Re: Re: [asa] health care

The "death panels" controversy was 100% fabrication. I know this is getting
close to off topic, but in the interest of clarification I want to comment
briefly. The health care reform bill had a provision that would pay
physicians to have discussions with patients about living wills, and other
end of life decisions.

These discussions are already mandated. After the Nancy Cruzan supreme
court decision a law was passed called the patient self determination act.
This law requires a discussion with every patient that is admitted to a
hospital to inform them about advanced directives and how to create one if
needed.

Medicare does not reimburse doctors for conversations about living wills at
this point. The point of this part of the bill is to encourage discussion,
it is not at all tied to the outcome of the discussion.

----- Original Message -----
From: "Bill Powers" <wjp@swcp.com>
To: "John Walley" <john_walley@yahoo.com>
Cc: "Jack" <drsyme@verizon.net>; <grayt@lamar.colostate.edu>;
<asa@calvin.edu>
Sent: Friday, September 25, 2009 5:05 PM
Subject: Re: Re: [asa] health care

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John:

I'm happy to see your comment relative to "death panels." In that,
although it was an obviously political exaggeration, there had to be
some truth in it. Unfortunately, by playing the exaggerated scare
tactic that point was missed.

The Triage Dilemma is how to "best" act given limited resources. The
question, of course, is always how to define "best." Not only are our
resources limited with regard to what can be done, but so too is our
knowledge limited.

Is it ever possible to have a wholly consequentialist morality? We can
imagine the development of "best practices" to most likely achieve some
measure of "best." But on what basis are what are "best" determined?
What consequences are best? How can we distinguish one set of
consequences as better than another set on consequentialist criteria
alone?

bill

On Fri, 25 Sep 2009, John Walley wrote:

> I think the "decades of individualistic thinking" were in part germinated
> with the New Deal social security programs where we set this expectation,
> not fully appreciating that it may one day lead to this, although it
> should have been obvious. I think this is a good lesson for us on all
> entitlement programs no matter how well meaning and needed they start out.

But now that we are here, how do we fix it? Who is going to tell the seniors
that their expectations of "no procedure left behind" is no longer reality
and maybe it should never have been? The Republicans won't because they are
already making hay telling them the opposite. I don't think the Dems can
because they have already denied the death panels too emphatically which
logically is where this is leading. Bottom line is somebody has to make
these decisions and people will likely die earlier from them. I think it
will take a third party like the Libertarians or independents to ever give
sanity a voice in our political system.

I would have been a death panel if the doctors had asked me what to do with
my dad and I was sure he was ok with skipping the last surgery and I think
he would have been if given the option. And I think that is just life. Yes
it should be a personal decision but the problem comes in when it is gov't
money funding Medicare. I think we ought to let the hospitals and doctors
and health insurance agencies merge to provide a holistic reasonable level
of health care to those that can afford it and a separate govt plan
providing minimum basic care to those that can't. That way you wind up with
a private health insurance plan that has a cash value like a life insurance
policy and you can choose to spend the money or not based on the situation.

John

________________________________
From: Jack <drsyme@verizon.net>
To: wjp@swcp.com
Cc: john_walley@yahoo.com; drsyme@verizon.net; grayt@lamar.colostate.edu;
asa@calvin.edu
Sent: Friday, September 25, 2009 10:45:31 AM
Subject: Re: Re: [asa] health care

Ezekiel Emmanuel (brother of Obama advisor Rahm) proposed in a Hastings
Center article 15 years or so ago that one possible calculus of a health
care treatment could be whether or not that treatment returns the patient to
a contributing member of society. Of course this is what he got in trouble
for with the seniors saying that Obama wants to kill grandma.

But perhaps it is decades of individualistic thinking instead of
communtarian thinking, that has gotten us in this postion. In my opinion it
is time that we become more communitarian.

Sep 25, 2009 12:16:53 PM, wjp@swcp.com wrote:

John et al.
>
>It seems to me that the issue of how resources are used must intersect with
>notions of the individual and their relationship with society.
>
>On one extreme it could be said that any use of resources should be a
>communal decision, at the other extreme that it ought to be an individual
>one.
>
>In answer to the question of who is our neighbor, the answer is everyone.
>So then, morally we need to at least apply the Kantian notion of
>universalizing all our actions.
>
>Universalizing actions can be accomplished by the individual or by society
>at large. Of course, if society is everyone, this becomes quite burdensome
>and impractical that every action be determined by the whole.
>
>On what basis should the decision of the whole be determined? On the basis
>of cost (whatever that means), on some utilitarian principle, or on the
>basis of an absolute morality? Is what is moral determined in practice by
>what the majority thinks, or by an Absolute measure?
>
>As Christians, we believe that was is right and wrong is determined by God,
>and has an Absolute standard. Even knowing this does not tell us how
>exactly to act in every given situation. For example, in your father's case
>is it "better" to hold life in the highest regard or to consider the "cost"
>to the community. The same might be asked of a child born with a serious
>and life threatening illness. Perhaps we should simply let that baby die
>and not try to save it.
>
>If the society decides, is the individual no longer a moral agent?
>
>Got to go. It's sprinkling and my teenage son easily dissolves, or so I'm
>told. I've never actually seen it.
>
>bill
>
>On Fri, 25 Sep 2009, John Walley wrote:
>
>> I agree with this comment and its relevance to science and faith.
>> Although I was not an Obama supporter in the election I applaud his
>> attempts to surface this issue of end of life care. He is right that it
>> is out of control. I think he was a little politically naive to think he
>> could float that though just because he supposedly had the endorsement of
>> the AARP. But the Republicans are shameless to politicize it and rally
>> the seniors by countering that they deserve unlimited healthcare.
>>
>> My dad was 79 and recovering from cancer surgery from 2 days previous
>> that almost killed him, and then they found a large brain tumor and
>> rushed him back in for emergency brain surgery and that did kill him. I
>> didn't even get asked about it, it was already decided and they told us
>> they had to do it to save his life. Looking back, I now think it may have
>> been better for all us to just let him live out his last few days in
>> peace.
>>
>> I think in my dad's case, the decision got made by the doctors and it was
>> an easy decision for them since their was a financial incentive to them
>> to do the surgery and since it was covered the family could hardly make
>> any objection to prevent it. I guess it is possible that he could have
>> survived and maybe we could have kept him around a few more years but I
>> think the tragedy of it was that I saw in his eyes that he was at the end
>> of his fight and I think he knew he wasn't going to make it. I only got
>> to see him for a few minutes before he got rushed back in. So from that
>> perspective I feel it was maybe not the best decision for him or the
>> family, not even considering the costs of an extra brain surgery
>> operation. There is a point of diminishing returns on healthcare, both in
>> results and quality of life. I think if my dad had time to think about it
>> and the decision wasn't made for him, he would have rathered to die at
>> home surrounded by family than on
>> an operating table getting his skull sawn open. I think I would.
>>
>> I am not a fan of letting the gov't make these decisions either but at
>> least in this particular case I don't think the doctors did any better
>> job. This really is a thorny ethical dilemma and one the church should
>> have dialogue on. I think the best solution would be some type of free
>> market solution where each family gets some level of health care credits
>> for their seniors like a health savings account and they can choose
>> whether to have the surgeries or not based on all these factors. I
>> particularly like Dick's observation of denying health insurance to
>> attorneys. That certainly shows the wisdom of the free market in my
>> opinion. :)
>>
>> John
>>
>>
>>
>> ----- Original Message ----
>> From: Jack <drsyme@verizon.net>
>> To: Terry M. Gray <grayt@lamar.colostate.edu>;
>> AmericanScientificAffiliation <asa@calvin.edu>
>> Sent: Friday, September 25, 2009 6:39:44 AM
>> Subject: Re: [asa] health care
>>
>> If you want to have a discussion on this topic that is relevant to our
>> purpose here why dont we discuss the issue of what amount of health care
>> is everyone entiltled too?
>>
>> Discussions on how health care is delievered is interesting, but more
>> political than moral or scientific. But there is no question that
>> resources used in providing health care are limited. I would like to see
>> a discussion on who deserves to get what and at what time, and who
>> decides this?
>>
>> To give a more specific example, we spend an inordinate amount of money
>> in the last month of a persons life. Is this the best way, most efficient
>> way, the fairest way to distribute health care?
>> ----- Original Message ----- From: "Terry M. Gray"
>> <grayt@lamar.colostate.edu>
>> To: "AmericanScientificAffiliation" <asa@calvin.edu>
>> Sent: Thursday, September 24, 2009 5:35 PM
>> Subject: Re: [asa] health care
>>
>>
>>> Not even close.....
>>>
>>> But we're a patient lot here. Most of the responses heretofore are proof
>>> that it's "off topic". But if we can control ourselves and connect it
>>> with faith/science matters (and we're not talking faith OR science here)
>>> then we can keep talking.
>>>
>>> TG
>>>
>>> On Sep 24, 2009, at 12:07 PM, Jack wrote:
>>>
>>>> This thread is not even close to being on topic is it?
>>>>
>>>>
>>>> Sep 24, 2009 05:39:07 PM, michael.andrea.r@ukonline.co.uk wrote:
>>>> Thank goodness we have the National Health Service for all its faults.
>>>>
>>>>
>>>>
>>>> ----- Original Message -----
>>>> From: "John Burgeson (ASA member)" <hossradbourne@gmail.com>
>>>> To: "asa" <asa@calvin.edu>
>>>> Sent: Thursday, September 24, 2009 5:50 PM
>>>> Subject: [asa] health care
>>>>
>>>>
>>>>> In eight US states and Washington, D.C., insurance companies are
>>>>> legally allowed to deny health insurance coverage to victims of
>>>>> domestic abuse, treating it essentially, if not literally, as a
>>>>> pre-existing condition.
>>>>>
>>>>> Which is one practice of the insurance companies I hope will be
>>>> stopped
>>>>>
>>>>> Great short clip about Health Care Reform!
>>>>>
>>>>> http://www.youtube.com/watch?v=kwRAIdVdVS4&feature=related
>>>>>
>>>>> --
>>>>> Burgy
>>>>>
>>>>> www.burgy.50megs.com
>>>>>
>>>>> To unsubscribe, send a message to majordomo@calvin.edu with
>>>>> "unsubscribe asa" (no quotes) as the body of the message.
>>>>>
>>>>>
>>>>
>>>>
>>>> To unsubscribe, send a message to majordomo@calvin.edu with
>>>> "unsubscribe asa" (no quotes) as the body of the message.
>>>> To unsubscribe, send a message to majordomo@calvin.edu with
>>>> "unsubscribe asa" (no quotes) as the body of the message.
>>>
>>> ________________
>>> Terry M. Gray, Ph.D.
>>> Computer Support Scientist
>>> Chemistry Department
>>> Colorado State University
>>> Fort Collins, CO 80523
>>> (o) 970-491-7003 (f) 970-491-1801
>>>
>>>
>>>
>>> To unsubscribe, send a message to majordomo@calvin.edu with
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>>>
>>
>>
>> To unsubscribe, send a message to majordomo@calvin.edu with
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>>
>>
>>
>>
>>
>>
>> To unsubscribe, send a message to majordomo@calvin.edu with
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>>To unsubscribe, send a message to majordomo@calvin.edu with "unsubscribe
>>asa" (no quotes) as the body of the message.ssage.
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Received on Fri Sep 25 17:26:11 2009