Saturday, December 28, 2013
Looming Death Panel
Computer glitches are only a minor flaw of Obama Care when measured against the care rationing component of the Affordable Care Act about to take effect with the creation of the Independent Payment Advisory Board that will deny what otherwise would have been life sustaining care for critically or chronically ill patients who are expensive to treat. Many vulnerable people will be subjected to medical murder under "medical futility policy" where that which sustains life including nutrition and hydration will be deliberately denied to hasten death. If you think I am exaggerating, I will tell you I witnessed the deliberate murder of my own father Seymour Goodman by Vanderbilt doctors and a so-called "care team" in a precursor of Obama Care on January 29, 2012. The death panels are real and are or will be a threat to everyone you love.
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Obviously, because of the scholarship of Dr. Pope, the foremost historian of medical futility and the law, we know there will be NO one definition of "medical futility" defined by the higher courts. Dr. Pope has indicated that all but about 5% of medical futility disputes between physician/hospitals and patient/surrogates are settled by the parties involved ---sometimes with the help of in-hospital ethics committees who are not always free of conflicts of interest.
Illuminate is right insofar that there IS HASTENING of DEATH when life-extending treatment is withheld by treating physicians that has NOT been deemed to be "medically futile" under some due process procedure who THEN unilaterally, and without informed consent, decide that the "charity" Medicare/Medicaid patient is better off dead. A unilateral covert/overt default DNR in the patient's hospital chart gives the hospital/physicians legal cover for withholding/limiting indicated life-extending treatments. These unilateral DNRs are mostly undiscovered. The matter is moot, the patient is dead.
It becomes complex when "rationing" is justified to save the system --- and does the "motive" for the Hospital Team to shorten life and hasten death, without informed consent, then become central to the issue?Is it murder, or something else?
If the motive for withholding treatment and hastening death IS primarily "financial" --to cap unreimbursed costs of treatment that will be or has been deemed by CMS and Big Insurance to be non beneficial, mistake or error -- and not a matter of medical futility and/or compassion? What is this? --a kind of fiscal expediency justified as serving the public good?
Surely! this is more than an ethics violation, isn't it? The patient is dead because of "fiscal futility."
Of course, this has been going on under both political parties for many years. At least under Obama Care, neutral Big Data will be used to stop OVER TREATMENT for profit and stem some of the greed in our for-profit system that is threatening the existence of the Medicare program.
Big Data under the ACA will define in a more neutral and unbiased manner what is futile "curative" care to begin with and this kind of neutral and visible "rationing" will do away with the need for "under the radar" rationing of health care by means of covert and overt default DNR Code that is extrapolated into the medical charts of the elderly/disabled to limit/cap unreimbursed costs
If our for-profit healthcare system and social program of Medicare/Medicaid for the elderly/disabled continues to be managed to provide profits for the private sector, probably the for-profit sector will offer a new insurance product that will be expensive and affordable only for the rich. This lucrative insurance product will then cover curative care that is denied by Medicare because it is determined to be medically and fiscally futile under Medicare reimbursement protocols of the ACA!
Follow the money!!
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