Fact-Checking Death Panels

The AP factchecks Sarah Palin's claim that the proposed health care reform bill would create death panels by depriving seniors of life-sustaining treatment.

Palin's claim:

Federal bureaucrats would play God, ruling on whether ailing seniors are worth enough to society to deserve life-sustaining medical care. Palin and other critics are wrong.

So, it's not true. It's another Sarah Palin lie. Either she's not intelligent enough to understand the plain English of the bill or, like Supreme Court opinions, she hasn't read it....or she's just an opportunist out for headlines that will mobilize the right-wing. Take your pick. I'll choose all three.

< WA Backing Off From Three-Strikes Laws | Patriarchy >
  • The Online Magazine with Liberal coverage of crime-related political and injustice news

  • Contribute To TalkLeft

  • Display: Sort:
    She's lying (5.00 / 0) (#1)
    by eric on Mon Aug 10, 2009 at 11:48:30 PM EST
    I don't even think she cares, though.  She is so brainwashed that her side needs to "win" that she will say whatever.

    I doubt she's thought it through that far (5.00 / 3) (#7)
    by gyrfalcon on Tue Aug 11, 2009 at 12:29:02 AM EST
    She's no different than any of the thousands of other willfully ignorant and spectacularly gullible right-wing folks who are showing up at town halls.  The liars and manipulators are the Betsy McCaugheys and New Gingriches and Rush Limbaughs who are consciously spreading outright lies for partisan advantage.  I honestly don't think Palin is even that clever or that subtle.  I think she actually believes this crap she's being told by the propagandists.

    And of course she hasn't read the bill.  The vast majority of the Democrats, including Obama, haven't read it either, and would need a translator to make any sense of its technicalities.


    I've watched the town hall news coverage (5.00 / 2) (#27)
    by Militarytracy on Tue Aug 11, 2009 at 06:37:17 AM EST
    this morning.  I have to wake up Josh soon to prepare for a visit to his dentist that will require mild anesthesia.  His particular gene anomaly creates a very small mouth.  I can't help noticing that many of my countrymen are terrified right now.  We sometimes ask ourselves what creates so much violence in our American culture.  We are a nation rooted in the belief that competition brings out the best in us, and even if you haven't flourished in this environment it is all you have probably ever known.  But so much competition and self induced scarcity of our basic human needs also brings out the worst in us and brings with it an insanity. We refuse as Americans to take a look at where the line is between a healthy competition and living in a constant fight or flight response that leads us all to possessing just a touch of crazy around the edges.  

    Digby points to (5.00 / 0) (#2)
    by Steve M on Tue Aug 11, 2009 at 12:00:14 AM EST
    this Ezra Klein interview with the person responsible for adding the "death panel" amendment to the Senate bill - who just happens to be conservative Georgia Republican Johnny Isakson.

    How did this become a question of euthanasia?

    I have no idea. I understand -- and you have to check this out -- I just had a phone call where someone said Sarah Palin's web site had talked about the House bill having death panels on it where people would be euthanized. How someone could take an end of life directive or a living will as that is nuts. You're putting the authority in the individual rather than the government. I don't know how that got so mixed up.

    This might come as a shock to you, Sen. Isakson, but there's a lot of dishonest demagoguery in that party of yours.

    Dear Gawd (none / 0) (#16)
    by MO Blue on Tue Aug 11, 2009 at 01:22:00 AM EST
    Why aren't Obama and the Dems using the fact that this is a Republican provision to debunk this insanity? This should have been highlighted in the weekly address Obama had on health insurance reform.

    Just to clarify (none / 0) (#19)
    by Robot Porter on Tue Aug 11, 2009 at 01:42:34 AM EST
    Sen. Isakson is an advocate for this provision,  "proposed an amendment similar to the House bill's Section 1233 during the Senate HELP Committee's mark-up." But he didn't write the section in the house bill.  He really couldn't, could he?  He's a Senator, this is House bill.

    The section in the House Bill led to the controversy.

    Rep. Earl Blumenauer, D-Ore wrote this section of the House bill.

    This doesn't make Isakson comments any less valid.  He has been a long supporter of this type of provision, and proposed something similar for the Senate bill, and supports the section of the House Bill.

    But it's not a Republican provision.  And he didn't write it.

    It's a completely uncontroversial position with wide bipartisan support.  

    I think the White House should use Isakson to debunk the false claims.  But calling it a Republican provision wouldn't be true.


    Palin is hardly alone in making this claim. (5.00 / 1) (#3)
    by caseyOR on Tue Aug 11, 2009 at 12:09:24 AM EST
    And this particular lie was started by former New York Lt. Gov. Betsey McCaughy, who happens to be a major wingnut shill.

    Palin's statements are pretty opportunistic. She is a member in good standing of the same band of liars that includes Newt Gingrich who made similar statements on TV this weekend.

    So, Palin is a liar, but she is hardly alone in this. In fact, she is just another member of the rightwing choir.

    Palin Is The Poster Girl for the Claim (5.00 / 0) (#21)
    by daring grace on Tue Aug 11, 2009 at 04:10:00 AM EST
    the person with high visibility and high 'credibility' among a certain audience to promote this claim, and keep it alive.

    I'm a New Yorker. I remember McCaughey when she was McCaughey Ross and my Lt Governor. Other than that and the few who read her column, I doubt anyone's heard her on this subject or knows who she is.

    She's not the person who gave this claim the spotlight. As far as I know she doesn't have a disabled child she can use to give this lie added vivid horror.


    Heh, we all see the current terrified on the (none / 0) (#28)
    by Militarytracy on Tue Aug 11, 2009 at 06:40:24 AM EST
    television.  But I know who is really scared of worn out worried to death Americans getting some of their basic survival needs met and then experiencing a mild sense of relief.

    "mobilize" isn't the word (5.00 / 1) (#22)
    by pluege on Tue Aug 11, 2009 at 04:47:54 AM EST
    "incite" the violent, ignorant "base" is more accurate.

    Palin's not the problem. (5.00 / 2) (#23)
    by lentinel on Tue Aug 11, 2009 at 05:04:41 AM EST
    She is like Limbaugh. A person with an opinion and a following.

    But the people actively selling us out are the people in power.

    It's Not Either/Or (5.00 / 1) (#43)
    by daring grace on Tue Aug 11, 2009 at 09:03:58 AM EST
    When the wingnut followers of Palin and Limbaugh storm these town hall meetings, they effectively drown out the rest of us who might be there trying to get tough questions answered.

    I'm not saying our leaders aren't perfectly capable of evading the answering of those tough questions. But these folks (ironically) assist any leaders who are trying to pass sub standard reforms and not answer for it; or who are hoping to still look serious about health reform.

    Or maybe it's not ironic since the health care industry win/wins on this one.


    If you (5.00 / 1) (#81)
    by lentinel on Tue Aug 11, 2009 at 12:35:19 PM EST
    got drowned out by followers of Palin at a town meeting I can understand your feeling.

    I would be interested in the question you would have posed if you had been able to speak.

    What I have witnessed, however, is the evasive by Press Secty Gibbs when asked direct questions. I have seen Obama do a 180° turn from his support for single-payer. I have seen the Obama administration cave to big Pharma. The profit motive for insurance companies is alive and well.

    Obama's last big press conference wherein he was to describe his plan was largely incoherent and rambling.

    No matter what Palin says, the trouble lies with the ineffectiveness of the leadership of the democratic party and its' titular leader, the president.


    No (none / 0) (#117)
    by daring grace on Tue Aug 11, 2009 at 04:57:19 PM EST
    Palin et al are still part of the problem, poisoning the well so even if the Dems were doing 100% what we wanted them to do, public option, single payer etc, they're working feverishly convincing some Americans to fear and reject health care reform.

    They're serving the forces that want to see this postponed for another 17 years or more.


    Here is an e-mail that got forwarded (5.00 / 0) (#36)
    by Anne on Tue Aug 11, 2009 at 08:39:54 AM EST
    to me, and which I expect will be appearing in InBoxes all over, very soon:

    Something to think about  (Received second hand)

    Senior Death Warrants:  

     I can vouch for this  to a degree.  Wednesday, I was at the doctor   whom I have been  going to since we moved down here (he is the one who discovered my  cancer).  I have to get a very expensive shot every 3 months  ($3000) that is designed to keep the PSI down and  help to prevent a  recurrence of the cancer.  Has  some uncomfortable side  effects, and I was questioning the need to continue with it, which he assured me was necessary.  He  then asked how old I was, and when I replied 70, he said that if this legislation goes  through as intended by the powers that be, that I  probably would not be  able to get it next year, as that would be    money better spent on  someone else with greater longevity.  I would be referred to someone to "counsel"  me.                      

    I asked him why the AMA had recently endorsed the plan.   He replied that only  about 15% of the nation's doctors were members of AMA, and most of  them were not really on the front lines of  doctorhood but in  some other areas of medicine.  He said he was a  member, but would not be after this membership  year.  This man got part of his training in London, and practiced in  Canada for 16 years  before coming to the US, and he has no use for socialized medicine, regardless of how you wrap it, or what kind  of bow to put on  it.  He said that we have a shortfall of around 400,000 doctors at the present time, and many of today's doctors are of the baby  boomer generation who are nearing  retirement and/or will decide to  hang it up rather than deal with the results  this is sure to  bring.

    Scary, my  friends.  The picture for our age group is not pretty.    


    In England anyone  over 59 cannot receive heart repairs or stents or  bypass  because it is not covered as being too expensive and  not  needed.

    Obama wants to have a  healthcare system just like Canada 's and England 's. I got  this today and am sending it  on.  If Obama's plans in  other areas don't scare you, this should.  Please do not let  Obama sign senior death  warrants  Everybody that is on  this mailing list is either a senior citizen, is getting close or  knows somebody that  is.  Most of you know by  now that the Senate version (at least) of the "stimulus" bill  includes provisions for extensive rationing of health care for  senior citizens. The author of this part of the  bill, former senator  and tax evader,  Tom Daschle was credited today by Bloomberg  with the following  statement: Bloomberg: Daschle  says "health-care reform will not be pain free. Seniors should be  more accepting of the conditions that come with age instead of  treating  them."

    If this does not sufficiently raise your ire, just remember that our esteemed Senators  and Congressmen have their own healthcare plan that is first  dollar or very low co-pay which they  are  guaranteed the  remainder of their lives and are not subject to  this new law if it  passes.

    Please use the power  of the Internet to get this message out. Talk it up at the  grassroots level.  We have an election coming up in one year and five  months.  And we have the ability to address and reverse the  dangerous direction the Obama administration and its allies have begun  and in the interim, we can make their lives miserable. Lets do  this!    

    If you disagree, do  nothing.

    I responsed to everyone else on the distribution list, using this interesting thing called "the facts," and can only hope it did some good.

    I'd love to see your response. n/t. (none / 0) (#40)
    by sallywally on Tue Aug 11, 2009 at 08:52:00 AM EST
    why is it that only now are the (none / 0) (#105)
    by of1000Kings on Tue Aug 11, 2009 at 03:56:25 PM EST
    fascists complaining about not trusting the government?

    where were they the past 8 years when we had a President declare war unilaterally...when the government decided it no longer needed a search warrant to record our conversations, find out what library books we checked out and find out what we've researched on the internet?

    seriously...this country is so F'd up right now...it's disgusting...what's the point anymore if people are this acute and stupid?

    all I can think about is Fight Club, seriously...


    I think everyone (5.00 / 0) (#46)
    by Bemused on Tue Aug 11, 2009 at 09:57:59 AM EST
      is missing the point of this particular provision.

      As I read it, the purpose is simply to mandate that insurers must cover counseling/consultations for people who wish arrange for the nature of their "end of life" treatment through living wills or other advance directives.

      It does not concern whether any other services themselves will be rationed or excluded from coverage but it also has nothing to do with mandating covering care designed to prolong life or enhance the quality of life in the terminal stage.

      The consultation/counseling in question  will not come from the government or from insurers. this provision would siimply mean that people who choose to seek such consultations will be covered and insurers may not write exclusions denying coverage for such consultations.

      That said, nothing in the provision -- or elsewhere I the bill as far as I can tell--- means that people will be entitled to have whatever care they desire covered just because of an advance directive.


    This will cut costs too (none / 0) (#52)
    by lilybart on Tue Aug 11, 2009 at 10:39:48 AM EST
    and not because we will euthanize people!

    If everyone made a living will, I bet most would choose NOT to be on tubes if they are basically a vegetable and now, if you don't have a living will, you will get the costly care that you might not want.

    So, this will cut costs I believe and it is a win-win to discuss these issues while everyone is thinking clearly and everyone knows what the patient really wants.


    Not exactly (none / 0) (#59)
    by ColumbiaDuck on Tue Aug 11, 2009 at 10:52:12 AM EST
    You are mostly correct, but it's actually related to whether Medicare will pay for such counseling.  But of course, Medicare doesn't "employ" doctors so it's still just a Medicare recipient talking to their personal physician.  Under this provision, the doctor would get reimbursed for their time (much as if they were discussing other health or treatment options).

    I hope this episode will finally (5.00 / 0) (#49)
    by Capt Howdy on Tue Aug 11, 2009 at 10:25:44 AM EST
    reveal to EVERYONE that this woman is not serious.

    that she is not a clever populist moderate and that any democrat with a conscience could never support her.

    that she is a brainless opportunistic hack and that she should be kept from the reigns of power at all costs.

    Governor Palin is making things up, (5.00 / 1) (#66)
    by KeysDan on Tue Aug 11, 2009 at 11:10:29 AM EST
    but if she were not around,  opponents would just make people up to make things up (cf. Harry and Louise).  The issue, to me, is that the proposed legislation has been unnecessarily placed in a defensive position as if their was no forewarning of opposition, including opposition based on misinterpretations, misconceptions, and flat-out lies. Moreover, taking on Medicare "reform" at this time, needlessly complicates and confuses what should be the prime objective of health care reform and extension for those under the age of 65.  The dual reform seems to be rooted in the need to fund a major portion of the extended health program and, thereby, diminish the need for new taxation.  However, this only feeds the cycle of doubt rather than assuring a critical focus.  

    It's (5.00 / 1) (#93)
    by Ga6thDem on Tue Aug 11, 2009 at 02:08:06 PM EST
    started. I've started getting severe warnings about "Obamacare". I'm so sick of these people even though I dont think Obama has a good plan.

    Is it against TL rules (5.00 / 3) (#96)
    by Spamlet on Tue Aug 11, 2009 at 02:24:04 PM EST
    to effectively call another commenter a liar?

    yes and the thread of insults (5.00 / 1) (#120)
    by Jeralyn on Tue Aug 11, 2009 at 05:16:43 PM EST
    has been deleted, since someone e-mailed me about it. Too bad, it could have been a productive discussion. And more than one commenter engaged in the personal insults.

    Golly, I wonder (5.00 / 2) (#99)
    by Spamlet on Tue Aug 11, 2009 at 03:01:37 PM EST
    who appointed all those old Clinton hands!

    Nevertheless, I'm crossing my fingers for Froomkin's first possibility regarding Obama and health care. You could say I'm hoping against Hope(TM).

    I've noticed (3.66 / 3) (#101)
    by Spamlet on Tue Aug 11, 2009 at 03:11:50 PM EST
    And yet these are the very ones so keen to enforce Da Roolz when it comes to others, and to appeal to Da Roolz even in the face of common sense, and to invoke Da Roolz in contexts where they don't apply and make no sense whatsoever.

    Jeralyn will definitely enforce (5.00 / 0) (#115)
    by MO Blue on Tue Aug 11, 2009 at 04:54:11 PM EST
    the sites rules when she is aware that they are being abused. You or anyone else need only to send her an e-mail describing the abuse and she will deal with it.

    "Never a saxophone borrower be"? (none / 0) (#114)
    by Steve M on Tue Aug 11, 2009 at 04:53:36 PM EST
    James Robertson (2.00 / 0) (#25)
    by jarober on Tue Aug 11, 2009 at 06:35:55 AM EST
    The problem is this: the fact that you're having to explain this is a problem.  You should listen to Bruce Carlson's two recent podcasts on this subject at My History Can Beat up your Politic" to get an idea of where health care reform is at politically.  

    I'd say it's not in a healthy place at the moment, and it's because of overreach.

    There is a real issue lurking here though (none / 0) (#4)
    by jerry on Tue Aug 11, 2009 at 12:17:38 AM EST
    There is a real issue lurking here, and it could be turned into an asset, but I fear Democratic politicians are too dumb and will let the status quo continue, and will shirk a necessary and good conversation.

    The real issue is that right now there are Death Panels and those are run by the insurance companies.  They do make decisions regarding coverage of medication and treatment.  And those decisions are largely opaque and unappealable, at least, I have never been able to appeal successfully.

    In a public option, won't there be those same panels discussing everything from end of life, to disability, to orthotics and fungal treatments?

    The public deserves a conversation on how those sorts of decisions will be made in a public option (should one come about).  Are these decisions of politicians?  Of bureaucrats?  Made in Washington?  Or are they decisions that will be left to doctor and patient, and if so, how, and how will that get paid for?  Will panels exist in Washington, or will they exist locally and encourage local variation and local appeal processes?

    I think this is a real issue in a public option.  But, I could be very wrong.  But that's my sense of it....

    Unfortunately (5.00 / 1) (#6)
    by Steve M on Tue Aug 11, 2009 at 12:28:29 AM EST
    screaming about Hitler tends to get in the way of having a "good conversation."  Maybe the public deserves a more thoughtful opposition, but they won't get it from the GOP.

    Won't come from the GOP (none / 0) (#10)
    by jerry on Tue Aug 11, 2009 at 12:37:41 AM EST
    But regardless, we should be discussing how decisions over treatment will be made.  I favor single payer universal health care, but one criticism used against it that does make me wonder is about the various forms of triage and decisions not to treat that are apparently made in the UK and Canada.

    I wouldn't mind someone factchecking that.  I don't know who to believe.  

    But if there is any case that in a public option that decisions similar to those made in my current private option will be made to deny treatment, I do want to know and discuss that ahead of time.

    And if there is some reason that those decisions won't be made, then that should be touted and talked about too.

    I don't think people like their current insurance.  I think people hate the unknown.  And I think people hate what is not covered now, so if a public plan covers everything, or makes decisions differently, I think that's a big asset.


    One thing is known (5.00 / 4) (#12)
    by shoephone on Tue Aug 11, 2009 at 12:40:18 AM EST
    Insurance companies deny care based solely on their profit motive.

    My expectation (5.00 / 2) (#14)
    by Steve M on Tue Aug 11, 2009 at 12:50:41 AM EST
    is that there would be published guidelines on what is and is not covered, promulgated through a standard government notice-and-comment procedure, and an appeals process for anyone who feels their claim was wrongfully denied.  This is the basic framework of Medicare as I understand it and it has worked quite well.

    People would always be free to go out of pocket or purchase private insurance if they want to pursue an uncovered course of treatment.  Even in a single-payer system, which of course is not going to be on the table any time soon, there is no serious suggestion that private supplemental coverage will be outlawed.


    That's true (5.00 / 2) (#31)
    by jimakaPPJ on Tue Aug 11, 2009 at 08:02:11 AM EST
    Steve M wrote:

    This is the basic framework of Medicare as I understand it and it has worked quite well.

    Been there done that for my Mom. Took a bit of calling but it got straightened out.

    Folks, Medicare is not staffed by mean ole nasty people looking to take your meds away. It is staffed by people who, more or less, have a 9 to 5 view of the world. No different than the average admin person I have run into in my private insurance.

    Instead of "supplemental" insurance I would say "secondary" based on the fact supplemental insurance for Medicare pays the difference between what Medicare paid and what was billed. If Medicare rejects the claim, supplemental pays nothing.

    Secondary pays based on the coverage purchased and can be quite expensive.

    And no it didn't make a lot sense to me but I have also been there done that on that. $336. and change to AARP each and every month.


    Right (none / 0) (#33)
    by Steve M on Tue Aug 11, 2009 at 08:18:44 AM EST
    Secondary is a better word.

    Steve M (none / 0) (#29)
    by Militarytracy on Tue Aug 11, 2009 at 06:46:13 AM EST
    are you suggesting that a new market for the super terrified to buy additional special medical coverage could/would be created?  So let me get this straight....more people get to fly business class and there will still be a first class option that could end up being a lot more firstier class than a compressed meat steak with msg sauce?  OMG....how can we possibly deal with that?

    RE: triage in Cananda and the UK (5.00 / 3) (#26)
    by Molly Bloom on Tue Aug 11, 2009 at 06:36:18 AM EST
    Ask yourself these questions:

    1. Are Canada and the UK democracies?
    2. Are the voters there completely stupid?
    3. Are the politicians there completely stupid?
    4. If the Canadian and UK health systems are as bad as advertised here in the US by opponents of single payer systems, why hasn't seem enterprising politician successfully campaigned on the idea of scrapping the single payer health care?

    Expand these questions to Germany and Australia.  

    So who should you believe, the opponents of single payer in the US (many of who have a vested interest in the status quo) or the citizens of the countries with single payer systems who are not demanding their politicians scrap their single payer systems?


    France, Great Britain and Canada are terrible (5.00 / 2) (#77)
    by MKS on Tue Aug 11, 2009 at 12:04:27 PM EST
    places.  Socialist back waters, they are.

    Take France.  Who would ever want to go, let along live, there?  The food?  Chocolate mousse, croissants, omelettes, souffles....Just awful.  The French can't even do "Freedom Fries" right.

    The mix of public and private medical insurance has led to so many deaths and third world medical care.

    And, no, a little time in Provence would just be h*ll on earth....


    Well (4.67 / 3) (#30)
    by Steve M on Tue Aug 11, 2009 at 07:14:15 AM EST
    Anyone who proposes reforming the system probably gets sent in front of one of their "death panels."

    LOL - n/t. (none / 0) (#37)
    by sallywally on Tue Aug 11, 2009 at 08:42:56 AM EST
    and Sweden and the Netherlands (none / 0) (#53)
    by lilybart on Tue Aug 11, 2009 at 10:41:49 AM EST
    and New Zealand, Hong Kong.....who is the odd man out here? the USA.

    Odd man out (none / 0) (#70)
    by coast on Tue Aug 11, 2009 at 11:42:58 AM EST
    Australia 21-50
    Canada 19-53
    UK 0-50
    Sweden 28-59
    Germany 0-45...
    odd man out again is USA 0-35

    These are the tax rates for each country.  In other words, if you want single payer system you'll need to raise taxes on everyone.


    What percentage of those tax rates is (5.00 / 1) (#78)
    by Inspector Gadget on Tue Aug 11, 2009 at 12:04:53 PM EST
    specifically for health care? That's kind of an important fact for your argument.

    Canadians pay $54/month for their healthcare premium over and above their taxes. Not sure if it is the same as here where a family premium is the same whether there is one child or 20.

    Seniors have a Medicare premium taken out of their Social Security checks.

    I'm with rea, our taxes will never increase to the same dollar value as we are currently paying for private health insurance just to implement universal coverage.


    raising taxes? (none / 0) (#74)
    by rea on Tue Aug 11, 2009 at 11:52:41 AM EST
    if you want single payer system you'll need to raise taxes on everyone.

    Well, but what you overlook is that people are paying for health insurance right now.  I don't care if my tax rates go up if my insurance bill goes down by a corresponding amount.  Given that the US health care system is the most expensive in the world, you would expect a change to single payer would mean that tax rates go up, but insurance bills go down by a greater amount.


    True, but (none / 0) (#76)
    by coast on Tue Aug 11, 2009 at 12:00:05 PM EST
    I'm not in a high bracket now and my cost for family coverage is moderate.  Raise my taxes over 10% and I'll be paying more than I'm currently paying between tax and insurance currently.  Also, many employer plans pay for the employee coverage (not family) or a portion thereof tax free.  That would no longer be the case in a single payer system.

    That can't be true in a low bracket (5.00 / 2) (#79)
    by Inspector Gadget on Tue Aug 11, 2009 at 12:18:38 PM EST
    Let's go low, to the 15% bracket.

    I pay $200 (and change) per month in income tax. Raise my taxes 10% and I'll pay $220 per month.

    My insurance premiums are $240/month. My employer pays those at this moment.

    So, UHCoverage raises my taxes 10% ($20) to cover my premium. My employer no longer has to pay the $240/month for my coverage and decides to share the savings 50/50 with me. I get a raise of $120/month.

    Even for a bracket where you pay $1000/month for taxes...a 10% hike is still only $100/month, and no family insurance premium is that low.


    Sorry, (none / 0) (#84)
    by coast on Tue Aug 11, 2009 at 12:53:06 PM EST
    IG you are correct about the 10% increase.  I need to clarify my original statement.  When I wrote "10% increase" I did not mean that my tax would increase from 15% to 16.5% (a 1.5% or 10% increase).  What I meant was an increase in the rate from 15% to 25% (10 percentage point increase).  I believe if you run the numbers under that scenerio you will see my point.  Sorry about not being clearer in my original post.

    Not sure why a public option (5.00 / 2) (#8)
    by MO Blue on Tue Aug 11, 2009 at 12:31:59 AM EST
    would operate using different coverage guidelines than Medicare.

    DEAN: Well, look, this is something Newt and I agree on. I don't want somebody in between the doctor and the patient. I don't want the possibility of losing your health insurance. I don't want people setting standards or denying care. That's all what we have now under the private health insurance system. That's what happens.

    Look, I've practiced -- I've practiced for 10 years. My wife is still practicing. Never once did I have a Medicare bureaucrat tell me what I could or couldn't do for a patient, but all the time we have bureaucrats from the insurance companies calling up and saying, "We're not going to cover this, and we're not going to pay for that, and we're denying coverage of that."

    The system we have right now is broken. We need to fix it. I think giving the American people some choices about how to fix it makes sense. C&L

    My own doctor told me basically the same thing. That once I was covered by Medicare I would not have a problem receiving the treatment that he recommended.


    I like Dean and so that's good to know (5.00 / 1) (#11)
    by jerry on Tue Aug 11, 2009 at 12:39:13 AM EST
    I have no experience with Medicare.  I know that my current plan has several times opted not to pay for certain drugs and treatments that my doctors assure me are normal and not experimental.

    If it is true that a public medicare like plan would leave these decisions to the doctor, than I think that's a very big deal that we should be talking about.


    I have Medicare. (5.00 / 4) (#13)
    by caseyOR on Tue Aug 11, 2009 at 12:45:09 AM EST
    It is the best health insurance I have ever had. Sure, there are things I would change. I think dental and vision should be covered, for example. But, hands down, Medicare is the least aggravating coverage of my life.

    I've had insurance bargained for by my union. I've had insurance paid by different employers with varying amounts of employee-paid premiums. I've had Kaiser, which drove me crazy. And I lived through some god awful years without any coverage before getting on Medicare.

    Every year Medicare sends me a booklet that explains exactly what is and is not covered. No ambiguity. No wondering if Medicare will pay the bill. My doctors always know prior to any treatment whether or not it is covered.

    In the world of health insurance Medicare is almost laughably simple. Maybe that's why Obama and the other big brains in his administration and in Congress just can't wrap their heads around it. I guess to so folks something so simple just can't be right.


    We are holding our breath for medicare (none / 0) (#54)
    by lilybart on Tue Aug 11, 2009 at 10:43:22 AM EST
    for hubby, which he gets in two years.

    then if nothing is reformed, I could maybe afford insurance without this job that is meaningless except for the benefits.


    Seems obvious to me as well (none / 0) (#24)
    by Rojas on Tue Aug 11, 2009 at 06:10:16 AM EST
    I don't understand why they don't use this line of attack. Is it because they are afraid of insulting the cash cow that they seem hell bent on selling us out to?

    Speaking of Democratic politicians (none / 0) (#39)
    by MO Blue on Tue Aug 11, 2009 at 08:49:26 AM EST
    being too dumb. Only my own sweet Claire can be strongly against single payer health care and a strong advocate for it at the same time.

    Claire McCaskill Strongly Opposed

    "We are not going to socialize medicine. I am not for single payer plan and that's just not going to happen. It's not even on the table. It's not even on the table. Not one plan that's been written has anything with a single payer system in it. Not one! So this is the fear people have that is based on nothing in fact. Not one plan is a single payer system," says McCaskill.

    Claire McCaskill Strong Advocate
    The Senator added that a lot of misinformation was being voiced in the public. She asked the crowd how many had Medicare and how many want to get rid of it. "Medicare is an example of government having a dominant role in health care," McCaskill said. "The main reason for the reform is to keep the Medicare program strong so that it is still around for our grandchildren."

    Is it 2012 yet?


    Clare (5.00 / 1) (#41)
    by jbindc on Tue Aug 11, 2009 at 08:52:36 AM EST
    I will send money to whomever runs against her.  She's horrible.

    I plan to contribute money and (5.00 / 0) (#42)
    by MO Blue on Tue Aug 11, 2009 at 09:00:46 AM EST
    time to defeat her if she runs for reelection. Might even cast my first ever vote for a Republican if that is what it takes.

    im in MO too (5.00 / 1) (#108)
    by of1000Kings on Tue Aug 11, 2009 at 04:05:55 PM EST
    and whoever runs against her will have my support...

    everything she has said in the past couple years has been conservative...how she ran as a D I'll never know...


    How'd they do that? (none / 0) (#5)
    by Steve W on Tue Aug 11, 2009 at 12:24:02 AM EST
    How did the AP "Fact check" Palin's statements about what WOULD happen? She's clearly making a prediction about the future, and the only way I can think of to "check" those predictions is to go to the future, look around, then come back and report. Does AP have a time machine?

    AP's opinion that Palin is wrong - is just opinion, not fact. Palin's opinion about the future - is just opinion, not fact.

    The only way anyone could say that Palin is "lying" about the future, is if they know that Palin looked into a magic crystal ball, saw a future without "death panels" but claimed she DID see "death panels" in there.

    Agree or disagree with someone, fine. But understand the difference between opinion and fact. Here's an example:

    1. 'The Holocaust never happened' - this is a lie, because it contradicts a historical fact.

    2. '5 people will die in the Garbage Avalanche of 2505AD' - this is not a lie, because the events of 2505AD have not occurred yet, there's no way to check this "fact"

    Palin's comments were in reference to (5.00 / 3) (#9)
    by caseyOR on Tue Aug 11, 2009 at 12:33:51 AM EST
    the section of the health insurance reform bills concerning doctor-patient conversations about living wills and end of life care.

    This provision, as currently written, says that a person on Medicare may, if that person so chooses, discuss their preferences for end of life care and having a living will with their doctor, and Medicare will pay for it. The patient can have this conversation once every five years at Medicare's expense. Nothing that I have read mandates that this conversation take place. It is voluntary. I don't see how this could be interpreted as mandating "death panels."

    This is pretty easy to fact-check. Read the language in the relevant legislation.


    I don't know. From the same AP article (5.00 / 1) (#38)
    by jimakaPPJ on Tue Aug 11, 2009 at 08:44:31 AM EST
    that says:

    The nonpartisan group FactCheck.org, a project of the Annenberg Public Policy Center at the University of Pennsylvania says the claim is false.

    We have this.

    However, millions of Americans already face rationing, as insurance companies rule on procedures they will cover. Denying coverage for certain procedures might increase under proposals to have a government-appointed agency identify medicines and procedures best suited for various conditions.

    Currently Medicare guidelines allow an insurance company to not pay for certain drugs in their Formulary unless the prescribing doctor justifies their use as a part of a normal and approved treatment.

    I have been through that on two drugs I take and two my wife takes. In all four cases it took about three days and caused no hardship.

    But these are the types of things that can expand in people's mind to denial of treatment, "death panels," etc.

    Another question would be, could this give a Doctor pause in prescribing a particular drug versus one she knew would not be questioned?


    Interesting take (none / 0) (#47)
    by rdandrea on Tue Aug 11, 2009 at 10:05:05 AM EST
    I have been through that on two drugs I take and two my wife takes. In all four cases it took about three days and caused no hardship.

    No hardship to you, perhaps.

    But what could your doctor have been doing, who could he or she have been treating, while instead wasting time justifying your drugs to insurance bureaucrats?

    You don't think the insurance bureaucracy itself is responsible for the rising cost of health care?


    Actually the insurance bureaucrats (none / 0) (#50)
    by jimakaPPJ on Tue Aug 11, 2009 at 10:27:53 AM EST
    were following Medicare guidelines, not that the companies were probably happy to do so. I am sure they like those rules.

    And I agree that she could have been more productive, or at least her RN could have been.

    Do I think the insurance bureaucracy itself is responsible? How so? It is in their best interest to keep cost down.

    Again, I think it is things like this that fuel the "Death Pane" complaints not the government sponsored meeting re living wills, etc.


    The provision is well-intentioned, (none / 0) (#72)
    by KeysDan on Tue Aug 11, 2009 at 11:50:56 AM EST
    but, in my view, separate doctor/patient conversations of this nature can be stilted.  Living wills and end-of life discussions should be integrated into doctor/patient consultations. Moreover, living wills should be a part of overall estate planning.

    So if I said that ... (5.00 / 1) (#15)
    by Robot Porter on Tue Aug 11, 2009 at 01:07:39 AM EST
    Obama's health plan would lead to everyone getting a fluffy pink bunny suit, and you said I was making that up.  I could counter:  

    I'm talking about something that will happen in the future. You can't prove everyone won't get a fluffy pink bunny suit, because it hasn't happened yet! So your fact check is wrong!


    Personally, I'm still holding out (5.00 / 1) (#17)
    by MO Blue on Tue Aug 11, 2009 at 01:25:41 AM EST
    for a pony and will not accept a fluffy pink bunny suit as a substitute. :)

    I don't know ... (none / 0) (#20)
    by Robot Porter on Tue Aug 11, 2009 at 01:46:29 AM EST
    Phyllis Schalfley (none / 0) (#18)
    by squeaky on Tue Aug 11, 2009 at 01:33:52 AM EST
       I profiled Schlafly for The Miami Herald (full text here) in 1987 after she had brilliantly, almost single-handedly stomped the Equal Rights Amendment ratification campaign into a powder by turning it into a gay-sex-rampage-enabling amendment. How, I never quite understood.

    So, I asked Schlafly about the formidable skills she deploys in a heartbeat on any public topic. See who she reminds you of...

    Schlafly adores absolutes. It's an efficient way to reason in debates.

    A serious debate requires an opponent of equal intellectual weight and moral force. Schlafly says she can't think of any honorable spokesman for the opposition -- someone of knowledge and integrity with whom she can respectfully disagree -- on any issue.

    People who think differently than she does are either lying, laughing or not truly confronting the issues, she says.

    I wish both sides... (none / 0) (#32)
    by Pragmatist on Tue Aug 11, 2009 at 08:07:43 AM EST
    would stop the Fricking lies & BS & just state the facts.  But, that appears to be too much to ask...so we have have to read through this 1,000 page monstrosity of legalize and try to interpret the proposed legislation.  I'm also concerned about the penalties for employers with over 25 employees.  The fine is only $750 per employee if you don't offer health care coverage.  Yet the avg health care policy cost a company ~$5K per person and ~$12K per family.  So what's a company's incentive to continue providing coverage.  My guess is many companies will willingly pay the fine. And then there's the penalty for the 'Cadillac' plans - which is what I offer my 14 employees (100% medical, dental, vision sans co-pays).  They govt is going to penalize me for offering this benefit.  This doesn't make any sense to me...

    Not sure I understand (5.00 / 1) (#45)
    by Steve M on Tue Aug 11, 2009 at 09:54:56 AM EST
    if a company would just dump their health care coverage because the fines aren't very expensive... why haven't they already dumped it, considering the fines under current law are $0?

    Can't speak for all... (none / 0) (#57)
    by Pragmatist on Tue Aug 11, 2009 at 10:51:51 AM EST
    but my guess is that there isn't an alternative such as govt sponsored health care.  Today, companies bear the cost in order to offer competitive compensation.  But, once there is an alternative, such as a govt sponsored program, which is avail to everyone, then the business could tell the employees to purchase health care from the govt vice their employer.  From my perspective, it will present a dilemma for many.  And unfortunately, I think many companies will 'opt out'/pay the fine.  Which, again, in my opinion, is not what the President is trying to do.  I may be completely incorrect, but it gives me pause; especially if I'm going to be penalize for offering a "Cadillac plan".  Personally, I think the govt should leave those of us offering quality plans to our employees alone.

    Well (none / 0) (#61)
    by Steve M on Tue Aug 11, 2009 at 10:58:17 AM EST
    If the government plan is just as good, then presumably people won't mind being switched into it, provided their wages are increased to match whatever the government plan costs them.  And of course they get portability as well.

    If the government plan isn't as good, then employers who offer a superior private plan will continue to enjoy a competitive advantage.  It's not as huge an advantage as when employer-sponsored health care is the only game in town, true, but I can live with that.

    On the other point, I understood the point of taxing employer-sponsored health insurance when John McCain proposed it (although I'm not sure if it's fair to call the withdrawal of a government subsidy a "penalty").  I don't so much understand its role in the current plan; on the one hand, we're incentivizing businesses to offer health insurance by fining them if they don't, but on the other hand, we're disincentivizing them by withdrawing the tax break.  Possibly there's something I'm missing.


    to clarify (none / 0) (#64)
    by ColumbiaDuck on Tue Aug 11, 2009 at 11:04:16 AM EST
    The public plan would be one of the many plans offered through a health insurance exchange.  Employers could choose to cover employees through the public plan.

    There are restrictions on employers (none / 0) (#85)
    by MO Blue on Tue Aug 11, 2009 at 01:05:38 PM EST
    accessing the exchange. IIRC employers with a work force of 10 or less are eligible to participate in the exchange during the first year of implementation (2013). Employers with a work force of 20 or less are eligible to participate in the exchange during the second year of implementation. Year three and over larger employers as only as permitted by the Commissioner.

    Depends on the bill (none / 0) (#90)
    by ColumbiaDuck on Tue Aug 11, 2009 at 02:03:10 PM EST
    Different versions allow different employers to participate.  In the Senate, it is those up to 50 workers with states and the feds able to set that higher.  However, I was really trying to make the point that an employer could choose the public option - it's not just for individual purchasers.

    The public plan isn't free (none / 0) (#62)
    by ColumbiaDuck on Tue Aug 11, 2009 at 11:00:03 AM EST
    People will still have to pay premiums.  While it would be administered by the government, it would operate under many of the same principles in private plans.  So there would be little distinction between an employer dropping coverage and telling employees to get it on the private market or through a public plan.

    Employers wanting to keep employees and keep them happy will continue to offer insurance.


    Sounds similar to my plan (none / 0) (#83)
    by 1040su on Tue Aug 11, 2009 at 12:52:42 PM EST
    as a New York State employee.  The Empire Plan was created a few years ago & is a version of a public option.  It's not a "Cadillac"  plan, but it's fine for me.  My co-pays are higher, but that is more than off set by the much lower premiums I pay.
    Here's what we're offered (last year)for individual coverage:
    Empire Plan - $48.15 per month
    HMO-Blue - $144.00 per month
    MVP - $82.64 per month.

    I don't need referrals, pre-approval for routine, preventative stuff etc...  The practice just needs to accept my insurance - that's it.  The one thing they have done is alter what medications they'll cover under tier 1, but they all have.


    This (none / 0) (#34)
    by Ga6thDem on Tue Aug 11, 2009 at 08:31:40 AM EST
    bill does nothing to help me so I dont really care whether it passes or not and could actually end up costing me more.

    What insurance do you have now? (none / 0) (#58)
    by lilybart on Tue Aug 11, 2009 at 10:52:02 AM EST
    do you have employer insurance, medicare or are you financially able to pay for any treatment no matter what?

    I think in a discussion, it is fair to ask you. I have great insurance at the moment but there has been talk of changing plans and if I leave/lose this job, then what? More and more employers are cutting insurance benefits.

    And, do you suuport reform so eveyone can get the care they need, even if you might pay more?


    I have (none / 0) (#89)
    by Ga6thDem on Tue Aug 11, 2009 at 02:01:11 PM EST
    an individual policy that I have to pay completely for myself.

    The problem is that everybody isnt going to get the care they need with Obama's plan. If everybody was paying into the system then I would support it but that's not what's happening from what I read.


    You are mistaken (none / 0) (#92)
    by ColumbiaDuck on Tue Aug 11, 2009 at 02:06:19 PM EST
    That this bill wouldn't help you.  In fact, you are the type of person most likely to be helped.  You are part of the individual market now - those are the folks who are in the worst position to get good rates from insurers because you don't have any negotiating power or market clout.

    The bills under consideration would allow you to purchase insurance through a "gateway" or "exchange" where many different private (and hopefully a public) plan are offered.  There you would be in a pool with millions of others, giving you the combined clout to get a better deal.

    Insurers would also not be able to deny you coverage because of a pre-existing condition or rescind your coverage if you become ill.


    Are you (none / 0) (#94)
    by Ga6thDem on Tue Aug 11, 2009 at 02:10:36 PM EST
    talking about the "nonprofit" exchange? I dont believe that will happen simply because I dont think insurance companies will participate.

    If the exchange has 20 million customers (none / 0) (#97)
    by ColumbiaDuck on Tue Aug 11, 2009 at 02:28:18 PM EST
    they will participate.  they participate right now in the Federal Employee Health Benefit Plan exchange because they want a big cut of the 8 million federal employees.  The proposed exchanges are modeled on this approach.

    Re: Health Insurance exchanges (none / 0) (#98)
    by Anne on Tue Aug 11, 2009 at 02:49:02 PM EST
    Most progressive policy wonks observing the reform process taking place in Washington have been quite smug. As the battles take place over a public option, over taxing employer-sponsored plans, or over the eligibility thresholds for government subsidies, these wonks are complacent knowing that the really important reform taking place is the establishment of the Health Insurance Exchange. Or so they believe.

    Within the Exchange the regulated private insurance industry will have to provide standard benefit packages, at affordable premiums made possible by competition, and without the intrusive perversities that currently permeate the industry and its products. What could be wrong with this?

    President Obama and the Democrats in Congress are currently facing a barrage of criticism for supporting the government takeover of health care. To fend off this criticism, what are the very first words out of President Obama's mouth? "You can keep the insurance you have!" So much for an insurance exchange market of comprehensive, affordable private health plans.

    Why would a phenomenally successful private insurer ever want to compete with itself by offering a heavily regulated Health Insurance Exchange product that has unaffordable premiums because of adverse selection? Because of the requirement of risk adjustment within the Exchange, and because individuals and employers with high health care costs will seek relief in the Exchange, all products offered by the Exchange will be too expensive.

    The Health Insurance Plan of California (later PacAdvantage) was designed not unlike the current federal proposals - an insurance exchange especially geared for small businesses. Because of adverse selection, it became a victim of the death spiral, and closed in 2006.

    The only way a Health Insurance Exchange could work would be if we moved all existing private plans into the Exchange, and established a system that would effectively pool risk. Even then it would be very expensive, partly because of the profound administrative inefficiencies, and it would still fall short on universality and equity. And at that we would still have to address the problem of the very large sector of our population who would not qualify for subsidies but who still could not afford the high premiums and out-of-pocket expenses of private insurance.



    Question (none / 0) (#104)
    by ColumbiaDuck on Tue Aug 11, 2009 at 03:50:53 PM EST
    Did the California exchange prohibit denying insurance on the basis of pre-existing conditions?  Because that is in all the federal proposals and would do away with a lot of the "adverse selection" issues.

    You can't (none / 0) (#109)
    by Ga6thDem on Tue Aug 11, 2009 at 04:06:33 PM EST
    compare it with the federal employee's situation because that is done through an employer--The Federal Government.

    These health exchanges have been done before and they didnt work out for the most part. The insurance companies aren't going to be competing for your business because they dont do it now. The only way that an exchange would work would be if you had it only offering a few plans so that the insurer could guarantee volume pricing.


    Who do you think ... (none / 0) (#123)
    by ColumbiaDuck on Wed Aug 12, 2009 at 08:29:25 AM EST
    is managing the exchange?  The pool of people don't have the same employer but the management of the exchange and the requirements for insurance companies to participate will be very similiar.  

    Many if not most (none / 0) (#35)
    by Rojas on Tue Aug 11, 2009 at 08:33:18 AM EST
    will export the jobs.
    It makes no sense. We need to remove the tie to employers.

    I got it gang.... (none / 0) (#44)
    by kdog on Tue Aug 11, 2009 at 09:08:32 AM EST
    if ya need healthcare and can't get it, just scream from the rafters that you want some euthanasia and the holy-roller righties will come running with all the care ya need...I mean look how they rolled in the Schiavo affair.

    You can't fact check an opinion (none / 0) (#48)
    by Slado on Tue Aug 11, 2009 at 10:23:04 AM EST
    And Sarah Palin gave an opinion shared by many that a gov't run system will result in government making decisions on who receives what critical care.

    If your opinion is that government should make these decisions rather then insurance companies or capitalist forces then say so but to argue Sarah Palin is making this up is also an opinion that I'd gladly "fact check".

    Boy does she push Jeralyn's buttons.

    But (5.00 / 2) (#51)
    by Dr Molly on Tue Aug 11, 2009 at 10:35:38 AM EST
    she also 'shared her opinion' on the specific content of the bill and tied that to the idea of 'death panels' - which is deliberately misinformative. She did not simply make a general statement on gov't run systems making decisions for people.

    Since there is nothing in the bill like that, she is spreading falsehoods.


    There is more conflicting and (none / 0) (#55)
    by MO Blue on Tue Aug 11, 2009 at 10:44:23 AM EST
    misinformation going around about the current health insurance package than there are pages in the House bill. And that is saying a lot.

    Then the counter to Palin's (5.00 / 2) (#56)
    by Anne on Tue Aug 11, 2009 at 10:46:36 AM EST
    opinion about what "government-run" health care might do ought to be what private insurance is actually doing, and has been engaged in doing for quite some time.

    Actually, before one even gets to Palin's "opinions," a good place to start would be with the fact that Medicare is not government-run - the collection of premiums and the payments to providers are government-administered; there is no government-employed doctor telling Medicare recipients what care they can and cannot have.

    But, back to Palin's "opinions:"

    There is already more than enough evidence that private health insurance companies have been engaged in  making decisions about what care it will and will not cover and will and will not pay for, how it prices people out of coverage, how it drops people who are too expensive and how it counts on people not appealing their decisions.  

    People like Palin apparently believe that the more evil they can attribute to the future behavior of the government, the better the private sector looks, so the sooner and louder this tactic can be neutralized through dissemination of what the private sector has been engaging in, the better.  

    I think one has to ask Palin whether she thinks the current business model for health care, where only those who can afford it can have it, where people are handcuffed to their jobs by benefits they would either not be able to get or could not afford in the individual market, where one can be one major illness away from financial disaster, is one that has been steadily improving our overall health and outcomes, and bolstering the economy instead of being a drain on it.  I would really like to hear the garbled explanation she would give to that.

    In my opinion, the fact that the debate is this far out of control can be laid directly at the feet of the president, who is still, even at this late date, being wholly ineffective on the entire issue, leaving the door wide open for people like Palin to control the conversation.

    Given that the current shape of this "plan" is so bad, it actually does deserve to die, but not because there is any credibility to Palin's "opinions."


    Health savings accounts (none / 0) (#60)
    by lilybart on Tue Aug 11, 2009 at 10:55:42 AM EST
    yeah, that is all we need, says the GOP.

    I wonder (none / 0) (#63)
    by ColumbiaDuck on Tue Aug 11, 2009 at 11:02:50 AM EST
    what type of insurance Palin gets now?  presumably she used to be covered as an employee of the state of Alaska.  Now does she buy her own insurance?  

    Expect the current shape of this "plan" (none / 0) (#65)
    by MO Blue on Tue Aug 11, 2009 at 11:07:28 AM EST
    to get even worse. According to my own sweet Claire:

    McCaskill noted that she was currently reading the bill 'page by page, but did not read the House bill because it wouldn't be approved.' She also noted that she 'is still spending half of every day on health care and really trying to get information from the public and health care providers on the issues.'  Link

    With Claire, who prides herself on voting against Democratic party objectives, devoting her time to the insurance package, the end result will resemble your worst nightmare.


    Re: Gov't employed doctor..... (none / 0) (#67)
    by vicndabx on Tue Aug 11, 2009 at 11:14:10 AM EST
    Here in the US with Medicare we have National Coverage Determinations:
    For NCD requests not requiring an external technology assessment (TA) or Medicare Evidence Development & Coverage Advisory Committee (MEDCAC) review, the decision on the request shall be made not later than 6 months after the date the completed request is received; (§731(a)(2)(A))
    For those NCD requests requiring either an external TA and/or MEDCAC review, and in which a clinical trial is not requested, the decision on the request shall be made not later than 9 months after the date the completed request is received; (§731(a)(2)(B))
    Not later than the end of the 6 or 9 month period described above, the proposed decision shall be made available on the CMS website (or other appropriate means) for public comment. This comment period shall last 30 days, and comments will be reviewed and a final decision issued not later than 60 days after the conclusion of the comment period. A summary of the public comments received and responses to the comments will continue to be included in the final NCD. (§731(a)(3)(A))

    Same policies exist in the UK:

    Short clinical guidelines are developed to the same rigorous methods as existing clinical guidelines but they are produced within a shorter 9 -11 month timescale. The criteria for their referral to NICE are the same as for topics selected for the main clinical guidelines programme, with an additional judgement about the urgency of the advice.

    Also note, the National Coverage Determination is dropped down to a local level and listed on the regional Medicare contractor's Local Coverage Determination pages.  Doctor's generally know ahead of time (or have the ability to find out ahead of time) what to bill/what not to bill - same as they do w/private insurers as seen for example here and here.  There is in the end, fundamentally no difference in the practices of the private insurer vs. those the gov't utilizes.  In fact, I would surmise many coverage determinations are based on whether "the gov't" pays for a particular procedure or not w/o supporting medical necessity evidence.  Appeals happen quite often under Medicare.  So much so, they have the entire process documented on various Medicare contractor websites.


    For the life of me, I cannot figure out why (none / 0) (#71)
    by Inspector Gadget on Tue Aug 11, 2009 at 11:48:32 AM EST
    Palin's opinion on health insurance is so much more newsworthy than Governor Freudenthal's is.

    Anyone who is out there spouting off talking points rather than actually attempting to honestly inform the people what is being discussed as being put forward for a vote to implement isn't worth a moment of our time.

    It's a distraction. For all the places Palin's comments have been published, thousands more people now have that image impressed on their brains. Thousands who never would have read, or heard it if the media wasn't making it the biggest story of the week.


    Yeah (5.00 / 0) (#75)
    by squeaky on Tue Aug 11, 2009 at 11:59:48 AM EST
    Palin's playbook is right out of Phyllis Schlafly 101:

    What interests me here is the tactical gimmick of arguing-by-extremes. Palin reflects the teachings of the master -- Phyllis Schlafly, founder of the Eagle Forum and a conservative-right tactician extraordinaire.


    In short, it's what "could" or "might" happen, no matter how far-fetched or disengaged from reality.

    USA Today

    It also makes a great news story, because it is so outrageous by someone so Predisential.


    Some decisions have to be made (none / 0) (#68)
    by Bemused on Tue Aug 11, 2009 at 11:21:24 AM EST
      The questions are who will make the decisions, which objectives are paramount and where lines are drawn.

      "Perfect" care for all people in all circumstances is not possible. As just one example, a disease that is extremely rare will  not in any  system gain the level of research and development of pharmaceuticals,  other research into treatment and management and practitioner expertise as will diseases that afflict great numbers.

       Is this "rationing" care? Do people with a rare disease have the same "moral right" to effective health care as those with common maladies? Or, does the collective welfare dictate that those people must receive lesser care because the cost of providing them with effective care will either (or both) deprive others of care or force others to pay "unreasonable" amounts to subsidize their care?

      This and all the other questions relating to the magnitude,  direction and sources of allocated resources constitute real issues of monumental importance.

       With any change or no change in the mechanisms through which the availability and costs of health care are managed these fundamental questions remain.

      At some point we need to be serious and stop either using the relaity such decisions have to be made to scare people or pretending that there is some magic elixir of better legislation that will make these issues vanish.


    I wish (none / 0) (#80)
    by ColumbiaDuck on Tue Aug 11, 2009 at 12:28:45 PM EST
    That research discussions where actually along these lines:

    As just one example, a disease that is extremely rare will  not in any  system gain the level of research and development of pharmaceuticals,  other research into treatment and management and practitioner expertise as will diseases that afflict great numbers.

    Because in reality, research dollars aren't allocated with the notion of two (or ten) serious diseases and the numbers affected but between serious diseases that might not reimburse well or erectile disfunction or "restless leg syndrome".


    Personally, I'm tired of the spin from both sides (none / 0) (#69)
    by vicndabx on Tue Aug 11, 2009 at 11:26:36 AM EST
    It seems everyone is trying to sell a load of bull$hit.  Facts are much more helpful.

    I would have to agree (none / 0) (#73)
    by coast on Tue Aug 11, 2009 at 11:52:21 AM EST
    get past all the rhetoric and what do you have, a bill that is not supported by the Republicans or the progressives of the Democratic party.  At the end of the day, who really wants this thing?

    There is too a Death Panel ... (none / 0) (#111)
    by RonK Seattle on Tue Aug 11, 2009 at 04:44:10 PM EST
    ... and Dr. Evil is going to turn it up to 11 and start throwing babies at it unless we fork over a ransom of one MILLION dollars!

    No Death Panel, my foot!

    That's why it may be best to ignore. (none / 0) (#116)
    by Dr Molly on Tue Aug 11, 2009 at 04:54:20 PM EST
    Zero sum game anyway.

    lol (1.00 / 0) (#119)
    by squeaky on Tue Aug 11, 2009 at 05:05:51 PM EST
    Great job of ignoring.

    ClintonCare Effect (none / 0) (#121)
    by squeaky on Tue Aug 11, 2009 at 05:31:59 PM EST
    Adriel Bettelheim has an interesting thesis about why Obama is not leading as strongly as many would like to see, regarding healthcare reform:

    How Obama lost control of health message

    He believes that Obama has taken advice the multitude of Clinton Administrations in the current WH, who were involved with President Clinton's  health care initiative in 1993-4. he calls it The `ClintonCare' effect

    The calculated deference to Congress on policy matters is no accident. Obama's West Wing is stocked with Clinton administration veterans who remain haunted by the failed attempts to overhaul the health system in 1993 and 1994 -- an effort that was effectively crippled after the White House developed a 1,342-page health overhaul bill, then demanded Congress pass it. In addition to Emanuel -- who was a senior adviser in the Clinton White House -- other Obama officials involved in that fight include Secretary of State and former first lady Hillary Rodham Clinton; Jeanne M. Lambrew, the director of the Department of Health and Human Services' Office of Health Reform; and John D. Podesta, Bill Clinton's former chief of staff, who serves as an informal adviser to the president.

    Such figures come to the debate with a clear cautionary message, observers say: The president should stay on the sidelines and keep Congress invested in an outcome until the time for serious horse-trading arrives.

    Adriel Bettelheim, CQ staff

    Heh (none / 0) (#122)
    by Spamlet on Tue Aug 11, 2009 at 08:13:53 PM EST