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Full Text of the House Dem "Advanced Care Planning" end-of-life consultation
JEFFHEAD.COM ^ | August 9, 2009 | Jeff Head

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 individual’s 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 professional’s 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 physician’s 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.


TOPICS: Culture/Society; Extended News; Front Page News; Government; News/Current Events
KEYWORDS: 111th; agenda; bhohealthcare; death; democrats; endoflife; euthanasia; healthcontrol; moralabsolutes; nobama; obamacare; obamatruthfile; prolife; readthebill; seniors; socializedmedicine; solventgreen
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To: stormer
The wording is there. There will be a panel and it will be a panel of government people.

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.

21 posted on 08/09/2009 11:10:42 AM PDT by Jeff Head (Freedom is not free...never has been, never will be. (www.dragonsfuryseries.com))
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To: stormer
I don't see anything wrong with folks developing a strategy to ease the transition for themselves and their families.

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?

22 posted on 08/09/2009 11:11:55 AM PDT by Dianna (Obama Barbie: Governing is hard.)
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To: Alamo-Girl
Exactly, Almo-Girl. It is clearly they as a gateway to the future implem,entation of ideas and plans held by Dr. Ezekiel Emanuel and those who think like him.

"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"

23 posted on 08/09/2009 11:13:17 AM PDT by Jeff Head (Freedom is not free...never has been, never will be. (www.dragonsfuryseries.com))
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To: Jeff Head
I think you are misinterpreting the wording. The section you've pasted refers to the stakeholders involved in the development of the program - not the decision making regarding individuals.
24 posted on 08/09/2009 11:14:44 AM PDT by stormer
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To: stormer
There's nothing wrong with famlies and individuals discussing things like living wills , long term care etc. It's when government gets involved that it's just a little creepy. It's a fairly short leap from discussing end of life options to encouraging one option, from there it's easy to go from , you've no hope for a produtive life so lets spend resources elsewhere. Finally, you're an undesirable so society has no obligation to keep you alive. The slippery slope argument

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

25 posted on 08/09/2009 11:14:45 AM PDT by YankeeReb
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To: Dianna
If heard that elsewhere, but all I can find are a bunch of blogs discussing it, no real information. But let's say it's true that the state is limited as to the insurance coverage offered - how is that different form any other insurance company? Insurance companies deny coverage ALL THE TIME. It's how they make money.
26 posted on 08/09/2009 11:20:49 AM PDT by stormer
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To: stormer
No, I understand that wording exactly. They will develop a program that will guide the practioners in exactly what they can and cannot offer...in what types of orders they can and cannot give.
(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.

27 posted on 08/09/2009 11:21:51 AM PDT by Jeff Head (Freedom is not free...never has been, never will be. (www.dragonsfuryseries.com))
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To: stormer
Am I to take it that the tin hat is for protection against my comment that statistics will be used to determine worthiness to live, that cost effective measures will be the main consideration on whether or not a person receives necessary life sustaining medicine or procedures or equipment? You think believing this is akin to seeing UFOs?

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.

28 posted on 08/09/2009 11:24:01 AM PDT by Republic
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To: Jeff Head

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:

http://uscode.house.gov/download/pls/18C115.txt

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.


29 posted on 08/09/2009 11:27:18 AM PDT by Kackikat (There is no such thing as a free lunch, because someone paid, somewhere.)
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To: hinckley buzzard
Such consultation shall include the following:

"Will" is a promise, "Shall" is an order.

30 posted on 08/09/2009 11:27:44 AM PDT by El Gato ("The Second Amendment is the RESET button of the United States Constitution." -- Doug McKay)
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To: stormer
Insurance companies deny coverage ALL THE TIME.

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.

31 posted on 08/09/2009 11:28:52 AM PDT by Dianna (Obama Barbie: Governing is hard.)
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To: Jeff Head; 185JHP; 230FMJ; 50mm; 69ConvertibleFirebird; Albion Wilde; Aleighanne; ...
Moral Absolutes Ping!

Freepmail wagglebee or DirtyHarryY2K to subscribe or unsubscribe from the moral absolutes ping list.

FreeRepublic moral absolutes keyword search
[ Add keyword moral absolutes to flag FR articles to this ping list ]


32 posted on 08/09/2009 11:29:01 AM PDT by wagglebee ("A political party cannot be all things to all people." -- Ronald Reagan, 3/1/75)
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To: Jeff Head

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?


33 posted on 08/09/2009 11:30:27 AM PDT by FrankR (We are only enslaved to the extent of charity we receive....INCUMBENTS OUT!!!)
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To: El Gato
Photobucket The way it reads, it seems like seniors are going to have to go through this for just having a bad case of hemorrhoids. Those protesting at the meetings should be demanding more that congress have the same health plan rules.
34 posted on 08/09/2009 11:31:01 AM PDT by Always Independent
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To: Jeff Head

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.


35 posted on 08/09/2009 11:34:12 AM PDT by Kackikat (There is no such thing as a free lunch, because someone paid, somewhere.)
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To: El Gato

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!


36 posted on 08/09/2009 11:39:21 AM PDT by Master of Orion
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To: ArchAngel1983

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. :(


37 posted on 08/09/2009 11:43:38 AM PDT by mojitojoe (All tyranny needs to gain a foothold is for the people to remain silent.)
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To: Jeff Head

EVIL, EVIL, ROTTEN people that that POS poaching in the WH surrounds himself with.


38 posted on 08/09/2009 11:46:17 AM PDT by mojitojoe (All tyranny needs to gain a foothold is for the people to remain silent.)
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To: stormer

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.”


39 posted on 08/09/2009 11:47:38 AM PDT by ForEvers
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To: Kackikat
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.

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.

40 posted on 08/09/2009 11:50:55 AM PDT by El Gato ("The Second Amendment is the RESET button of the United States Constitution." -- Doug McKay)
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