Skip to comments.Full Text of the House Dem "Advanced Care Planning" end-of-life consultation
Posted on 08/09/2009 10:35:59 AM PDT by Jeff Head
I have had many questions and comments regarding the PDF file of the House Democrat Health Care plan I made available for download on my site, HERE.
Most are, as am I, appalled at the plan and the wording of it...particularly when taken in context with the cited quote and views of the chief architect of the plan, and chief advisor to Obama on Health Care and Policy advisor to the Democratic Congress on HEalth Care, Dr. Ezekiel Emanuel, HERE.
Some however attempt to rationalize, or even make statements regarding the plan that just are not there, are not supported (at least IMHO) by fact, and certainly are at odds with the views openly stated by the chief advisor who has helped craft the plan.
This is particularly true when it comes to the end-of-life counseling portion of the plan identified pn page 425 of the plan where it amends the Medicare laws and thus applies to seniors over the age of 65.
So, I thought I would post the wording of that section, directly from the plan, but formatted so yuou can follow it. People need to make up their own minds.
The way I read it, the section makes the sessions required, it brings government bureaucrocy into life planning where the individual, the Dr. and family should make the sole decisions, and it open up the possibility for government health orders regarding the end-of-lie treatment of the elderly.
Far, far too much government involvement and power, particularly given the clear eugenics and infanticide reasoning of the auther.
Here it is. You decide.
Advance Care Planning Consultation
(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:
-----(A) An explanation by the practitioner of advance care planning, including key questions and considerations, important steps, and suggested peo1ple to talk to.
-----(B) An explanation by the practitioner of advance directives, including living wills and durable powers of attorney, and their uses.
-----(C) An explanation by the practitioner of the role and responsibilities of a health care proxy.
-----(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).
-----(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.
-----(F)(i) Subject to clause (ii), an explanation of orders regarding life sustaining treatment or similar orders, which shall include
----------(I) the reasons why the development of such an order is beneficial to the individual and the individuals family and the reasons why such an order should be updated periodically as the health of the individual changes;
----------(II) the information needed for an individual or legal surrogate to make informed deci-sions regarding the completion of such an order; and
----------(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 decisionmaker (also known as a health care proxy).
--------(ii) The Secretary shall limit the requirement for explanations under clause (i) to consultations furnished in a State
----------(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
----------(II) that has in effect a program for orders for life sustaining treatment described in clause (iii).
--------(iii) A program for orders for life sustaining treatment for a States described in this clause is a program that
----------(I) ensures such orders are standardized and uniquely identifiable throughout the State;
----------(II) distributes or makes accessible such orders to physicians and other health professionals that (acting within the scope of the professionals authority under State law) may sign orders for life sustaining treatment;
----------(III) provides training for health care professionals across the continuum of care about the goals and use of orders for life sustaining treatment; and
----------(IV) is guided by a coalition of stakeholders includes representatives from emergenc 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.
(2) A practitioner described in this paragraph is
(A) a physician (as defined in subsection (r)(1)); and (B) a nurse practitioner or physicians assist1ant who has the authority under State law to sign orders for life sustaining treatments.
(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).
(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, 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.
(4) A consultation under this subsection may include the formulation of an order regarding life sustaining treatment or a similar order.
(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
I see nothing in this wording that makes these "sessions" elective and voluntary.
Sorry, my bad.
BTW----------Where in the HELL is tort reform withing the 1000 plus pages of this tome from the depths of hell?
Do you mean the actual WORDING of ‘death panel’? OF COURSE those words are not in the plan....the death panel refers to the statistics that will be set that determine who has a nice enough quality of life, determined again, by the death mongers, to earn a few more years of life using equipment needed to support that life. IE...are those dependent on that expensive ozygen contributing members to society, etc.
Sounds peremptory to me.
In case anyone is in doubt as to the meaning of this phrase--it is an Orwellian bureaucratic device to refer to orders ending life, not sustaining it. Things like "no heroic measures," "palliative (comfort) care only" and the alltime fave, "Do Not Resuscitate."
is guided by a coalition of stakeholders includes representatives from emergenc 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
There is no problem with people doing this for themselves, with their Doctor, you know, the one they chose, and their familites...it's when statists and others want to interject government and their "complete lives" calculations and government bureaucrats and "stake holders" that is the issue.
With me and most people I know.
Here's a clue. If you want top consult with the government on your end of life issues...knock yourself out. But don't try and force it on me and mine or most folks I know.
My mother has severe diminsia. She's 84 years old and we take care of her and get her the treatment she needs. Ezekiel believes such people should not get any treatment.
We have done this for five years and my mother has interacted with her great grandkids...and they with her. Government will not deprive me of that experience as long as I draw breath. God may...and I have faith in Him and His timing and control of such matters. But not the governemtn.
As God is my witness; when Obama-Care leaves me for dead I swear I will take as many of these bastards with me as I can! I mean, what the hell are they going to do about it kill me?
That’s because it is.
Obama/Dems are masters at double speak, remember it all depends on what the definition of “is” is.
Nothing wrong with folks developing a strategy to 'ease the transition'...VOLUNTARILY, on their own hook. EVERYTHING is wrong when goobermint gets involved with 'developing' such 'strategies'.
But I intend to do all in my power to never let it get that far.
Defeat it now...spread the word to all you know. Put the fear of God and the voters into these reps now so they fear their own constituents more than they fear Pelosi or Obama and it goes down.
Or, failing that, neuter the quislings in 2010 and turn it back thereafter, and particularly after we run the ringer out of the Whitehouse in 2012.
The death panel will have a benign title, something like "Advanced Care Planning Healthcare Coalition." You have to realize, bills are written to deliberately obscure as much as they delineate and define. That's how they get people to go along with the music without reading the words.
I reject that categorically and on priniple, but also particularly in light of the wording and the beliefs and quotes from those who have crafted the plan that go directly to what Republic posted.
No tin foil hat there. The quotes are what they are and they are cited. The wording for government determination for life sustaining treatment are there.
You may accept that...but I do not.
The state of Oregon has already resorted to these types of measures. A woman dying from cancer was refused treatment because it could not heal her, only relieve her discomfort as she died. The state told her they wouldn't pay for treatment, but offered to pay for assisted suicide meds.
Do you think the federal government wouldn't resort to this type of pressure or worse?
"Strict youngest-first allocation directs scarce resources predominantly to infants. This approach seems incorrect. The death of a 20-year-old woman is intuitively worse than that of a 2-month-old girl, even though the baby has had less life. The 20-year-old has a much more developed personality than the infant, and has drawn upon the investment of others to begin as-yet-unfulfilled projects.... Adolescents have received substantial substantial education and parental care, investments that will be wasted without a complete life. Infants, by contrast, have not yet received these investments.... It is terrible when an infant dies, but worse, most people think, when a three-year-old child dies, and worse still when an adolescent does."
"Unlike allocation by sex or race, allocation by age is not invidious discrimination; every person lives through different life stages rather than being a single age. Even if 25-year-olds receive priority over 65-year-olds, everyone who is 65 years now was previously 25 years. Treating 65-year olds differently because of stereotypes or falsehoods would be ageist; treating them differently because they have already had more life-years is not."
"Ultimately, the complete lives system does not create 'classes of Untermenschen whose lives and well being are deemed not worth spending money on,' but rather empowers us to decide fairly whom to save"
Remember Hitler's final solution was the final step, there were smaller steps before that, starting with denial of medical care to the "non productive".
"Every favor to a constituency should be linked to support for the health-care reform agenda". : Dr Zeke Emanual
(iii) A program for orders for life sustaining treatment for a States described in this clause is a program that - (IV) is guided by a coalition of stakeholders includes representatives from emergenc 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.
So a physician, nurse, or physician's assistant will be greatly contrained by what a board of government officials and others determines is best, in advance, and based on a set of life year formula.
As I said, a categorically reject it.
I am happy working with my Dr., my family, and my curch in that regard thank you very much, and do not need such a "panle" of the government making the decsion for us in advance.
Darlin, if you do not believe this is going to happen under the government run health/death debacle, you might need to read the bill....it will take you hours....and I mean HOURS to read what is available online, I guarantee that you will replace the tin foil with a volcano.
Thanks, as always your articles are clear and understandable. It would be great if sometime this week you could do one on the laws regarding TREASON:
On FreeRepublic everyone is so passionate about what our elected leaders are doing, and rightly so, but we have to make sure that noone violates this law in the process. It would surely bring great media attention to wrong side...again, it seems logical that everyone here needs a refresher course....to dot our i’s and cross our t’s in times of trouble.
"Will" is a promise, "Shall" is an order.
Absolutely. If my insurance company denies a needed surgery, I can pay for it myself. If the government denies it, I cannot decide to pay for it myself. I would have to take my chances leaving the country.
How convenient for commiebama...their “cutoff” age is 65, and my eligibility for social security is 66. Why did I pay in all that money all these years?
Is this the original HR3200 or the NEWER One approved by some blue dogs, that Waxman said he wasn’t going to release until after August recess?
Anyway, it makes me think they will change sections and page numbers to throw everyone off, when new bill is released for a vote. It will be to confuse Seniors/Readers to think some things were changed or removed, when in fact, they will just be moved to another place in the monstrosity bill.
We will need to really work fast to find the new places to where their devious minds have put the end-of-life clauses, and watch to see if they change TERMINOLOGY on us.
The Left’s explanation of this is that many insurance plans do not cover end of Life Planning and that this section describes exactly what constitutes the plan and what will be covered.
Personally, I don’t see anything here that mandates anyone to do anything. Aside from that the rest of the plan sucks!
I’ve heard many express the same sentiments. This could get ugly very fast. I have never seen so many Americans as enraged and horrified as they are right now. I was picking up a prescription yesterday and some elderly woman was sobbing and telling the pharmacist what she read in the bill. The pharmacist agreed with her. It was very sad. :(
EVIL, EVIL, ROTTEN people that that POS poaching in the WH surrounds himself with.
I read a relevant post by Paul on Powerline this morning. In part:
“(Charles)Lane (Washington Post) argues that the “consultations” provided for in Section 1233, while not mandatory, are not “purely voluntary” either as the Democrats have claimed. Thus, he writes, “Section 1233 lets doctors initiate the chat and gives them an incentive — money — to do so. Indeed, that’s an incentive to insist.” As Lane notes, common sense tells us that Section 1233 would place senior citizens in a situation where they will feel pressured to sign end-of-life directives that they would not otherwise sign.
The federal govenment should not be in the business of skewing end-of-life counsel, and thus end-of-life decisions. Lane concludes:
Ideally, the delicate decisions about how to manage life’s end would be made in a setting that is neutral in both appearance and fact. Yes, it’s good to have a doctor’s perspective. But Section 1233 goes beyond facilitating doctor input to preferring it. Indeed, the measure would have an interested party — the government — recruit doctors to sell the elderly on living wills, hospice care and their associated providers, professions and organizations. You don’t have to be a right-wing wacko to question that approach.”
How can we not violate the law, when the law itself is illegitimate? There is only one definition of Treason applicable in these United States, it's contained in the Constitution, Article III, Section. 3.
Treason against the United States shall consist only in levying War against them, or in adhering to their Enemies, giving them Aid and Comfort. No Person shall be convicted of Treason unless on the Testimony of two Witnesses to the same overt Act, or on Confession in open Court.
A lot of the stuff in that section of the code is clearly in violation of the first and second amendments to the Constitution. Interpreted as the Obamites will soon get around to doing, the NRA is an " organization which engages both in civilian military activity and in political activity" which must "register" with the Government "on such forms and in such detail as the Attorney General may by rules and regulations prescribe."
The law makes exercising your first and second amendment rights illegal.
Of course there is an exemption for Foreign Friends of The Messiah, that is " (d) Any duly established diplomatic mission or consular office of a foreign government which is so recognized by the Department of State;". But they slipped up, there is also an exemption for " (e) Any nationally recognized organization of persons who are veterans of the armed forces of the United States, or affiliates of such organizations." They'll have to remove that particular exemption.
The fact that the seniors are singled out for end of life counseling with only the benefits of dying being explained, it stands as hard evidence of the true intent.
After all, if the old folks (and I am one) die early then it reduces the drain on medicare and social security funds - leaving more money there for the favored "others." In that regard, it is the most brutal tax imaginable.
And if they do so in violation of their contract with you, or your employer, you can take them to court to recover your expenses. If your employer agrees with them, you can take your employer to court. You won't be able to take the "public sector" to court.
Anywhere you see "shall", it's a mandate/order, "may" indicates an optional allowed activity. "Will" is a promise, which may or may not be kept.
This is what many of us warned would happen when the government murdered Teri Schiavo. It didn’t take long did it? The government best keep it’s hand off my loved ones I will make that solemn promise on this matter. Any involuntary means to try and end a loved one of mines life will be met with resistance in kind at the ones trying to carry it out.
In so doing he tells us that that is exactly what he is too. He’s learned to be mostly polite about it...but he seems over they years to always have gotten his way. When things get tough, I expect we will se the mask come off...like it’s started doing this week.
Coincidence, I’m sure.
Absolutely outstanding insight, dearest sister in Christ!
This ultimately is a brutal form of "social (re)engineering" by political criteria. And the main political idea at work here is: We give to our "friends," and punish our "enemies."
People WAKE UP! Your life and liberty are being stolen from you in broad daylight by a gang of Chicago-style THUGS.
Thank you ever so much for writing, dearest A-G!
Fred Thompson has pointed out that the word “may,” which would identify the sessions as voluntary, does not appear in the section.
I just looked it up and E. Emanuel was born in 1957. He looks at least twenty years OLDER than he is. I am SHOCKED that he is so much younger than me. He is so evil.