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60,000 patients put on death pathway without being told...

MaggieD said:
Well, I won't argue the point except to say that there is a huge difference between being conscious and being lucid. Frankly, I think doctors should convene family meetings . . . it's usually the other way around. Families simply must understand that their responsibility is to do what's right for their loved one. And very often, keeping them alive at all costs isn't in their best interests at all.

Truth be told? Even with clear direction from a HCPOA, most doctors won't withdraw treatment without a family consensus. (Lizzie would be better able to say this with conviction than I . . . but I believe it's true.)
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Oh believe me I know...But what we can not allow is some financial incentive motivate docs to make these decisions themselves, without consulting anyone...Once we go down that path we might as well just construct death centers where everyone can report at their average LE age for their mandated lethal injection.
 
j-mac said:
Ok, so apples to apples you are about 12% higher than I pay. Germany also has a little more than a quarter the population as the US is....So, there is really no way to compare the two.
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LOL now that is almost a classic when it comes to excuses. The "we got a bigger population so therefore we cant do as countries who are smaller and better than us.. " excuse.... pathetic. Population size does not matter and never has.
 
PeteEU said:
LOL now that is almost a classic when it comes to excuses. The "we got a bigger population so therefore we cant do as countries who are smaller and better than us.. " excuse.... pathetic. Population size does not matter and never has.
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Who said EU countries were better? Hell, they seem to be just killing people for money.
 
MaggieD said:
No doctor is going to make that decision while I'm lucid. And with a healthcare power of attorney in my cousin's name, she's me. I, unlike others here, don't fear that doctors are going to "off me" just for the helluvit.

Everyone should have a HCPOA in place. Every single one. It is a gift to your family. It is a gift to yourself. Otherwise intelligent people have trouble facing the necessity of having one. I was my husband's. My husband was mine. I wouldn't burden my Angel Boy Tommy with that as he'd keep me propped up in the living room holding my hand while watching TV 'til I dried up and blew away. :rofl That's why I chose my cousin. And I'm blessed that she accepted that awesome responsibility. (We're like sisters.)
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I'm currently working on my living will, and will have it notarized next week. I decided to do this after working in a nursing home and seeing for myself the consequences of not having one. I'd recommend it for everyone, no matter how young.
 
PeteEU said:
LOL now that is almost a classic when it comes to excuses. The "we got a bigger population so therefore we cant do as countries who are smaller and better than us.. " excuse.... pathetic. Population size does not matter and never has.
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Actually it does Pete.
Population per square mile/kilometer, with a greater density allowing more efficiency.

The U.S. has 84 people per square mile, while the UK has 650, Germany has 609, France has 289.
It's not just population density, it's also, location of where most people live.
 
I think the right misses the point and job of the Pathway clinic.
 
j-mac said:
Who said EU countries were better? Hell, they seem to be just killing people for money.
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Never said the EU countries were better.

And American insurance companies are not killing people for money?
 
Evenstar said:
I'm currently working on my living will, and will have it notarized next week. I decided to do this after working in a nursing home and seeing for myself the consequences of not having one. I'd recommend it for everyone, no matter how young.
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Good for you, Evenstar!!!! If there was one thing I could put on everyone's New Year's Resolutions List, it would be that. Soooo important. Good for you!!!
 
Harry Guerrilla said:
Actually it does Pete.
Population per square mile/kilometer, with a greater density allowing more efficiency.

The U.S. has 84 people per square mile, while the UK has 650, Germany has 609, France has 289.
It's not just population density, it's also, location of where most people live.
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Gaw what a load of horsecrap. We get it, the US is a big country.. but that is totally irrelevant when it comes to healthcare and healthcare statistics.

And most people live in cities or around them, so using the excuse that many people live in the middle of no where and hence cant get good healthcare is... pretty lame.
 
PeteEU said:
Gaw what a load of horsecrap. We get it, the US is a big country.. but that is totally irrelevant when it comes to healthcare and healthcare statistics.

And most people live in cities or around them, so using the excuse that many people live in the middle of no where and hence cant get good healthcare is... pretty lame.
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You fail to understand economies of scale.
It's cheaper to build a few hospitals serving one, geographic location, than it is to build several hospitals serving dispersed communities.

It's not dick waging, it's reality.
 
PeteEU said:
Never said the EU countries were better.
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You didn't? I certainly didn't say this:

PeteEU said:
...The "we got a bigger population so therefore we cant do as countries who are smaller and better than us.."
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So I understand you were interpreting what I said, but you were off.

And American insurance companies are not killing people for money?
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I am not getting into whether or not an entity (government vs. Insurance companies) are making life choice for incentive. Both are equally intolerable to me, especially when you consider that both entities use non medical personal to arrive at CBA decisions.

These decisions should be made with medical personnel, in conjunction with family members making an informed decision. If you have a bureaucratic panel making this decision based purely on CBA then you are going to have poor quality decisions being made.
 
MaggieD said:
Wow. Well, there's not much chance of my ending up with your witch's curse. My life and death is planned out. Tom, my significant other I've been with for 13 years, isn't my HCPOA. My cousin is. I've had long talks with her, and she is quite aware of the 3-day rule (as in 3minutes/3days/3weeks). I've made my wishes very clear to her, and I trust that she will abide by them with not a guilty bone in her body.
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I stand by what I said. COPD, in the long run, gets nothing but worse from day of diagnosis. Live long enough? One will die from it or its complications. That is NOT the same thing as the terminal illnesses I've referred to in my posts.
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Are you trying to tell me that you think that COPD patients have it easy compared to what your Husband went through?

I find what you are saying here very disturbing and rude. "That is NOT the same thing as the terminal illnesses I've referred to in my posts." The hell it aint and you are very misinformed if you truly think otherwise. You obviously have not been around someone with COPD or perhaps have only been around people with COPD not in the final stage. In fact from your statement here I would say that you are completely ignorant of what happens in the course of COPD. I have watched other loved ones die from cancer (Grandpa, Mother in law, Step dad, My neice) and my dad died in 2007 from Heparin-induced thrombocytopenia after suffering a massive heart attack. Look that up. The end stages of cancer and the end stages of COPD are pretty close to them same. COPD is a terminal illness not a chronic disease you would be wise to understand that and exactly what it means.

Money was not a consideration in my late husband's case -- nor my father's. Both were on Medicare. My late husband elected not to take chemotherapy. They'd have been thrilled to administer it to him at an average cost of $50,000 to the system. And the hospital where my dad died? They would have also been thrilled to keep him in intensive care for six months until he finally gave up the ghost.

These decisions should always be made for the good of the patient. No where did I say anything differently. Not for the good of the family. Not to assuage their conscience. Not to keep them from feeling guilty. Not because they can't bear to make hard decisions. For the good of the patient. Always. And keeping a terminal patient alive until their poor little bodies finally give up is often not in the best interest of the patient at all.
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Both of these paragraphs have nothing to do with me or with anything that I said. Actually most of everything that you have been saying to me is a complete strawman argument. I am not sure why you believe that lying in my face was a good idea but please stop it now.



Again since you totally ignored what I actually said and just started making up ****, my concerns are that the patient will lose their freedoms and liberties because of some people who are more concerned with money rather than doing whats right. The other side of the coin of hospitals wanting extra care for financial gain that are pointless,is insurance companies wanting nothing done to save money. Just let them die they are going to die anyways. Had this attitude been prevalent with my Mom she would have died the first night in the hospital in 1998. My Mom did not want to suffer anymore than most people. And I did not make her suffer by holding onto her and not letting her go (like what you so rudely insensitively implied) off and on she had a DNR order that I signed and witnessed each time. But she did not want to die and at times though they were few she didnt feel that it was time to leave yet. More often than not she wanted to die. But something inside her made her keep trying despite doctor after doctor giving her ridiculously short prognosis of death. Each doctors visit amazed her doctors they couldnt explain why she wasnt dead yet. In 1998 we went top a conference for end stage COPD patients where we learned about end of life options. Periodically we would attend refresher of that conference and each time the other people that attended last time became smaller and the new people became larger.

Dont compare what we went through because just as I have no clue what you went through, you have no clue what i went through. And frankly I am disgusted that you would be childish enough to think that one terminal illness is a pissing contest.

I have nothing more to say to you.
 
MaggieD said:
Why would I report you?

My husband died of lung cancer after a year-long battle. He had a tumor in his lungs the size of an orange. They removed one lobe. The surgery was excruciatingly painful. Horrible for him. The first day after surgery, they took him off most pain medication; he couldn't even talk he was in so much pain. He took radiation every day for six weeks -- we had to drive 150 miles every day for the treatments. The drive was extremely painful for him every single day.

The doctor recommended chemotherapy...said he'd take it for the rest of his life, although it might extend it. "Would you do it if you were him?" I asked. "If I had a son graduating from college, and I wanted to be there for his graduation? I might. Otherwise, I would not." (He didn't take it.)

Anyhow, before he recovered from the surgery? The cancer had moved to his spine. To his spleen. To his kidneys. He was in intractable pain for the rest of his life. Could barely walk. Only in the last few months did they medicate it away. And when they did that? He was gone as well. His death was horrible. I was with him every step of the way.

My dad had a stroke. He lived with it for nine miserable years. Hated his life. He could barely walk. Had lost any quality of life he had left. His wife had to work, so the kids helped out every single day of those nine years. He was always falling...one day he fell and really hurt his back. The pain wouldn't subside. It left him crying like a baby and in agony every time he moved. Doctors couldn't find a reason for it...they put him in the hospital where he got pneumonia and his kidneys failed. The kidney doctor told us matter-of-factly that he'd be on dialysis at least three days a week for the rest of his life. "How about his back pain," we asked. "We can't do anything about that." We placed him in hospice at the hospital. He died in two days.

Don't call me a monster. I've been there and bought the T-Shirt. My heart's been broken twice -- with more in the headlights. I don't know how you can possibly take the position you're taking when you withdrew life support from your mother. Kind of hypocritical, don't you think?
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I want to say something to you, but I don't have the words. :(
 
RabidAlpaca said:
I know I sound like a broken record, but the Germans manage to provide 100% full coverage for every citizen on half the per capita and half the percentage of GDP costs of our system. They don't kill old people here, and they don't turn away the poor. We're doing something wrong.
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I found this from 2009...

Costs in the German system are shared between employers and workers, whose premiums are pegged to income, the paper reports. Everyone is obliged to pay into the plan — the world’s oldest publicly sponsored health-care system that dates back to Bismark in 1883 — and the government is looking to boosting employee contributions to cover a $11.1 billion shortfall expected next year, according to the WSJ.But that’s only a short-term answer. “Germans already pay 8% of their gross wages into the centralized health-care pot, while their employers contribute an amount equal to 7% of gross wages,” the paper reports. Longer term, analysts expect Germany will be forced to make painful cuts to the system.
“Yet in a country where quality universal health care is considered a basic right, such proposals are extremely controversial,” the WSJ says. Contrast that with overhaul efforts going the other way in the U.S., where proposals to extend health-care coverage to more Americans are proving extremely controversial as well.

Germany’s Health Care Suffers From Some Familiar Ailments - Health Blog - WSJ
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And from a study done by Columbia University...

German Health Care Industry—Trend Germany is likely to experience a slower economic growth due to an increasingly
challenging global economic environment and the debt crisis that affects the European
society. In addition, declining external demand will limit the net export and lead to a drop
in the growth of GDP and an increase in unemployment rate. Consequently, the
government will make a bigger contribution to statutory health plans.
Knowing that statutory health care system is financed by payroll taxes and
employers contribute to the premiums as well, the government will have to take a
tremendous reform to focus on this system.

German Health Care Industry—Summary
Overall, Germany has a very well-developed health care industry with a rich
history, huge markets, large figures of providers, goal-oriented regulation guidelines and
sound actuarial foundations. However, on the other hand, Germany is facing conundrums
such as an aging population, rising costs, and declining health care quality. Though a
humongous number of reforms have been executed, the problems seem to persist. Hence,
Germany needs to find efficient and innovative ways to solve them.

http://ce.columbia.edu/files/ce/pdf/actu/actu-germany.pdf
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So my conclusion is that although it may be working for you at the moment, Germany has huge problems with its system, that may force it in the coming years to open it to more private insurance options.
 
Evenstar said:
Should society pay for expensive treatment for a terminally ill person? Where do we draw the line?

I have no problem keeping such a person alive (however pointless it may be) if they or their own family foots the bill.
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We should draw the line in a humane way. Telling people to **** off because they have no money is not humane it is ****ing evil and the pinnacle of assholeness. This is not the dark ages or back in the caveman days. Kindness is not measured by money. If we can put a man on the moon we can save a dying human being or at least make their death humane. Shoving terminal people out hospital doors just because their family have no money divides the monsters from humans.


Do you have kids? A man shoots up a school killing and injuring 6 and 7 year olds, what you are asserting is that the surviving children that did have enough money should have been left to die. What you are asserting is that money is more important than human life. Sounds a bit greedy and self centered. Only a monster would knowing kill a child because the kids family was poor. By law an parent or whoever is responsible for a child can be convicted of murder for neglect of a childs welfare that leads to death. Which is exactly what you are promoting.
 
FreedomFromAll said:
We should draw the line in a humane way. Telling people to **** off because they have no money is not humane it is ****ing evil and the pinnacle of assholeness. This is not the dark ages or back in the caveman days. Kindness is not measured by money. If we can put a man on the moon we can save a dying human being or at least make their death humane. Shoving terminal people out hospital doors just because their family have no money divides the monsters from humans.


Do you have kids? A man shoots up a school killing and injuring 6 and 7 year olds, what you are asserting is that the surviving children that did have enough money should have been left to die. What you are asserting is that money is more important than human life. Sounds a bit greedy and self centered. Only a monster would knowing kill a child because the kids family was poor. By law an parent or whoever is responsible for a child can be convicted of murder for neglect of a childs welfare that leads to death. Which is exactly what you are promoting.
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Well, then it is a good thing that what you are promoting happening, does not take place in the US. In the US most seniors have medicare, and are treated relatively well in palliative care. Those who are indigent, or other circumstances also receive EoL care, in many cases pro bono by the hospitals, and the costs are spread throughout the system...Could things be better? Sure....But I don't think it is accurate to paint a picture of Poor people just being turned away from hospitals and told to F off....That is untrue.
 
sawyerloggingon said:
The death panel cometh.
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It's here already. It's called insurance companies who don't want to render the services that it's customers have paid for, otherwise known as a denial letter.
 
j-mac said:
I found this from 2009...



And from a study done by Columbia University...



So my conclusion is that although it may be working for you at the moment, Germany has huge problems with its system, that may force it in the coming years to open it to more private insurance options.
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So even if the costs double, we'll still be providing full health care at the same cost that you're paying today. I don't see the downside.
 
danarhea said:
It's here already. It's called insurance companies who don't want to render the services that it's customers have paid for, otherwise known as a denial letter.
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There are cap limits on health care insurance plans. It's one of the few measures than can keep costs down at all. Suppose I buy a health care insurance plan and pay $400 per month, for 20 years. That would be $96,000 paid in for my health care, in case I need it for an unexpected health care problem, such as a heart attack, requiring cardiac artery bypass grafts. The cost of heart bypass is typically going to run in the neighborhood of $75,000-$125,000, depending on how many arteries need bypass, and complicating factors. That's just the hospital/surgical procedure/thoracic surgeon/anesthesia bill. That doesn't take into account the follow-up visits, and drugs that you will be on after your surgery. The money you have paid in for the past 20 years will already have been spent on your care.
Assume you are diagnosed with cancer of one type or another. You will be looking at possibly surgery, chemotherapy, and/or radiation treatments, and you will also likely be requiring additional hospitalizations for complications and effects of the curative treatments. This runs up your health care costs quickly, and your initial "investment" of health care dollars will have been met in short order.
At that point, you are a cost, and are not contributing to your health care expenses. Multiply this scenario by all the citizens in this country, half of which are not paying income taxes, and a huge number of which are already dependent on government for their very existence via SS, medicare, medicaid, and welfare programs.
 
j-mac said:
Well, then it is a good thing that what you are promoting happening, does not take place in the US. In the US most seniors have medicare, and are treated relatively well in palliative care. Those who are indigent, or other circumstances also receive EoL care, in many cases pro bono by the hospitals, and the costs are spread throughout the system...Could things be better? Sure....But I don't think it is accurate to paint a picture of Poor people just being turned away from hospitals and told to F off....That is untrue.
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Um I didnt say that. I was responding to someone and what they were promoting in case you didnt notice. Please take a moment to read what they said.


But since you brought it up, this sounds like a F you if I ever heard one Jacksonville woman dies after insurer repeatedly denies her a liver transplant | jacksonville.com


My point though is that we need to find a solution to the question of choosing life over money. By this I do not support what is not working or what will never work. What I am saying is that if a person is dying and a procedure will save their life it would be unethical to stop that live saving procedure because the patient lacks money to pay for it.


No I do not have the answer right off the top of my head. But I do think that there is an answer that would satisfy those interested that actually have good morals. Ethically though letting someone die that cannot afford a surgery is the same as letting someone die when you could have done something. There is a difference though one is individual guilt while the other would be state forced death if a law was enacted making it mandatory to be able to pay for life saving medical care or they will just let you die.
 
lizzie said:
There are cap limits on health care insurance plans. It's one of the few measures than can keep costs down at all. Suppose I buy a health care insurance plan and pay $400 per month, for 20 years. That would be $96,000 paid in for my health care, in case I need it for an unexpected health care problem, such as a heart attack, requiring cardiac artery bypass grafts. The cost of heart bypass is typically going to run in the neighborhood of $75,000-$125,000, depending on how many arteries need bypass, and complicating factors. That's just the hospital/surgical procedure/thoracic surgeon/anesthesia bill. That doesn't take into account the follow-up visits, and drugs that you will be on after your surgery. The money you have paid in for the past 20 years will already have been spent on your care.
Assume you are diagnosed with cancer of one type or another. You will be looking at possibly surgery, chemotherapy, and/or radiation treatments, and you will also likely be requiring additional hospitalizations for complications and effects of the curative treatments. This runs up your health care costs quickly, and your initial "investment" of health care dollars will have been met in short order.
At that point, you are a cost, and are not contributing to your health care expenses. Multiply this scenario by all the citizens in this country, half of which are not paying income taxes, and a huge number of which are already dependent on government for their very existence via SS, medicare, medicaid, and welfare programs.
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That's the issue, a heart bypass shouldn't cost 75-125 thousand. Even if you paid the doctors thousands an hour, it wouldn't amount to a fraction of that. Our health care system is bloated and is focused far more on "making-it-rain" profits than keeping our population healthy. I support the free market 100%, but the way our government and country is structured due to health care lobbies is certifiably insane. Poor people simply can't afford proper health care. If we provide nothing else, this of all things should be available.
 
RabidAlpaca said:
That's the issue, a heart bypass shouldn't cost 75-125 thousand. Even if you paid the doctors thousands an hour, it wouldn't amount to a fraction of that. Our health care system is bloated and is focused far more on "making-it-rain" profits than keeping our population healthy. I support the free market 100%, but the way our government and country is structured due to health care lobbies is certifiably insane. Poor people simply can't afford proper health care. If we provide nothing else, this of all things should be available.
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The bolded is easy to say, when you are unaware of the costs incurred by the hospital providing the services.
 
lizzie said:
The bolded is easy to say, when you are unaware of the costs incurred by the hospital providing the services.
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Don't act like the costs aren't bloated, you know they are. Hospitals charge insurance companies a thousand bucks for an IV bag. Gee, I wonder why health insurance is so damn expensive here. There are two fundamental things that our society should be able to afford: Education and healthcare. I dont' care if you have to eat ramen every day and buy your clothes from good will, you should be able to see a doctor when you're sick.

If we can't afford those two things, we might as well be a **** hole like afghanistan.
 
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