Dickday's Rational Rationing ...Ammended
A not so new argument is being made on MSM concerning the new Health care legislation as the Senate decides today whether or not THEY CAN EVEN DEBATE THE GODDAMN THING. (blesses himself and as he curses all repubs in the Senate)
That it is nothing new is evident in an article in the WSJ in December of last year:
Americans will not put up with such limits, nor will our elected representatives. Mr. Daschle himself proves this. He punts the hard decisions about rationing to an unelected board. Yet his main proposals are not only about expanding subsidized programs to cover more people but about adding the massively expensive benefit categories of mental health, which has a strong lobby behind it, and long-term care, which is important to the broad middle class. http://online.wsj.com/article/SB123060332638041525.html
The article was attacking Senator Daschle who was spear heading the health care reform front for the incoming White House crew. I found this new take on the same crap in a conservative blog today:
For those who are hoping that Congress will deliver health care reform that includes a government run option, be careful what you wish for.
Despite the constant drum beat from Barack Obama, Nancy Pelosi, Harry Reid, and other Democrats who declare that a government run health care option would not result in a rationing of services, this notion simply seems to defy logic.
Why would anyone believe that it is possible to provide quality health care coverage to an additional 31 million people, without an increase to the number of doctors and while decreasing the cost of health care? The most logical conclusion that can be reached is that the government must begin to ration services, and the quality of our health care will be impacted in a very negative way.
In fact, this is exactly what has happened in other countries that have already been down this road. Rationing of health care has been well documented in Great Britain and in Canada. long waits to receive vaccinations and some have even been turned away.
As the Chicago Tribune put it a couple months ago:
Left unsaid by those who raise
fears of rationing by any "government-run" or government-related
health care is how much rationing the insurance industry does now.
For decades, experts writing in The New England Journal of Medicine and
elsewhere have concluded that we do "ration" health care. We just do
it through gross disparities in race, sex, age, regions, income and education. http://archives.chicagotribune.com/2009/aug/09/health/chi-oped0809pageaug09
You can google and discover stories of individuals denied proper medical care after they had paid premiums for health insurance coverage individually or through their employer. http://www.healthreform.gov/reports/denied_coverage/index.html
You can find hundreds upon hundreds of links. Or you can read blogs right here at TPM.
The death panels have been operating in this country forever. Haley Barber or some other repub asshole opined recently that if Congress wanted to get rid of pre-existing condition clauses in insurance contracts the bill would pass 400 to 35 in the House with a similar percentage voting for the provision in the Senate.
This is a goddamn lie and it enrages me because the repubs would have done it nine years ago. It is a statement made that is false and that the speaker knows is false as he makes the statement and it is done with one purpose in mind: Derail the health care package and help insurance companies make more money than ever.
There have been times in our country when we came close to egalitarianism. But the possibility of a true democratic republic embodying the promises contained in the Declaration of Independence and the Constitution never came as close to becoming a reality as it did during World War II.
It was a time when the American People were looking for fairness.
With the Masters of War making money hands over fists and millionaires like Joe Kennedy strutting in suits that cost as much as a working man could make in a year, Roosevelt actually proposed a 100% tax on all incomes over $25,000.00. Probably about half a million dollars today.
Many controls were put on the economy. The most important were price controls, imposed on most products and monitored by the Office of Price Administration. Wages were also controlled. In addition, the military imposed priorities that largely shaped industrial production.[1][2] wiki
There has never been enough of anything in this country to 'go around', never. The percentage of people who have certain commodities available to them shifts depending upon whether or not the repubs are in control or not.
But rationing was instituted in WWII in order to 'equal things out' so to speak:
Rationing is often instituted during wartime for civilians as well. For example, each person may be given "ration coupons" allowing him or her to purchase a certain amount of a product each month. Rationing often includes food and other necessities for which there is a shortage, including materials needed for the war effort such as rubber tires, leather shoes, clothing and gasoline. Towards the end of the First World War, panic buying in the United Kingdom prompted rationing of first sugar, then meat, for the rest of the war. During World War II rationing existed in many countries including the United Kingdom and the United States.
With the onset of World War II, numerous challenges confronted the American people. The government found it necessary to ration food, gas, and even clothing during that time. Americans were asked to conserve on everything. With not a single person unaffected by the war, rationing meant sacrifices for all. In the spring of 1942, the Food Rationing Program was set into motion. Rationing would deeply affect the American way of life for most. The federal government needed to control supply and demand. Rationing was introduced to avoid public anger with shortages and not to allow only the wealthy to purchase commodities
While industry and commerce were affected, individuals felt the effects more intensely. People were often required to give up many material goods, but there also was an increase in employment. Individual efforts evolved into clubs and organizations coming to terms with the immediate circumstances. Joining together to support and maintain supply levels for the troops abroad meant making daily adjustments. Their efforts also included scrap drives, taking factory jobs, goods donations and other similar projects to assist those on the front. Government-sponsored ads, radio shows, posters and pamphlet campaigns urged the American people to comply. With a sense of urgency, the campaigns appealed to America to contribute by whatever means they had, without complaint. The propaganda was a highly effective tool in reaching the masses.
Rationing regulated the amount of commodities that consumers could obtain. Sugar rationing took effect in May 1943 with the distribution of "Sugar Buying Cards." Registration usually took place in local schools. Each family was asked to send only one member for registration and be prepared to describe all other family members. Coupons were distributed based on family size, and the coupon book allowed the holder to buy a specified amount. Possession of a coupon book did not guarantee that sugar would be available. Americans learned to utilize what they had during rationing time.
http://www.u-s-history.com/pages/h1674.html
The only downside to all of this was the black market. Big deal. The percentages of abuse were small and never compared to say prohibition.
But there has always been and will always be rationing of health care services in one form or another. That is a fact of life.
If you are in need of a kidney transplant, you are put on a list by the hospital. The death panel decides whether or not you are going to die.
I pointed out before the terrible case of Mickey Mantle when he received a liver transplant. A no good drunk people screamed at the time. He was, after all, put at the top of some list. Personally, I would have put that man at the top of just about any list. The point here is that there will always be arguments, petty or otherwise, that someone received a life giving organ and someone else did not. Priorities are set on the basis of age, relative health, etc.http://www.unos.org/
Right now, insurance companies decide who will live and who will die just considering the needs OF THEIR OWN INSUREDS.
And as the Chicago Tribune article points out, 45 million people are told to do the best they can waiting in line at ER;s across the country.
We were a different country when we fought World War II, fighting two fronts simultaneously. There was no unemployment. There was under employment. Did you know that we actually used POW's to help us take up the slack in parts of our economy including agriculture?
We came together as a country. We sacrificed together. We shared what we had.
Sometimes I do not much like the country I live in today.
Reading the preceding, I realized that Dickday had passed a wealth of wisdom to each of us readers. Yet,he forced me to further consider our health care quandary:
What "IS" rational when we speak of illness or the terminally ill?
For the health insurance provider: It's get well fast or die quickly --
minimize losses.
For hospitals: Treat the patient, utilize as many of the hi-tech medical
devices as can be justified and release said patient within the number of days
specified by the treatment payee.
Doctors: Must manage the the case and attempt to heal or help the patient plus... do no harm.
Follow-up visits to principle physicians are, usually, required. Let us not
forget Big Pharma as our patient progresses or digresses, as the case may be.
Every step of the healing process is closely monitored by the payee...Before or
after the fact. Each entity is acting in a manner that appears to be rational
in relationship to the patient.
Under the microscope, the system is actually a tug-of-war for revenue! In this
game there is only one looser -- if those directly involved can not come to an
agreement, the patient owes the difference!
I have read that 50% of an individuals' health care costs are spent in the last
two years of a persons' life.
Under the present health care system, the patients' recovery is implied to be
the ultimate goal. Rationally speaking, the ultimate goal is the desire to maximize
profit.
Yes, we do have our death panels. Check into the organ transplant systems.
Someone is prioritizing those lists. How many hours do doctors spend writing
letters of justification to health insurance companies in order to get
authorization for procedures they wish to perform?
One act that can bring some rationality into this health vs. profit fiasco is
what the Republicans call the "Kill Grandma" clause...I call it the
Living Will. This document should be mandatory for all citizens over the age of
21.
There are hundreds of various Advanced Directive forms available at clinics, hospitals and doctors' offices. I copied and pasted this information fro the Mayo Clinic informational URL.
http://www.mayoclinic.com/health/living-wills/HA00014
Advance directives: More than just living wills
Advance directives are written instructions regarding your medical care
preferences. Your family and doctors will consult your advance directives if
you're unable to make your own health care decisions. Having written
instructions can help reduce confusion or disagreement. Anyone age 18 or older
may prepare advance directives.
Advance directives include:
· Living will. This written, legal document spells out the types of medical
treatments and life-sustaining measures you do and don't want, such as
mechanical breathing (respiration and ventilation), tube feeding or
resuscitation. In some states, living wills may be called health care declarations
or health care directives.
· Medical power of attorney (POA). The medical POA is a legal document that
designates an individual -- referred to as your health care agent or proxy -- to
make medical decisions for you in the event that you're unable to do so. A
medical POA is sometimes called a durable power of attorney for health care.
However, it is different from a power of attorney authorizing someone to make
financial transactions for you.
· Do not resuscitate (DNR) order. This is a request to not have cardiopulmonary
resuscitation (CPR) if your heart stops or if you stop breathing. Advance
directives do not have to include a DNR order, and you don't have to have an
advance directive to have a DNR order. Your doctor can put a DNR order in your
medical chart.
How to plan for end-of-life issues
Injury, illness and death aren't easy subjects to talk about, but by planning
ahead you can ensure that you receive the type of medical care you want, to
take the burden off your family of trying to guess at what you'd want done.
Start by having a conversation with your loved ones. Let them know you're
creating advance directives and explain your feelings about medical care and
what you'd want done in specific instances.
If you want to encourage parents or other family members to create advance
directives, explain that it's important for you and the family to know how they
would want to be treated. It's generally best to approach the subject in a
matter-of-fact and reassuring manner.
Keep in mind that a living will cannot cover every possible situation.
Therefore, you may also want a medical POA to designate someone to be your
health care agent. This person will be guided by your living will but has the
authority to interpret your wishes in situations that aren't described in your
living will. A medical POA may also be a good idea if your family is opposed to
some of your wishes or is divided about them.
Choosing a health care agent
Choosing a person to act as your health care agent is possibly the most
important part of your planning. You need to trust that this person has your
interests at heart, understands your wishes and will act accordingly. He or she
should also be mature and levelheaded, and comfortable with candid
conversations. Don't pick someone out of feelings of guilt or obligation.
Your health care agent doesn't necessarily have to be a family member. You may
want your health care decision maker be different from the person you choose to
handle your financial matters. It may be helpful, but it's not necessary, if
the person lives in the same city or state as you do.
What treatments would you want?
In determining your wishes, think about your values, such as the importance to
you of being independent and self-sufficient, and what you feel would make your
life not worth living. Would you want treatment to extend life in any
situation? Would you want treatment only if a cure is possible? Would you want
palliative care to ease pain and discomfort if you were terminally ill?
Although you can't predict what medical situations will arise, be sure to
discuss the following treatments. It may help to talk with your doctor about
these, especially if you have questions.
· Resuscitation. Restarts the heart when it has stopped beating (cardiac
death). Determine if and when you would want to be resuscitated by
cardiopulmonary resuscitation (CPR) or by a device that delivers an electric
shock to stimulate the heart.
· Mechanical ventilation. Takes over your breathing if you're unable to do so.
Consider if, when and for how long you would want to be placed on a mechanical
ventilator.
· Nutritional and hydration assistance. Supplies the body with nutrients and
fluids intravenously or via a tube in the stomach. Decide if, when and for how
long you would want to be fed in this manner.
· Dialysis. Removes waste from your blood and manages fluid levels if your
kidneys no longer function. Determine if, when and for how long you would want
to receive this treatment.











