More of Obama's slippery slope.

[Jason Rees]

"Dear Leader" or"Choosen One". Please pick one epithet and stick with it, would you? We are getting confused.

Gene

It's like Pringles: you can't have just one. Besides, the man's got alot on his plate. McDonalds has its Chipotle, the Chosen One has his Dear Leader. He got there as the Chosen One, and has been working his way to Dear Leader. Now we're just waiting for him to finish off the Trinity.

[Glenn]

I'm shocked that our former warriors against government intrusion into our rights have donned skirts and grabbed pom-poms.

That's because most political debates have less to do with the topic and more to do with supporting/opposing whoever is in power. The Republicans support "government intrusion" by Republican administrations while the Democrats oppose them, and vice versa. That's mostly what we see in any issue.

Look at aspects of the current health care bill turmoil. Since 1990 hospitals and nursing homes are required to have end-of-life counseling with patients. In 2003 the Republicans introduced a bill that included providing for Medicare coverage of this end-of-life counseling, and 204 Republican representatives and 42 Republican senators voted for it with none of them (or others in the party) condeming it as "death panels" then. This year the Dems introduce a bill that includes extending that coverage to include physicians, and suddenly the Republicans see it is an advocation for death panels.

Frankly there are too many examples like this, against both sides. The topic, and more importantly understanding the topic, simply does not matter to many members of political parties, it is all about their party being victorious over the other party. That is a major reason why I do not believe in political parties, or belong to one.

[Bill Glasheen]

It's like Pringles: you can't have just one.

That actually would be Lay's Potato Chips.

Or... In making light of the 7 words you can't say on TV, George Carlin comes up with a harmless-sounding snack.

New, Nabisco Tits! Bet you can't eat just one!!!

- Bill

[MikeK]

Glen,
At least both parties are being consistent in their inconsistency, and that has to count for something.

I've been reading Last Best Hope by Joe Scarborough and would recommend it to fellow conservatives and Classical Liberals to remind us of what is core to our stance.

[Jason Rees]

That actually would be Lay's Potato Chips.

- Bill

Bleh. Never cared much for Lay's. A Pringles tube OTOH, and I turn into Pavlov's dog.

[mhosea]

That actually would be Lay's Potato Chips.

- Bill

Bleh. Never cared much for Lay's. A Pringles tube OTOH, and I turn into Pavlov's dog.

You guys are reminding me of grad school leading up to my PhD qualifying exams. Lays? Not interested. Pringles? OK I'll have a half-inch stack. OTOH, I know from experience that entire bags of Hawaiian kettle fried potato chips + stress = 20 pounds.

[Jason Rees]

[Rising Star]

Noted that Obama was photo'd sans helmet while riding his bike. Is that because should there be an accident he is less at risk for a brain injury? couldnt help that!

John

[IJ]

The faux crisis over death panels is particularly disheartening to me. First, because its a total BS complaint, and second, because we actually need to have some death panels. Not people who weigh in on individual patients, but people who make tough decisions that no, medicaid and medicare won't just pay for anything at all, not even everything that works, just because a doctor "wants it" and the patient "wants it." Money is not hope. We should not be throwing it at futile conditions. But what was I confronted with last week? An ACTIVELY DYING woman with advanced cancer one of my hospital's oncologists wanted to give salvage chemo (ineffective in healthy people for the drug and condition in question) to. What do we know about this stuff? Well, chemo doesn't work and makes things WORSE when people's performance status is poor--and so they spent money injuring a patient who left for inpatient hospice (ie, to die within hours to days) on the third day i took care of her. And until I showed up on Monday, she was a "full code," ie, do everything possible if her heart stops. You mean, if she dies of cancer and the end of her natural life?!? I laughed when the team said they'd been trying to get her and the cancer docs to agree to a DNAR order--and just wrote one in the chart on the spot. "But she wants everything" came the reply. Well, I want a million bucks, and for her to live, but we were getting neither. Until individuals and our society face facts, we're toast on healthcare (and our deficits).

[Bill Glasheen]

The faux crisis over death panels is particularly disheartening to me.

It is indeed BS. There are very real things to be concerned about over Obamacare. End-of-life counseling isn't one of them.

That doesn't mean we don't try. My dad is volunteering his body to science now - because he wants to live through a particularly bad case of metastatic cancer and some academic oncologists have an idea they need some lab rats for. There's a quid pro quo in this instance. If it works, there will be breakthrough treatments for cancer when my generation gets to be his age. And if it doesn't, well everyone walked into this with eyes wide open.

However...

An ACTIVELY DYING woman with advanced cancer one of my hospital's oncologists wanted to give salvage chemo (ineffective in healthy people for the drug and condition in question) to. What do we know about this stuff? Well, chemo doesn't work and makes things WORSE when people's performance status is poor

That's a no-brainer. Primum non nocere. The evidence says it doesn't work, so DON"T DO IT!

Not on my father...

Well, I want a million bucks, and for her to live, but we were getting neither. Until individuals and our society face facts, we're toast on healthcare (and our deficits).

That's the problem (more or less) in a nutshell. The rate of healthcare inflation is greater than the growth of the GDP. It isn't sustainable.

At some point, somebody has to say "No."

If you have the bucks to pay for plastic surgery and you want to look like a freak, well go for it.



If you want somebody else to pay for it, then they get to say when and if.

- Bill

[cxt]

I think the problem with the "death panels" is the dangerously "fuzzy" nature of just where and when and how they will run.

Denying people treatments that could well save them is quite another story---and some paper pusher making that call instead of a person own MD is what is people are scared of.
We have stories coming out of the UK about proven cancer meds being denied for various reasons that make little sense to us across the pond.

It is interesting to me however that people can so change their minds on what is "compassion" and what is simple "hard truths" depending on the context.

IJ is quite correct that there simply not enough money to do everything we want and hard choices need to be made.

[Bill Glasheen]

IJ is quite correct that there simply not enough money to do everything we want and hard choices need to be made.

So... Here we have 3 knowledgeable people who see the problem for what it is - from three different political perspectives. And because we aren't politicizing the problem, we don't get hysterical about calling a spade a spade.

No "fix" is without pain. And no approach gets around RATIONING healthcare if you don't have the out-of-pocket money to cover what the system - public and/or private - can't cover for everyone. The only difference is the degree to which we let government enter the healthcare sector.

The truth is, as long as you let a 3rd party make the decision (employer-based insurance, Medicare, Medicaid), then you're going to want it all and won't be happy when you don't get it. Bitch, bitch, bitch... When it comes to a benefit, it's what we do when we don't get our way. Pay for it out-of-pocket and you find religion really fast.

If an auto was an employer-based benefit, then we'd all want Bimmers. And why not? It's a right, you know...



The reality is that many will drive clunkers until the government or the car companies bribe us to do differently.

- Bill

[Jason Rees]

As I understand it, Medicaid/Medicare are going bankrupt. So why is it covering birth control, plastic surgeries, and sex changes?

[Glenn]

I think the problem with the "death panels" is the dangerously "fuzzy" nature of just where and when and how they will run.

Denying people treatments that could well save them is quite another story---and some paper pusher making that call instead of a person own MD is what is people are scared of.

That is no different then it is now, except that currently it is the insurance companies making the calls, and they decide based on cost not what is in the best interest of the patient. Case in point, my wife had some complications after our last child was born, and her doctors fought tooth and nail with the insurance company to try to keep her under hospital care longer. The insurance company said no, she had stayed in the maximum allowed days. After a horrible night for her at home, a home-visit nurse came by to check on her the next morning and immediately sent her back to the hospital.

We have stories coming out of the UK about proven cancer meds being denied for various reasons that make little sense to us across the pond.

We don't have to look to the UK for such stories, there are plenty of examples here in the U.S., a quick search leads to this example

Insurance Won't Pay NorCal Mom's Cancer Treatment
May 12, 2009
SAN FRANCISCO (CBS 5) - Will your insurance company pay for the treatment your doctors recommend? They may not. That's what a single mother from Chico said she found out.

In late April, Shelly Andrews-Buta was scheduled to undergo treatment for breast cancer that had spread to her brain, threatening her life.

The experience has been emotionally devastating. "I have two beautiful children, you know, I'm a single mom, they need me to be around," Andrews-Buta told CBS 5 Investigates.

But instead of having doctors working to remove her brain tumors on the day the surgery was scheduled, she sat in a San Francisco hotel room. Why? Because at the last minute, her insurance company, Blue Shield, decided it wasn't going to pay for the treatment her doctors at UCSF Medical Center had recommended.

Andrews-Buta was stunned. "I mean this is my life, this is my life, this isn't, gee, if we don't do it you're just going to have a cut that doesn't heal, this is you're going to die," she said.

Without treatment, her doctor told her she in fact would die: tumors had invaded 15 separate areas in her brain.

"I wanted to rapidly get control of these lesions," said UCSF radiation oncologist Dr. Penny Sneed. "I felt there was a great time urgency, and we couldn't wait."

Just two weeks prior to the scheduled date for surgery, Andrews-Buta could still walk. Now she's almost paralyzed and unable to walk without assistance.

Dr. Sneed told her that her best chance of survival lay with a high-tech machine called a "gamma knife."

There's no actual cutting with the knife. Instead, the beams of radiation called gamma rays target a tumor from multiple angles.

The radiation can shrink and even kill a tumor without harming surrounding brain tissue.

Dr. Sneed, who is co-director of UCSF's Gamma Knife Radiosurgery Program, described it as an amazing machine and the most appropriate treatment for Andrews-Buta.

But the doctor said when it came to getting Blue Shield's approval for the procedure; she was surprised to learn that the company's policy lays out that a patient who has more than three brain tumors, what doctors call lesions, would not be covered for the gamma knife procedure.

Dr. Sneed felt the policy was unreasonable. "What I was up against was just a rule: 'Well, if it's more than three lesions, that's too many,'" Sneed said.

Blue Shield said it would pay instead for a less expensive treatment called whole-brain radiation, in which doctors try to kill tumors by exposing the entire brain to radiation. But Dr. Sneed said that wasn't the best option for Andrews-Buta.

"Gamma knife treatment works faster than whole-brain radiation in shrinking lesions," Sneed said. She believes Andrews-Buta's tumors are growing too quickly to be halted by the whole brain radiation.

Sneed is considered an expert on both procedures but said Blue Shield representatives didn't seem to want to listen to her opinion.

"There wasn't enough opportunity, I believe, to discuss it and talk about the pros and cons, and my rationale," she said.

So why did Blue Shield overrule Dr. Sneed? In emails, a company representative told CBS 5 Investigates that Blue Shield's position is that for patients with multiple tumors, gamma knife surgery 'does not improve survival' better than whole brain radiation.

But UCSF doctors say whole brain radiation has serious side effects as well.

"When the whole brain is irradiated, it suffers some form of injury," according to UCSF neurosurgeon Michael McDermott, also a co-director of the gamma knife program.

"What we're looking at is permanent or irreversible changes in the brain", said McDermott.

And Dr. Sneed said many patients suffer the effects of the radiation in their everyday lives. "They may have trouble remembering things. And that can really impact their quality of life, ability to work and function."

Other insurance companies do cover the procedure. Just a week after Andrews-Buta's treatment was denied by Blue Shield, a patient with similar cancers had her gamma knife treatment approved by a different insurance company.

Courtney LeBoeuf also suffers from breast cancer that metastasized to the brain and she, too, has multiple tumors exceeding Blue Shield's guidelines; in her case there are 10 tumors in her brain.

"I've heard wonderful things about this procedure," said LeBoeuf shortly before undergoing treatment. "And many women and men who have gone before me have had tremendous results with very little side effects."

They're results Shelly Andrews-Buta wanted her to be able to get as well. So a group of her friends got together and raised more than $30,000 to put toward paying for her treatment. Andrews-Buta still owes about $12,000 but her friends will hold a fundraiser at the end of June to cover the remainder of the cost.

Blue Shield sent the following statement to CBS 5 Investigates regarding Shelly Andrews-Buta's case:

"Blue Shield makes medical necessity decisions based on what is the most appropriate safe and effective treatment. To do that, we rely on the best evidence-based medical research available and the clinical opinion of medical experts. While we approve of gamma knife surgery when appropriate, in this case, the most appropriate treatment is whole brain radiation therapy, which we would approve for medical necessity if requested."

So the insurance company decided it knew best how to treat her, regardless of her doctor being "considered an expert on both procedures". If there are more than three lesions, they will not pay for use of gamma knife, no discussion, you have to take the cheaper alternative instead.

A bureaucrat is a bureaucrat, regardless of whether they work for the government or not. Why a lot of people favor health-care reform is because they figure anything has to be better than the current system.

[Glenn]

If an auto was an employer-based benefit, then we'd all want Bimmers. And why not? It's a right, you know...

The reality is that many will drive clunkers until the government or the car companies bribe us to do differently.

There is a big difference between type of car and type of care. You aren't going to have friends raise $30,000 so you can get a nicer car if your loan is denied, like they did for potentially life-saving care the insurance company denied in the one example I just posted.

Besides, not all of us are as fanatical about luxury/sports cars as you are Bill I always have been and always will be an American-made work-horse family sedan kinda guy. If it costs over $20,000 new, it has too many features I don't care for (although I am going to have to start amending that figure due to inflation). I tried a luxury car once, got a good deal on a Crown Victory, and absolutely hated it. Suffered through it for a couple years before finally trading it in for a Taurus.