The 'Death Panel' is a figure of speech on both sides of this debate. No such thing actually exists, but you are wrong, plenty of people die of heart attacks because their blood pressure or cholesterol issues are not treated because they can't go to a primary care physician due to lack of health insurance, to give an obvious example. Plenty more probably die of untreated asthma, and many other easy to treat conditions for the same reason. The fact that millions of Americans can't get routine health care is a national disgrace.
...plenty of people die of heart attacks because their blood pressure or cholesterol issues are not treated because they can't go to a primary care physician due to lack of health insurance...
Did you even bother to read what I wrote? Lack of health insurance does not prevent people from seeing a doctor. It forces people to pay it themselves, but they can always see a doctor about problems. If someone dies because they didn't see a doctor because they don't want to pay for it, that is their choice (not a happy choice, I agree, but it is a choice).
By that reasoning, the only thing keeping me from visiting the International Space Station is my unwillingness to pay the $20 million fee that the Russians charge for such a trip.
Don't believe me? Here is a real world example. I take a common cholesterol lowering drug, because like my immediate ancestors, I have hereditary elevated levels of the stuff. The prescription alone, which has the potential to add many years to my life, costs me $50 per month and I have pretty decent health insurance. Of course I have to visit my doctor regularly and when I do, I have lab work done to check my cholesterol levels and many other parameters to make certain that I am where my doc wants me to be. I had a bout of bronchitis not too long ago, which required chest X Rays, and medication, and I just had a cardiogram to see how the ole ticker was holding up.
As a silver-tongued, silver haired Sales Sum'bitch I earn an above average income, but I wouldn't be able to afford all of this without my health insurance. I really should appreciate my benefits more than I do, but what keeps me on the disgruntled side of the equation is that I have to constantly fight with them to get them to do what they are supposedly contracted to do without my constant attention.
The point is, without good health insurance you are screwed one way or the other. You have to either do without the medical care you need to stay healthy, or you pay sky high bills that most folks can't afford.
Routine screening saves lives, it isn't even a debatable point.
You ever price out the cost of a mammogram without insurance? It is in the ballpark of a week long Caribbean vacation, but for a 40 year old woman, it has a statistical chance of saving her life, so don't tell me that lack of insurance doesn't cost lives. It clearly does.
By that reasoning, the only thing keeping me from visiting the International Space Station is my unwillingness to pay the $20 million fee that the Russians charge for such a trip.
Essentially that is correct. You'll notice I didn't say it was an easy obstacle to surmount, but that is a correct statement.
Don't believe me? Here is a real world example. I take a common cholesterol lowering drug, because like my immediate ancestors, I have hereditary elevated levels of the stuff. The prescription alone, which has the potential to add many years to my life, costs me $50 per month and I have pretty decent health insurance. Of course I have to visit my doctor regularly and when I do, I have lab work done to check my cholesterol levels and many other parameters to make certain that I am where my doc wants me to be. I had a bout of bronchitis not too long ago, which required chest X Rays, and medication, and I just had a cardiogram to see how the ole ticker was holding up.
As a silver-tongued, silver haired Sales Sum'bitch I earn an above average income, but I wouldn't be able to afford all of this without my health insurance. I really should appreciate my benefits more than I do, but what keeps me on the disgruntled side of the equation is that I have to constantly fight with them to get them to do what they are supposedly contracted to do without my constant attention.
The point is, without good health insurance you are screwed one way or the other. You have to either do without the medical care you need to stay healthy, or you pay sky high bills that most folks can't afford.
I don't disagree with any of that. In fact, you have now just repeated exactly what I said. It isn't a happy choice, but it is your choice, not some misnamed "death panel" run by the insurance companies.
Routine screening saves lives, it isn't even a debatable point.
I never said it didn't, so don't put words into my mouth.
You ever price out the cost of a mammogram without insurance?
Nope, I'm unmarried, so I can't make any useful input on that subject. Luckily, I know enough to keep my mouth shut.
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You don't have female family members who are 40 years of age or older?
If a screening mammogram finds a small breast cancer (stage 1), it can be cured with surgery, unless it is aggressive, in which case a course of therapy after the surgery usually cures it. Worst case scenario is that 10 to 15 years later, in a couple percent of cases, the cancer comes back, which buys plenty of time for better treatments to be invented.
That same tumor, undiagnosed will become fatal by the time it becomes noticeable by non medical means. This is significant because breast cancer is a leading cause of death for women.
Mammograms save lives, lots and lots of lives, but aren't affordable on an average income, so either women have health insurance or they die of preventable disease.
Keep in mind that this is but one very specific example and that there are dozens if not hundreds of others.
I will say it again, the fact that millions of Americans lack basic health insurance is a national disgrace!
Now you are just wildly off topic. None of this has anything to do with the claims by the article posted that there are "death panels" run by health insurance companies. You are just as bad as Sarah Palin is.
What I have just said is factual, and you can verify that by independent sources, which makes me nothing at all like Sarah Palin. 
And sorry, I thought the topic was that people died due to lack of medical insurance and that you were disputing that indisputable fact.
What you have just said is off the topic. The claims made by the article, that you submitted (which implies your agreement with them), that so-called "death panels" exist and are run by insurance companies is not proven. The fact that you miscast greed of companies as a "death panel" is indeed no better than Sarah Palin miscasting the euthanasia counseling as a "death panel", which is exactly why you are just like Sarah Palin. All that comes out of either of your mouths are partisan bullshit based on you personal opinions.
(1) Non-ER doctors, clinics, and hospitals routinely refuse to provide non-emergency care to patients who cannot prove they can pay. (A breast cancer patient whose insurance was rescinded three days before her scheduled double mastectomy testified before Congress that the hospital refused to do the surgery unless she put down a deposit of $30,000, which she did not have. http://www.youtube.com/watch?v=dT_2GjSkzHE. This is just one of thousands of documented cases.)
(2) Emergency rooms are required by law to provide emergency and stabilization care to all comers, regardless of ability to pay. They send the resulting bills to collection. What cannot be collected is partially covered by Medicaid and higher charges to paying patients.
(3) Just before the housing and banking collapse, over 60% (500,000 cases per year) of personal bankruptcies were primarily caused by medical bills. Of those, 75% were filed by people who had health insurance when they became ill.
(4) Many states have low homestead exemptions. In these states, medical collections can easily cause a family to lose its home. Parents may be reluctant to incur debts that could make their families homeless.
(5) Failure to pay medical bills is routinely reported to credit agencies. Individuals may be reluctant to incur large medical debts because the resulting bad credit report may significantly damage their future housing and employment prospects.
(6) Good sources of reasonably objective information on health-care and health insurance policy can be found at the Kaiser Family Foundation (http://healthreform.kff.org/), the Commonwealth Fund (http://www.commonwealthfund.org/), and the Research section of Physicians for a National Health Program (http://www.pnhp.org/single_payer_resources/pnhp_research_the_case_for_a_national_health_program.php).
(7) Finally, if -- after visiting the PNHP site -- you're still one of those guys who thinks the "free market" is the best solution to every problem, please read Kenneth Arrow's article "Uncertainty and the Welfare Economics of Medical Care" (http://www.who.int/bulletin/volumes/82/2/PHCBP.pdf).
Accusing the accuser of the same false idea is the simplest trick in the book, but simple tricks for simple minds, so that is not surprising.
I would have to say that Sarah Palin started this tactic except her use was a lot more nefarious. She invented the "death panel" term to exaggerate the facts with the intent of inducing fear and panic to further her cause (which apparently worked because droves of people are shouting down speakers at these town hall meeting echoing her phrases while bypassing civil discourse and blackballing those with legitimate questions who seek a real debate. Simple tricks for simple minds indeed). And I say she started the tactic because the assertion that people have been dying and having a poor quality of life due to lack of health care has been around long before she began making headlines and unless I am wrong is the entire reason for this health care reform. I certainly don't know the exact numbers, but I have heard about enough documented cases that I don't believe the assertion that the lack of health care causes some deaths to be false and I certainly believe proper health care raises the quality of life.
You are just as bad as Sarah Palin is.
Speaking of simple tricks (and off topic a bit), another simplest trick in the book is to attack your opponent instead of defending your stance, but I guess you already knew that.
Doctors are required to treat anyone, regardless of whether they can pay
While it is true that doctors can not deny patients treatment in case of emergency, they can certainly deny non-emergency primary care and regular checkups, but how many emergencies could be avoided entirely with proper health-care including regular checkups.
None of this has anything to do with the claims by the article posted that there are "death panels" run by health insurance companies
I don't think the article is literally saying that health insurance companies have some back room with a sign that says "Death Panel Board Room". It seems to me that the author is just taking the asinine (as the author put it fictitious) term invented by Mrs. Palin and showing how it also applies to the current private health insurance paradigm. While they don't run literal death panels, their business practices and profit goals do occasionally have the effect of determining who receives complete, proper health care and who doesn't (thus who gets the better quality of life and sometimes unfortunately who lives and who dies).
With that said, while some cases of death and decline in quality of life can be attributed to denied health care, just as many if not more can be attributed to people simply making poor life choices (think poor diet, smoking, drug use, drinking and driving, promiscuous sexual activities, etc, etc) and should it really be the burden of the taxpayers to take responsibility for these individuals who fail to be responsible for themselves? However, at the same time, most well-off Americans enjoy the lifestyle they do as a result of many of these uninsured people making near minimum wage (the people who transport, cook, server your food, the people who stock the shelves in the stores you frequent, the people who clean up your messes and handle your garbage, etc), shouldn't these people be allowed the same level of health care as the well off people making hundreds of thousands of dollars a year to ensure the well-being of society as a whole?
Perhaps the issue doesn't just lie in government vs private health care, but we should be looking at why health care is so unaffordable in the first place. Why is it that the minority of people who abuse the system (make false insurance claims, seek unsubstantiated lawsuits, abuse their prescription drugs to fuel an addiction, etc) raise the premium for everyone else and ultimately lead to people being denied health coverage. Is this not a form of taxation? This tax, instead of being inclusive where everyone shoulders the debt (in whatever manner the government determines), is exclusive where only those who can afford it remain and those who either can't afford it or fit the profile of people who have abused the system in the past (in whatever manner a private organization determines) are denied the same level of treatment. Is this fair or just?
This is a tough debate indeed and it is hard to come to a definitive conclusion for the best course of action, but I think these fear-mongering techniques and shouting matches bring nothing to the table and only cloud the truth, confuse people, and make it harder to come to a reasonable decision. And while this article makes some good points, it is also guilty of partisanship, feeding into the fear mongering, and ultimately it offers no real solutions either.
The difference between what I am saying and what Palin has said is simple; Palin is talking paranoid fiction and I am giving common factual examples.
That should count for something!
The examples you just gave don't have anything to do with "death panels" though. It is a political term designed to scare people. No one is sitting in an office saying Person A lives and Person B dies. You and Sarah Palin are spreading fear and terror to rally people to your cause. So, no, real world examples that have nothing to do with the topic at hand count for nothing, at least not to me, and hopefully not to anyone with a logical mind.
I am not disagreeing with any of those statements. However, what does that have to do with "death panels"? It is a very simple question that you are trying to derail with off-topic examples. No where here have I said or implied that the current system is without flaws, but none of that has to do with "death panels". As I have said numerous times, that term is nothing more than a political term designed to scare and frighten people. Neither side should be using it.
I would have to say that Sarah Palin started this tactic except her use was a lot more nefarious. She invented the "death panel" term to exaggerate the facts with the intent of inducing fear and panic to further her cause...
Well, I've heard the phrase "death panel" many times before Sarah Palin used it, but I will agree she is the first I heard apply it to Obama's health insurance bill. However, either side using it spreads fear and exaggerates the facts, so I probably disagree that she was more nefarious than the article writer or Gramps for posting it.
...because the assertion that people have been dying and having a poor quality of life due to lack of health care has been around long before she began making headlines and unless I am wrong is the entire reason for this health care reform. I certainly don't know the exact numbers, but I have heard about enough documented cases that I don't believe the assertion that the lack of health care causes some deaths to be false and I certainly believe proper health care raises the quality of life.
I don't disagree that health care has problems. No one have I stated or implied that it is without flaws. However, none of that has anything to do with the false idea that "death panels" exists. You only decry Sarah Palin using it, when no one has any right to make such claims, even as a metaphor.
Speaking of simple tricks (and off topic a bit), another simplest trick in the book is to attack your opponent instead of defending your stance, but I guess you already knew that.
You are referring to the logical fallacy of attacking the messenger, not the message (yes, I am highly aware of it). However, the statement I made was based on the similarity between the messages used by Gramps and used by Sarah Palin. Had I said something like, "Gramps is an idiot, so what he says doesn't matter" (I don't believe this, by the way), you would be correct. The fact that I showed exactly how the tactic they (both Gramps and the article writer) used is the same as Sarah Palin's tactic on this issue is what makes the difference between attacking the messenger and attacking the message. The comparison is made because of the message. That is why it is that particular fallacy doesn't really apply. However, I will say that my making such a statement doesn't really add anything to the conversation, and would have been better left unsaid.
With regards to the rest of what you said, I completely agree. Here I am simply trying to point out that either side using the term "death panel" is simply trying to scare people, and it is in poor taste.
The claims made by the article, that you submitted (which implies your agreement with them),
excuse me? surely you jest? maybe you are into shooting the messenger?
I must admit, I fail to see how that is shooting the messenger.
Hi, Jammer170 -- I appreciated the cordiality of your reply.
First, my replies were not off-topic. Re-read your original post. You claimed that doctors provide care to everyone regardless of ability to pay (because of the Hippocratic Oath) and that people only die because they choose not to see a doctor (because they don't want to pay). I refuted those claims. It follows from that refutation that when an insurance company weasels out of paying for life-saving care, they are in many cases -- when the patient can't pay out of pocket -- condemning people to death. In that sense, insurance companies do in fact act as "death panels."
Second, I don't think it's an unfair political or rhetorical tactic to point out that the Palin "death panel" label is not only a gross mischaracterization, but actually applies rather well to the interests *she* is trying to protect. If TV news were still dominated by professional journalists, Palin's claim would have been rightfully dismissed as ridiculous and the story would have died. Now that TV news no longer investigates or analyzes claims and simply takes them at face value, propaganda is reported as unfiltered news and given broad exposure. It's disingenuous to insist that victims of this kind of propaganda play by old-school rules in the new media environment when the victimizers are not. This is a case of the Prisoner's Dilemma and the tit-for-tat strategy applies; players who hold to high moral standards and always play fair end up losing. If you'd like to see more good faith in political discourse, your criticism should be directed at initial breaches, not at responses.
You claimed that doctors provide care to everyone regardless of ability to pay (because of the Hippocratic Oath) and that people only die because they choose not to see a doctor (because they don't want to pay). I refuted those claims.
Actually, you didn't refute those statements. In fact, you explicitly agreed with my statements. You will not be allowed to die simply because you can not pay. You showed that people won't be given long-term routine medical care, but that is vastly different than the implications from the term "death panel". I won't debate the advisability or long-term negative effects about not providing routine medical care (its far too complicated, and I doubt any of us has any expertise in the matter - or indeed if anyone has that expertise). Since you didn't refute my statements, the rest of that particular paragraph is unsupported.
Second, I don't think it's an unfair political or rhetorical tactic to point out that the Palin "death panel" label is not only a gross mischaracterization...
I don't disagree with you there.
...but actually applies rather well to the interests *she* is trying to protect.
Obviously I disagree, plus that is an unsubstantiated claim. You don't know if she is trying to protect the health care insurance industry (to be fair, we don't know that she wasn't, either - its just unproven either way). In fact, given her past, it is much more likely the closest she has come to the proposed health care bill is through some third party, who could have had any number of agendas in describing it to her (Occam's Razor applies here - in this case, ignorance on her part, which isn't exactly a first for her). Clearly she was way off target with her claims, but stating that health insurance companies are acting as "death panels" is also a gross mischaracterization. It is a scare tactic, regardless of who uses it, in this case being used to promote government intervention in the health care insurance system.
While I agree with the remainder of your statements regarding the main stream media, it is also going off-topic of already a long-winded discussion. I'm am just going to reiterate what I stated at the beginning, the use of the term "death panel" is a political scare tactic, and neither side should be using it. You will not be allowed to die at the determination of anyone other than a medical doctor currently working on you. Beyond that, the complexity of the system because incredibly hard to judge, and you can't lay the end result at the feet of any one person or group of people, and any attempt to do so is a gross mischaracterization, done for some sort of personal reason (political, monetary, or whatever).
I think we're going to have to disagree. I believe I refuted your claims and even provided a link to a case in point.
A recent Commonwealth Fund study (http://tinyurl.com/n2fmyq) shows that, of 19 developed countries, we have the highest rate of amenable mortality (deaths that could have been avoided with appropriate treatment). France, which has a government-run, universal, quasi-single-payer system and spends half what we do per capita on medical care, placed first with an amenable mortality rate 40% lower than ours. Parse that however you will.
Perhaps you are misunderstanding the point I am trying to make. You said:
Emergency rooms are required by law to provide emergency and stabilization care to all comers, regardless of ability to pay.
That is what I am saying. You will not be allowed to die, simply because some random flunky at the health insurance company decides not to pay your bills. That is the implication of a "death panel". Do you now disagree with your own statement?
ETA: It occurs to me that perhaps what you disagree with me on is the definition of a "death panel". If so, then yes, we will just have to agree to disagree.
Emergency and stabilization care does not encompass all types of life-saving treatment. If you need a liver transplant, or chemotherapy, or radiation therapy, or any number of other life-saving medical interventions that do not qualify as emergency care, you can't get them done by just showing up at the ER. If you can't pay, and Medicaid won't take you, and you can't get taken on as a charity case somewhere, you're not going to get treated. And if you don't get treated, you're going to die. That's right -- if you don't get non-emergency treatment in time, and you show up at the ER when you are really, really sick, they're not going to be able to do anything for you, and they are going to "allow you" to die. In such cases, when the insurance company decides not to pay (whether justifiably or in bad faith) they are in essence deciding that you are going to die. And that is why the "death panel" label, however hyperbolic, more aptly describes private insurance companies than it does the end-of-life counseling provisions in HR 3200.
My friend and I had the same kind of cancer. I had great insurance (being a teamster at the time), she had none. Our treatments and subsequent "quality of life" could not be more different. I got to shop for the best care (asking the hospital nurses proved to be a great way to find a great oncologist), she was on Medicaid and did not.
PS "amenable mortality" sounds like a good thing.
The claims made by the article, that you submitted (which implies your agreement with them)
Ummm. No. Sometimes things are just interesting, funny, ironic, stupid, and/or, we just want to start a conversation - at least in my case that is so.
Oh yeah - end-of-life counseling is not euthanasia counseling. But I suppose it could be...
Ummm. No. Sometimes things are just interesting, funny, ironic, stupid, and/or, we just want to start a conversation - at least in my case that is so.
True. In this case, I was also using what I know about the submitter in making that statement. Additionally, the submitter could have submitted this story as weird, but instead he submitted it as report rather than weird, which does seem to imply some agreement to its validity (or at least I think so).
Oh yeah - end-of-life counseling is not euthanasia counseling. But I suppose it could be...
I don't recall if I've said this before, but I would say euthanasia counseling is a subset of end-of-life counseling (its one option, anyway).
I'm a primary care doc. I have several patients simply pay $65 cash for their visits and do the labs at the health department. If they can't pay, we work around it. But its hard to say they can't afford it. They skip on insurance as a gamble to pay for their life style. They wait until they get diagnosed with medical problems and then its pre-existing and insurance will not cover it.
Medicaid and medicare are by far the worse insurances about restricting treatments (although in my state medicaid is outsourced to one of several private companies). Medicare is tolerable IF you pay for a supplement. Docs are forced to accept unassigned patients if the ER deems them admission worthy. We bill but know that we will rarely be paid on these cases. Even so, the current system is better than any of the proposed (Which will make guideline on who can and cant get treatment- see Tom Dachels book)
I do feel the term death panel is misleading. It will be more of denial panels. For example, renal cell carcinoma has an expected survival of 6 months after diagnosis. A medicine called sudent can increase survival to 2-3 years. However it costs $4000 a month. There are many ways to get it or a similar drug if needed in the U.S. We have had 2 cases, both without coverage and they are on it. In England, if you are not approved (based on age etc.) then you have no recourse. The drug company spent millions developing the drug. They have to split the cost among a few thousand cases. If they can't make a profit then all future R&D will be put in common ailments like heartburn or other unnecessary treatments. Not that I support price gouging, but if you're running a company you going to want a profit.
Its late, I'm rambling. Please don't report me to the white house.
Thanks, I really appreciated your comment. Far better to hear from some one in the know rather than folks regurgitating stats and opinions.
I agree, but of course the doc forgot to mention that in England you have the same recourse as anyone in the US has, which is to pay for your treatments out of your pocket. When he said no recourse, he meant none from the national health plan.
And for the record, I have not been regurgitating stats and opinions, I happen to know something about the diagnosis and treatment of breast cancer due to the kind of work I do. I know of this first hand.
Hi, ars9876 ---
It's cool that a PCP is posting here.
England's National Health Service isn't the only alternative model out there. Check out France, which pulls out all the stops for cancer treatment. From what I have read, they don't use cost/QALY guidelines like England and simply pay for the best treatment available. (It helps that they have monopsony bargaining power -- this really helps bring down the price of most medications.)
France's healthcare system was ranked best in the world by the World Health Organization in their last survey, back in 2000. (Obviously, one can quibble with how the various factors that went into the ranking were weighted, but it's generally regarded as delivering high-quality care to everyone at reasonable cost.) Their system is also the second most expensive -- a very distant second to us. (In PPP-adjusted dollars, they spend half per capita what we do, while covering *everyone*.)
The French system is admittedly somewhat stingy with PCP rates, but on the other hand, physicians' education and training is free, their kids' education is free, they have low malpractice premiums, very limited need for billing and adminstrative staff, and essentially zero collection problems. PCPs still manage to eke out very comfortable upper-middle-class livings while living significantly less stressful lives.
I hope you will check out the Physicians for a National Health Program website (www.pnhp.org) and consider their endorsement of HR 676 (single-payer). PCPs in particular are likely to make out better under that plan than under the current rgime. By my reading, it's even more generous than the French "Scu" and -- based on Kaiser Family Foundation scoring of similar single-payer bills -- would still reduce the nation's overall medical expenditures.
People are taking the term "death panels" way too literally.
its really cool when they pull the switch the you hear the eeeeyyyyyyooooooooooooooooooo and them three beams join up and shoot out at the planet... wait thats the deathstar...nevermind
maudie... Check this out
Access denied (at work) "web chat blah blah blah"
Will check it out from home tonight. Tanks.
jammer170
Accusing the accuser of the same false idea is the simplest trick in the book, but simple tricks for simple minds, so that is not surprising. Quite simply, this article is an outright lie. No one in America dies due to a lack of health insurance. Doctors are required to treat anyone, regardless of whether they can pay, under the Hippocratic oath. If a person does not get treatment because they don't want to pay, well, that is a choice. It is not decided by a "death panel".