Arizona death panel?

I doubt it because the post uses the word "I" which seems to be a word that does not exist in the vocabulary of DonDiego

Well, there's that, plus I think I remember reading somewhere that dandiego HATES tomatoes.

I'm not asking if it is Don Diego, I'm asking if he is related. I would not expect all Diegos from the Don Diego family to speak and write in third person, but I could be wrong on that.

Naaa,too F'd up a thread. I have to say, some insensitive and ignorant Mother F'er's posted on this thread.

It is reasonable for Chil to resurrect this thread, since there is new information out concerning end of life discussion and compensating the MD for it, similar to a consultation for diabetes or heart problems.

Let me say that ANYONE using the phrase "death panel" is irresponsible in doing so.

Some history:

In the 1950s-60s, the dialysis procedure had been refined sufficiently to be performed in the United States. A FEW dialysis machines were sprinkled about the US with the FEW doctors and staff trained to perform it, thus, it could be offered to a fortunate few patients who met medical, economic, and social criteria. MEDICAL criteria: young adult, no other life-threatening disease, e.g. heart trouble, diabetes), possible kidney transplant candidate. ECONOMIC criteria: Able to pay for treatments (insurance or private pay) and likely able to start or resume gainful employement as dialysis improved their health status. SOCIAL criteria: Family man with children, working or likely to work again.

At that time, Medicare, an amendment to the Social Security Act, paid 80% of cost of medical care for persons age 65 and over (same as today). Later amendments added "blind" persons of any age, and "disabled" of any age. Still did not include dialysis. Like it or not, it was a matter of supply for dialysis, sort of a paradox: not available because it was expensive/expensive because it wasn't very available.

And I suppose the brain trust decided that not many people would live a long time past 65 years, either, to qualify for Medicare. Well, duh.

**Personal note: A good friend dialyzed in his home back in that day, his brother running his treatments (after being taught how). Each week they would go to the bus station to pick up his dialysis supplies that had been shipped COD. Some weeks he didn't have quite enough money to pay the COD so he could not get his supplies. He would go to family and friends for help making the payment. He recalls his brother running to the buss station with the money just before his shipment was re-loaded to be returned. He got a transplant some time in the 70s, still going strong today.

Anyway, many of you will remember the "60 Minutes" program with Shana Alexander and/or the LOOK Magazing article "They Decide Who Lives and Who Dies", with the ghostly blackened images of four or five humans deciding which folks with kidney failure met the three criteria and would be given dialysis. If this was ever called a "death panel" I don't remember that, it might have been. Dialysis took 6-8 hours in those days, sometimes longer, and again, it was more of a rarety that a community had a hospital or other system with one or two dialysis machines. Home dialysis was offered, but again...like my friend's situation above, had its costs, and few people were willing or able to take it on.

Eventually, the technology improved to where dialysis could reasonably be performed in larger numbers if there was money to support it. Nephrologists and policians lobbied congress to fund dialysis, and around 1972, Medicare was amended to include funding of kidney disease and dialysis care, 80% funded. I don't know the Medicaid history, which I think came later, but in any case neither agency pays 100% of a patient's cost for dialysis (and related care). Once there was funding, dialysis became available to the masses quite quickly.

Interestingly, and typically, at that time the number crunchers estimated 19,000 people per year would require dialysis (and the funding). Oops,they didn't count on people living longer (for many reasons), the medical critera being relaxed (the patients outlived their doctors), the economic and social criteria being non-relevent anymore. All comers, any age, any condition, as long as the patient wanted it. Ten times that number or higher.

And that brings us to the end-of-life counseling controversy.

Most MD visits are scheduled at 15-20 minute increments, that is, 15 minutes of face to face time with your doctor. Some of you are more fortunate, but this is getting to be the way it is. Most of us have known about "advance directives", where you fill out a form that specifies your wishes for medical care at the "end" of your life, whether you want aggressive care, resuscitation etc., or just what is necessary to keep you comfortable until you draw your last breath.

As usual, discussion of this in the press segued from giving people an opportunity to think this over and express their wishes on paper, to "all old people will be left to die." Which is to be expected from rable rousers and others who have nothing else to do.

Thanks, O2bnVegas.

Lots of the folks here hate it when we remind them of the things they've written in this forum. (And for good reason.)

Google is not hard.

'End of life counseling' is just pussyfooting around the problem. When someone is hospitalized without a signed Do Not Resuscitate order the hospital is obligated to use all means necessary to artificially keep that person alive. For many this means spending your final weeks or months or years on earth in great pain or in a vegetative state while medical science spends hundreds of thousands of dollars maintaining your unconscious rotting sack of flesh.

The medical establishment, nursing homes, big pharma, insurers are living off barely alive flesh

The real solution is obvious. If you wish to be selfish and spend your final time on earth stealing medical resources from future generations then you should have to pay for that throughout life via substantially higher insurance premiums or Medicare taxes and premiums...

40 to 50% of our medical costs are going to this grotesque experiment in technical life extension. If everyone simply agreed to DNR orders and had end of life directives, then it's possible we could really all have affordable healthcare during the years when we most need it. Then when your body finally gives out you spend your final days at home or hospice....without pain....and with your family.

And for the idiots that object to the 'Death Panels' of socialized medicine...There is none of that with my suggestion. Only a personal decision to either die with dignity and save a ton of money throughout your life or to die as an unthinking vegetable on a breathing machine and spend lots of your own money for the pleasure.

Mrs. AlanLeroy and I have had living wills and DNRs and our end of life wishes have been documented for many years. We did that because it's the right thing to do. In order to get the vast majority of people to sign up for that program there's a single, simple way to encourage them...Money. Unfortunately, I don't think 'Free Optional End of Life Counseling' is going to make much difference....But it's a start. Perhaps if President Obama used the 'Bully Pulpit' to encourage people to sign an advanced medical directive that would be helpful too.

So here we are 4 years after this thread and we have similar insurance policies nationwide and a shortage of organs to transplant. So who decides who gets a kidney? I assume it is the medical community on the basis of need - in essence a "death panel" as it has always been. I am still more comfortable with the medical community making this decision than the government. We are still in desperate need for Tort reform and allowing insurance companies to sell insurance across state lines.

LOL we had a big round of tort reform under G.W. Bush. Did your rates fall? Tort reform will do absolutely nothing to the cost of health care because the cat has already been skinned. In most states the victim of even gross incompetence can’t even recover enough to cover their actual medical expenses from the incompetence. The taxpayer ends up paying for their care.

Across state lines – do you even stop to analyze this crap before you say it? There are five companies that control 99% of the individual health insurance market across the entire country. If the mergers go through that will leave three. These three companies already sell polices in every state they want to do business in. All the across state lines talk is just bull shit perpetrated by the insurance industry that is designed to get insurances companies to be able to base their operations in the state with the least consumer friendly regulation. That means if you have a problem with your health insurance instead of going to your state’s capital to complain you could very well have to travel to some place remote like Alaska to complain.

Federal Tort reform under George W. Bush --- really? Wikipedia

Tort reform is also proposed as one solution to rapidly increasing health care costs in the United States. In a study published in 2005 in the Journal of the American Medical Association, 93% of physicians surveyed reported practicing defensive medicine, or "[altering] clinical behavior because of the threat of malpractice liability." [37] Of physicians surveyed, 43% reported using digital imaging technology in clinically unnecessary circumstances, which includes costly MRIs and CAT scans.[37] Forty-two percent of respondents reported that they had taken steps to restrict their practice in the previous 3 years, including eliminating procedures prone to complications, such as trauma surgery, and avoiding patients who had complex medical problems or were perceived as litigious.[37] This practice restriction hits rural areas especially hard, as small towns find themselves without practitioners in high-risk areas such as obstetrics and emergency medicine, or practices without competition as physicians consolidate into single practices to distribute the high costs of malpractice insurance premiums

Tort reform is controversial. George W. Bush made tort reform a centerpiece of his successful run for Texas governor and of his second-term domestic policy agenda. In the 2004 presidential election, Democratic vice presidential nominee John Edwards, a successful trial attorney, was criticized by tort reform advocates for lawsuits that he brought against obstetricians on behalf of children who suffered severe birth injuries; reformers criticized the suits as relying on "junk science", while Edwards denied the allegation.

Republican lobbyist Grover Norquist points out possible political motivations for tort reform, writing in American Spectator that "Modest tort reform, much of which has been actively considered by committees in both houses, would defund the trial lawyers, now second only to the unions, and this is debatable, as the funding source of the Left in America."

As far as selling across state lines, wouldn't is save the insurance companies (and hence consumers) a ton of money if the same policy could be sold nationwide? Imagine the cost of a car if they had to make "customized" cars and warranties for each state. Remember when California has unique emissions requirements new cars and new cars cost >$500 more in California?

SCOTUS has approved a "Federal" approach for medical care - isn't it about time for a Federal approach for medical tort reform and nationwide insurance providers? This may be the only way the ACA could be "affordable".