What This Means For You

Physicans for Reform ^ | Undated | Unattributed

[GiovannaNicoletta]

The powerful story of Barbara Wagner demonstrates why this discussion is of utmost importance. When Barbara’s lung cancer reappeared during the spring of 2008 her oncologist recommended aggressive treatment with Tarceva, a new chemotherapy. However, Oregon’s state run health plan denied the potentially life altering drug because they did not feel it was "cost-effective." Instead, the State plan offered to pay for either hospice care or physician-assisted suicide.

In stunned disbelief you may ask, "How can this be? This happens in Europe. I’ve heard stories of Britain’s National Health Service delaying intervention until the patient dies or reports of physician-assisted suicide in the Netherlands. But in America?"

The answer is simple. Oregon state officials controlled the process of healthcare decision-making—not Barbara and her physician. Chemotherapy would cost the state $4,000 every month she remained alive; the drugs for physician-assisted suicide held a one-time expense of less than $100. Barbara’s treatment plan boiled down to accounting. To cover chemotherapy state policy demanded a five percent patient survival rate at five years. As a new drug, Tarceva did not meet this dispassionate criterion. To Oregon, Barbara was no longer a patient; she had become a "negative economic unit."

In 1994 Barbara’s state established the Oregon Health Plan to give its working poor access to basic healthcare while limiting costs by "prioritizing care." In 1997 Oregon legalized physician-assisted suicide to offer "death with dignity" to patients who chose to die without further medical treatment. In the end, the State secured the power to ration healthcare in order to control its financial risk, even if that meant replacing a patient’s chance to live with the choice of how to die.

When queried about withholding Barbara’s treatment, Dr. Walter Shaffer, a spokesman for Oregon’s Division of Medical Assistance Programs, explained the policy this way, "We can't cover everything for everyone. Taxpayer dollars are limited for publicly funded programs. We try to come up with policies that provide the most good for the most people."

Dr. Som Saha, chairman of the commission that sets policy for the Oregon Health Plan, echoed Shaffer, "If we invest thousands and thousands of dollars in one person's days to weeks, we are taking away those dollars from someone [else]."

Twice Barbara appealed the ruling. Twice Oregon denied her treatment.

Government compassion sounds so noble when first introduced. In fact, this well-intentioned motive fueled the creation of the State-sponsored health plan that now denied Barbara’s treatment. As "we the people" become more and more reliant on the government, inch by precious inch, liberty slips away. Citizens become powerless in dependency. Seduced by sweet words of compassion, the welfare of the State silently usurps the wellbeing of the individual citizen. Secure in the belief that government will care for them, many Americans slumber in complacency until one day, "we the people" awake to find liberty lost.

[Jeff Head]

EZEKIEL EMANUEL AND THE OBAMA CARE FINAL SOLUTION
(Must Read - Sick, eugenics quotes of Emanuel)

[Dianna]

This is the story I referenced on the other health care thread.

[M. Dodge Thomas]

Oregon has taxpayer funded medical care for individuals not otherwise insured.

The fund has only limited financing available - decisions have to be made about who will receive what kinds of treatment.

Wagner had advanced lung cancer, which become resistant to previous chemotherapy, paid for by the same program.

Tarceva was expected by her doctor to extend her life for four to six months.

On the basis of pre-established criteria, it was determined that the provision of Tarceva was not “cost-effective” in the sense that the same amount of money would produce a greater aggregate improvement in the the quality of life for other patients.

On the basis of the same criteria, it was determined that the fund would pay for hospice care, or for physician-assisted suicide, an option which is legal in Oregon, in which is chosen by around 50 people a year.

If the voters of Oregon has wanted to provide unlimited life extending care to recipients of the fund, they could have voted in representatives ready to raise taxes to provide the funds to do so.

They don’t, and I doubt that many readers here would vote to be taxed to supply such care on an unlimited basis either.

This is how it works: unless we are willing to pay taxes to provide such care on a unlimited basis, we can disagree with the criteria used to perform the rationing, but it’s pretty hard to argue that rationing itself is unreasonable.

[Diogenesis]

"Our Health Death Panels mean that WE live.
Death to the lame, the handicapped and the old -- unless they are OUR families."

"Mass. Pushes Rationing to Control Universal Healthcare Costs (RomneyCare)
A 10-member Massachusetts state healthcare advisory board unanimously recommended
that the state begin rationing healthcare to keep the state’s marquee universal health care program afloat financially.
The July 16 recommendations, the Boston Globe explained, would result in a situation where “patients could find it harder to get procedures they want but are of questionable benefit if doctors are operating within a budget.
And they might find it more difficult to get care wherever they want, if primary doctors push to keep patients within their accountable care organization.”
The Globe stressed that the recommendations would “dramatically change how doctors and hospitals are paid, essentially putting providers on a budget as a way to control exploding healthcare costs and improve the quality of care.”
"Budget" is a more politically acceptable word for rationing.
The Globe also noted that “consumer advocates said patients are going to have to be educated about the new system.” Yes, apparently they will have to get used to having their healthcare rationed.

[rawhide]

Coming soon to every community under obammacare! Except for those who have the right political connections. This would never happen to one of obamma’s kin!

[Syncro]

Barbara was no longer a patient; she had become a "negative economic unit."

Can't be stressed strongly enough where our government will take us in the health (death) care field if they are doing this in Oregon.

[BigBobber]

Are any AIDS patients denied their drugs in Oregon becasue they are not “cost effective”?

This is why we don’t want politicians and bureaucrats involved with these decisions. They will funnel money to their political allies and deny their enemies. Plain and simple.

[Defiant]

State plan offered to pay for either hospice care or physician-assisted suicide

Didn't Kevorkian go to jail for that?

[freespirited]

This mentality carries over into practice. Peer recognition goes to the most thorough and aggressive physicians. The prudent physician is not deemed particularly competent, but rather inadequate. This culture is further reinforced by a unique understanding of professional obligations, specifically, the Hippocratic Oath's admonition to "use my power to help the sick to the best of my ability and judgment" as an imperative to do everything for the patient regardless of cost or effect on others.

So there you have it, right from one of Obama's top health advisors, Ezekial Emanuel, bro of the WH Chief of Staff. The problem with health care today is the Hippocratic Oath and the vile notion that the physician's duty is to the patient!

Let us hope that while Congress is deforming health care, it abolishes this outrageous concept.

/sarc
=================
Quote from Emanuel, Ezekial J and Fuchs, Victor R. The Perfect Storm of Overutilization. JAMA 299: 2789-91, 2008 (June 18).

[SatinDoll]

My sister is around 50 years old, lives in Oregon, and has fibro mialgia. A former rock-n-roll musician, she has been a drug addict in the past, hasn’t been employed in years, is on food stamps, and relies daily on time-released morphine to relieve her symptoms.

Most people afflicted with fibro mialgia end their own lives because the pain cannot be stopped - it is not physical pain but originates in the pain center of the brain.

Oregon health care has offered her one option - assissted suicide.

[stormer]

Again, no attribution.

[Dianna]

This is how it works: unless we are willing to pay taxes to provide such care on a unlimited basis, we can disagree with the criteria used to perform the rationing, but it’s pretty hard to argue that rationing itself is unreasonable.

Rationing always occurs. Right now, we ration care based upon (largely) the ability of someone to pay for the care OR find someone else to pay for the care.

It isn't a great system, but it does leave the onus on the individual as the ultimate decision-maker.

[lt.america]

This story highlights certain inevitabilities. Public option leads to single payer, single payer leads to actuary based medical practice or rationing, and rationing will lead to higher mortality rates.

[Dianna]

I've never learned to post a clickable link, sorry.

http://abcnews.go.com/Health/story?id=5517492&page=1

http://www.kval.com/news/26140519.html

http://www.wral.com/golo/blogpost/5755842/

http://www.thenewstribune.com/1078/story/532612.html

http://www.washingtontimes.com/news/2009/jul/29/a-euthanasia-mandate/

[Pelagius of Asturias]

Once upon a time, liberals valued life as uncalculable, meaning it was too valuable to put a price on. Remember the gun control debates when they would say, “If it saves just one life it is worth it.”

My how times have changed.

[jwparkerjr]

Another part of the other side of the coin is that it's the use of such new drugs early on in the sickest patients that give docs the best idea of how they work and how to improve them. Data gathered from actually using new drugs on actually sick patients can be invaluable. No drug hits the market fully understood, regardless of how many clinical trials have been run with them.

I'll bet given a shot at it we here at FreeRep could find lots of ways in that state's budget to find the money to treat this lady! There's not a government budget at any level that could withstand a rigorous going over by someone who heads a family, works for a living and has to decide every day where to spend limited resources.

I know I'm preaching to the choir here, but it's high time government learned to live within its means, just as taxpayers have to!

[Screaming_Gerbil]

...This is how it works: unless we are willing to pay taxes to provide such care on a unlimited basis, we can disagree with the criteria used to perform the rationing, but it’s pretty hard to argue that rationing itself is unreasonable.

Thank you for your voice of reason on this subject, which is a difficult one to discuss. What you said puts it in perspective and makes a lot of sense.

[KrisKrinkle]

‘...Oregon’s state...did not feel it was “cost-effective.”’

So how does this kind of thinking apply in other areas, either in Oregon or nationally under ObamaCare?

For instance the Bureau of Corrections.

If a convict doing life without parole needs health care will it be deemed “cost-effective” to give it too him? Or will it be “cost-effective” to just give him pain meds (or suicide assistance) and let him die early?

What if he's only doing a twenty year stretch?

I know this twists things a little, but if they are concerned with what is “cost-effective”, is it “cost-effective” to let someone stay on death row for twenty years of appeals before before the execution? And veering back to health care, will someone on death row be eligible for suicide assistance?

Where else will they take this “cost-effective” mind set?

The above questions are rhetorical.

[green pastures]

A link to one of the Barbara Wagner articles here:

http://www.kval.com/news/26140519.html

I also recall recently reading about a 53 year old man with prostrate cancer in Oregon who was also denied treatment for the cancer but was told he could choose assisted suicide. I did a quick search and found a link here:

http://www.foxnews.com/story/0,2933,392962,00.html

53-year-old Randy Stroup of Dexter, Ore.

“Lane Individual Practice Association (LIPA), which administers the Oregon Health Plan in Lane County, responded to Stroup’s request with a letter saying the state would not cover Stroup’s pricey treatment, but would pay for the cost of physician-assisted suicide.”