limit care to those who are dying anyhow?)
4 ‘‘(B) The level of treatment indicated under subparagraph (A)(ii) may range from an indication for full treatment to an indication to limit some or all or specified
7 interventions. Such indicated levels of treatment may include indications respecting, among other items—
9 ‘‘(i) the intensity of medical intervention if the patient is pulse less, apneic, or has serious cardiac or pulmonary problems;
12 ‘‘(ii) the individual’s desire regarding transfer to a hospital or remaining at the current care setting;
15 ‘‘(iii) the use of antibiotics; and
16 ‘‘(iv) the use of artificially administered nutrition and hydration.’’
(What they mean: As of now, the patient will decide how much is too much when they are facing the end of their life, or family does. With this bill, the government will make those decisions for you. Remember, the wording sounds good and looks innocent, but you have to consider the whole rather then the parts. Healthcare rationing + Eugenics = End of life planning! Still skeptical, read further regarding "Physician Quality Reporting Initiative".)
18 (2) PAYMENT.—Section 1848(j)(3) of such Act (42 U.S.C. 1395w–4(j)(3)) is amended by inserting
20 ‘‘(2)(FF),’’ after ‘‘(2)(EE),’’.
21 (3) FREQUENCY LIMITATION.—Section 1862(a)
22 of such Act (42 U.S.C. 1395y(a)) is amended—
23 (A) in paragraph (1)—
24 (i) in subparagraph (N), by striking
25 ‘‘and’’ at the end;
1 (ii) in subparagraph (O) by striking
2 the semicolon at the end and inserting ‘‘,
3 and’’; and
4 (iii) by adding at the end the fol5
lowing new subparagraph:
6 ‘‘(P) in the case of advance care planning consultations (as defined in section 1861(hhh)(1)), which are performed more frequently than is covered under such section;’’; and
11 (B) in paragraph (7), by striking ‘‘or (K)’’
12 and inserting ‘‘(K), or (P)’’.
13 (4) EFFECTIVE DATE.—The amendments made by this subsection shall apply to consultations furnished on or after January 1, 2011.
16 (b) EXPANSION OF PHYSICIAN QUALITY REPORTING
17 INITIATIVE FOR END OF LIFE CARE.—
18 (1) PHYSICIAN’S QUALITY REPORTING INITIATIVE.—Section 1848(k)(2) of the Social Security Act (42 U.S.C. 1395w–4(k)(2)) is amended by adding at the end the following new paragraphs:
22 ‘‘(3) PHYSICIAN’S QUALITY REPORTING INITIATIVE.—
24 ‘‘(A) IN GENERAL.—For purposes of reporting data on quality measures for covered professional services furnished during 2011 and any subsequent year, to the extent that measures are available, the Secretary shall include quality measures on end of life care and advanced care planning that have been adopted or endorsed by a consensus-based organization, if appropriate. Such measures shall measure both the creation of and adherence to orders for life
sustaining treatment.
(What they mean: Now comes the good part. The physician is to report all end of life services (that is what they shared with YOU) so that the Secretary can use that information to develop quality measures on advanced care planning and have a consensus-based organization (which is? and consists of who?) measure the creation of and adherence to end of life care. What they are doing is collecting data to determine what you do or don't need. Remember, they are all about saving money not lives!)
10 ‘‘(B) PROPOSED SET OF MEASURES.—The Secretary shall publish in the Federal Register proposed quality measures on end of life care and advanced care planning that the Secretary determines are described in subparagraph (A) and would be appropriate for eligible professionals to use to submit data to the Secretary.
17 The Secretary shall provide for a period of public comment on such set of measures before finalizing such proposed measures.’’.
(What they mean: The government will put forth quality measures for physicians to follow when it comes to assisting you in your advanced care plan. Hmmmmmm...)
20 (c) INCLUSION OF INFORMATION IN MEDICARE & YOU HANDBOOK.—
22 (1) MEDICARE & YOU HANDBOOK.—
23 (A) IN GENERAL.—Not later than 1 year after the date of the enactment of this Act, the Secretary of Health and Human Services shall update the online version of the Medicare & You Handbook to include the following:
3 (i) An explanation of advance care planning and advance directives, including—
6 (I) living wills;
7 (II) durable power of attorney;
8 (III) orders of life-sustaining
9 treatment; and
10 (IV) health care proxies.
11 (ii) A description of Federal and State resources available to assist individuals and their families with advance care planning and advance directives, including—
15 (I) available State legal service organizations to assist individuals with advance care planning, including those organizations that receive funding pursuant to the Older Americans Act of 1965 (42 U.S.C. 93001 et seq.);
22 (II) website links or addresses for State-specific advance directive forms; and
1 (III) any additional information, as determined by the Secretary.
3 (B) UPDATE OF PAPER AND SUBSEQUENT
4 VERSIONS.—The Secretary shall include the information described in subparagraph (A) in all paper and electronic versions of the Medicare & You Handbook that are published on or after the date that is 1 year after the date of the enactment of this Act.
6 SEC. 1751. HEALTH-CARE ACQUIRED CONDITIONS.
7 (a) MEDICAID NON-PAYMENT FOR CERTAIN HEALTH CARE-ACQUIRED CONDITIONS.—Section 1903(i) of the Social Security Act (42 U.S.C. 1396b(i)) is amended—
10 (1) by striking ‘‘or’’ at the end of paragraph (23);
12 (2) by striking the period at the end of paragraph (24) and inserting ‘‘; or’’; and
14 (3) by inserting after paragraph (24) the following new paragraph:
16 ‘‘(25) with respect to amounts expended for services related to the presence of a condition that could be identified by a secondary diagnostic code described in section 1886(d)(4)(D)(iv) and for any health care acquired condition determined as a noncovered service under title XVIII.’’.
(What they mean: They will determine if your condition is one they want to cover. Yes, you read right. Using the SSA 1886(d)(4)(D)(iv) which I have listed below as a courtesy: http://www.ssa.gov/OP_Home/ssact/title18/1886.htm#act-1886-d-5
(iv) By not later than October 1, 2007, the Secretary shall select diagnosis codes associated with at least two conditions, each of which codes meets all of the following requirements (as determined by the Secretary):
(I) Cases described by such code have a high cost or high volume, or both, under this title.
(II) The code results in the assignment of a case to a diagnosis-related group that has a higher payment when the code is present as a secondary diagnosis.
(III) The code describes such conditions that could reasonably have been prevented through the application of evidence-based guidelines.
The Secretary may from time to time revise (through addition or deletion of codes) the diagnosis codes selected under this clause so long as there are diagnosis codes associated with at least two conditions selected for discharges occurring during any fiscal year.
They determine coverage based on cost 'SSA 1886(d)(4)(D)(iv)(I)', and again a condition that requires a higher payment as a secondary diagnosis 'SSA 1886(d)(4)(D)(iv)(II)', and conditions that could have reasonably been prevented, uh yeah fatties/smokers/drinkers/any other area the government determines "preventable" 'SSA 1886(d)(4)(D)(iv)(III)', and don't forget the part about how the Secretary, and I love this verbiage "from time to time", may revise the list of such conditions! This is screaming "healthcare rationing" and "death panel". The government will reserve the right to determine what it will and will not cover based on cost, not on what is best for the American people!)
The key things to consider regarding this part of the bill...
1. The friends/advisers Obama aligns himself with. If he does not buy into those radical beliefs then why would he entertain anyone who does? Remember, you are only as good as the company you keep!
2. The government clearly stated how healthcare will be rationed in section 122 pg 29 lines 4-16, section 123 pg. 30, and section 142 pg 42. Whereas, you will not choose your healthcare the government will create a government committee who will determine what health benefits you receive. This directly ties to the section of the bill detailed above. If the physician has to report to the government committee your stage of life based on your medical diagnosis and issues then they directly determine your benefits. Keep in mind the government is all about saving money not lives!
3. The expressed need of the government to know what is going on with you and how severe your condition is. Why would the government need to know anything about your condition if they did not intend on having a direct impact on what services you recieve. Look, as Obama said, "you can put lipstick on a pig but it's still a pig." Don't let the government fool you by using words in a fashion that makes you feel safe and cared for. No government has ever cared for it's people!
It is time to realize that YOU are best at determining what you need and how much of it you get. Granted insurance companies don't give you carte blanc but you do have to option of paying out of pocket for more if you choose. With this plan you can not do that because that specific care will not be made available to you. The next thing on my agenda is how this plan controls physicians and nurses in a way that is almost like the draft into the military. Will we be MADE to work even if we choose not too, where we can live based on community healthcare need and how much money we can make? The answer is YES!!!!!!!!!!!!!!!
Stop Socialist Reform...Protect our Constitution and our Freedoms...Take Our Country Back from the Government we elected to work FOR us not AGAINST us! The lives of our children are dependent upon this!
B
Subscribe to:
Post Comments (Atom)
No comments:
Post a Comment