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

TheDemSocialist said:

Oh were talking about the OP. I thought we were talking about my link because that is what you quoted.

But yes the link does say that.

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They both say the same things when quoting the director of the NHS program, however the rub is what was found out by independent studies...And yes, they do highlight where patients themselves were never consulted about the decision of the doctors who may be tied to financial incentives for their decision.

Boo Radley said:

Minimal. They can do more.

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But none the less. There are provisions where there is no escape from the mandates that all insurance must cover, right?

j-mac said:

But none the less. There are provisions where there is no escape from the mandates that all insurance must cover, right?

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Important difference. In works against your argument. It's a death panel because it makes them provide more? :lamo

Boo Radley said:

Important difference. In works against your argument. It's a death panel because it makes them provide more? :lamo

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I know that is what it has been sold as,

Beginning in 2013, the Chief Actuary of the Centers for Medicare and Medicaid Services will determine in particular years the projected per capita growth rate for Medicare for a multi-year period ending in the second year thereafter (the "implementation year"). If the projection exceeds a target growth rate, IPAB must develop a proposal to reduce Medicare spending in the implementation year by a specified amount. If it is required to develop a proposal, the Board must submit that proposal in January of the year before the implementation year; thus, the first proposal could be submitted in January 2014 to take effect in 2015. If the Board fails to submit a proposal that the Chief Actuary certifies will achieve the savings target, the Secretary of Health and Human Services must submit a proposal that will achieve that amount of savings. The Secretary must then implement the proposal unless Congress enacts resolutions made to override the Board's (or the Secretary's) decisions under a fast-track procedure that the law sets forth.[1]

Independent Payment Advisory Board - Wikipedia, the free encyclopedia

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And this

President Obama’s ACA established the Independent Payment Advisory Board (IPAB), a 15-member panel of unelected federal employees; its members to be appointed by the president and confirmed by the Senate. The law does not require the IPAB to be bi-partisan in structure, as is required for almost all other independent agencies. Its mission is specific – to restrict payments to doctors and hospitals in order to achieve a reduction in Medicare spending beneath a specified cap.

The reality is that the IPAB represents an unprecedented shift of power from individual Americans and their families to a centralized authority, a controlling Board of political appointees that is virtually unaccountable, and destined to become President Obama’s version of the NICE rationing board in Britain’s socialized medical system, the National Health Service.

But wait – President Obama and the ACA supporters point to specific language in the ACA law that explicitly prohibits “rationing.” Beyond the obvious – the absence of any definition of rationing in the law – is that this is implausible deniability, since all evidence points to the de facto rationing that will clearly result from IPAB’s dramatic payment cuts to doctors and hospitals.

We know that doctors cite the money-losing reimbursement rates for government insurance as the Number One reason for refusing new Medicaid and Medicare patients. And we know, even before the ACA payment cuts of 31 percent in 2013, more than 20 percent of primary care doctors already were not accepting any new Medicare patients (five times the rate of doctors who refuse private insurance), and about 40 percent of primary care doctors and 20 percent of specialists already refused most new Medicare patients. By 2019, Medicare cuts under the Obama law will be so severe that payments will become even lower than Medicaid, a system by which almost one half of doctors already refuse to accept new patients.

IPAB: President Obama's NICE Way To Ration Care To Seniors - Forbes

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So, to your point that it isn't explicitly a "death panel" as laid out by language, but the result will be the same.

You would rather they had a blank check? (NICE is about cost-effectiveness, not rationing.)

Manc Skipper said:

You would rather they had a blank check? (NICE is about cost-effectiveness, not rationing.)

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typically a barbiturate, paralytic, and potassium solution are always more cost effective than providing informed consent so that proper decisions can be made....Good grief.

This IS what happens when you put the Government in-charge of healthcare, this IS what could happen in America. Its sad.

MaggieD said:

It is a great step forward, in my opinion. When someone has a terminal disease and is in the last stages, it is absolutely foolish to keep spending tens of thousands -- hundreds of thousands -- prolonging the inevitable. It is horribly difficult on the person as well as on their families. There is only one reason for doctors to treat clearly-terminal illnesses: they make more money keeping you interminably alive than by letting you die a peaceful death.

As for paying them a bounty. That's just pejorative bull****.

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As opposed to here in the U.S. where they do everything they can to prolong terminal peoples' lives of being plugged into machines until they can sap all the insurance or medicare they can all while bankrupting the patients' family.

j-mac said:

I know that is what it has been sold as,



And this



So, to your point that it isn't explicitly a "death panel" as laid out by language, but the result will be the same.

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No, it won't. Forbes, an opinion and from a problematic source, is inaccurate in their assessment. Nothing prevents anyone from buying more, getting more. It is another scare effort that skews the reality. There is no death panel in either language or result.

Evenstar said:

Sorry, but that is not reality. Reality is that healthcare is a business and people are in it for money. Everything is about money. So yes, one must consider dollars and cents when deciding what care is administered to those who cannot or will not support themselves. Do you want to pay my bills?

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The reality is that not everything is about money. And there is a stark difference between those that cannot and will not support themselves and a those who at the moment are unable to pay for life saving medical care.

You mentioned reality, as if there is no way to intervene in reality. Myself I aim higher I dont give in so easily that I would accept that today in modern times that we should let people die at of need of money to pay for medical care. And fortunately your way of thinking is in the minority. BTW it is only people like you that are talking about the lazy idiots the rest of us have observed that compassion can be met with sacrifices. Your problem is that all you are concerned about is deadbeats but I am not even talking about deadbeats, I am talking about the reality that some people are just not available to pay huge amounts of money for a service that would save their life. We are actually talking about people that worked very hard all their lives or children that could not chose their parents nor their families.

But then compassion is the last thing on your mind when it comes to your bank account isnt Evenstar?

Evenstar said:

Sorry, but that is not reality. Reality is that healthcare is a business and people are in it for money. Everything is about money. So yes, one must consider dollars and cents when deciding what care is administered to those who cannot or will not support themselves. Do you want to pay my bills?

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These people paid into medicaid for their entire working lives, and when it comes time to pay for a single life support machine and a cot, medicaid tells them to **** off. Tell me again how not getting something you paid for makes you a deadbeat.

MaggieD said:

I understand. You're offended with things that I've said based on your very personal and heart-felt experience with your mom. I get it. If you have taken my relating my own personal experiences with the death of a spouse and a father and the decisions we made as being in some kind of pissing contest with you, that was not my intention at all.

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Ok lets leave our personal tragedies aside for the moment then. And I apologies since i did get emotional, I guess since the 10th is edging up... well you know.

I know of no other way to relate on DP than to share my personal experiences. I firmly believe that our country cannot afford to think that "life at any price" is the responsibility of our government.

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The bold is your arguments against an mysterious argument in which I never gave. Who made those claims and assertions? I never did.

Ill make that clear for you since you seem to think that I said those things.

I never said that government was responsible for medical care. I said that we the people are responsible for we the people.

And FFS I never said anything about quantity of life vs quality of life. That was all you.

And, further, I believe that quality of life far outweighs quantity. As a society, we've just got to grow up and face those hard truths.

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Perhaps it is your argument that needs mature? Countless generations of Americans never gave in as you are right now. Americans have resolve and ambition we are not the type of people who give up on a challenge, at least not all of us. Its all about priorities and the will to make the world a better place. Money is a factor in that challenge but a prosperous country can work miracles you could say that Americans have worked these miracles before and we will do it again. I have faith in this country and its system of government. Many Americans will not bow down and give up just because a pessimistic section of society thinks that we should. I am for one glad that our countries founders were not defeatists like yourself, or we would all be bowing to the King right now crying about the hard truths of monarchies.

RabidAlpaca said:

These people paid into medicaid for their entire working lives, and when it comes time to pay for a single life support machine and a cot, medicaid tells them to **** off. Tell me again how not getting something you paid for makes you a deadbeat.

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All right, let's get real here. About $$ and about the whole discussion of "when do we stop treating a dying man"?

Do you really think that the $99 a month seniors pay for Medicare comes anywhere close to paying for their medical bills?? What have people paid into the system? They've paid in a whopping 1.45% of their income only since 1983. Now, if you're 12 years old, I suppose this sounds like forever; but for baby boomers retiring now? It's only half of their working career, at best. At best. So, let's look at the numbers: let's be generous!! An average annual income of $50K for 29 years = Medicare premium payments that total $21,000. One simple surgery, 3 days in the hospital? Kiss that all goodbye. One knee replacement? Probably all of that and more.

Medicare is unsustainable. That is a given. But know what? That's not the most important part of the basis discussions like this. The most important part is that it is not humane to continue to aggressively treat dying patients. It's inhumane to put a terminally ill person on a breathing machine long-term. It's wrong to shoot the poisons we call chemotherapy into a terminally ill patient (making them sicker than DOGS) for the sake of two more months.

We simply have to learn that death is a natural part of life. And we have to learn to have these discussions without people insinuating that those who wish to have these discussions are heartless.

If you want to live on a breathing machine having food pumped into your stomach through a hole in your side while you lie helpless in bed for months on end waiting for your heart to give out or your kidneys to fail? Bed sores infecting? Breathing tube infecting? Stomach tube infecting? Intractable pain. That's on you. As for most of the rest of us?? That's a scene from a very scary horror movie. And money has nothing to do with it.

FreedomFromAll said:

Perhaps it is your argument that needs mature? Countless generations of Americans never gave in as you are right now. Americans have resolve and ambition we are not the type of people who give up on a challenge, at least not all of us. Its all about priorities and the will to make the world a better place. Money is a factor in that challenge but a prosperous country can work miracles you could say that Americans have worked these miracles before and we will do it again. I have faith in this country and its system of government. Many Americans will not bow down and give up just because a pessimistic section of society thinks that we should. I am for one glad that our countries founders were not defeatists like yourself, or we would all be bowing to the King right now crying about the hard truths of monarchies.

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Dang. I almost Liked your post. This last paragraph? Well, I think I'm just going to have to accept that you and I will never agree.

Harry Guerrilla said:

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.

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Oh I agree.. but that aint how it is.. not by a long shot. Fact is the US has fewer hospitals, fewer emergency rooms, fewer doctors and fewer nurses than many of the nations you are compared too... per capita that is.... and you pay far more than everyone else.

At the end of a the day, those small remote communities exist in every country. Hospitals tend to be put in the large population areas and then people have to come to said hospitals... not the other way around. So again.. using the "size of my country" excuse is just idiotic. No one puts a 400 bed hospital in a town of 3000 people.

j-mac said:

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.

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I agree fully.. and that is what happens in the UK and elsewhere. There are no bean counters that do that.. the Daily Mail is wrong. When a terminal patient is not treated, then it is the doctor that makes that call and sometimes yes.. without talking to the family. Every situation is different. Having just lost my mother last week, then I know how it feels and making such decisions are far from easy and are overwhelming. That is why I personal am grateful for professional doctors that can make those calls when needed.

MaggieD said:

All right, let's get real here. About $$ and about the whole discussion of "when do we stop treating a dying man"?

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I never said to "treat" a dying man, I said to not off them to save cash if he doesn't want to be offed. I'm not suggesting we start forking out huge expensive surgeries for someone who's more than likely going to die. A breathing machine, some medication, and a cot are not that expensive.

MaggieD said:

Do you really think that the $99 a month seniors pay for Medicare comes anywhere close to paying for their medical bills?? What have people paid into the system? They've paid in a whopping 1.45% of their income only since 1983. Now, if you're 12 years old, I suppose this sounds like forever; but for baby boomers retiring now? It's only half of their working career, at best. At best. So, let's look at the numbers: let's be generous!! An average annual income of $50K for 29 years = Medicare premium payments that total $21,000. One simple surgery, 3 days in the hospital? Kiss that all goodbye. One knee replacement? Probably all of that and more.

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Precisely why our medical system is broken. In the rest of the world none of those things cost anywhere near that much. Here in Germany everybody is treated for everything, and the doctors still "make it rain". *The entire system costs half as much, and they dont' put anybody down like dogs.

MaggieD said:

Medicare is unsustainable. That is a given. But know what? That's not the most important part of the basis discussions like this. The most important part is that it is not humane to continue to aggressively treat dying patients. It's inhumane to put a terminally ill person on a breathing machine long-term. It's wrong to shoot the poisons we call chemotherapy into a terminally ill patient (making them sicker than DOGS) for the sake of two more months.

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That's not your decision to make. You don't get to decide when someone is done living, THEY do. I don't know what your faith is, and I'm not trying to assume with this statement, but I find that most religious people hold to the thought that "Well, if he dies now he'll be in a better place, in heaven, having a great time." I don't see life that way. In my view, when you die, you are dead, and that is it. Any experience is better than not existing in my opinion. I would never force anyone to continue living against their will, just as I would never force anyone to die against their will. That is the fundamental difference between you and me.

MaggieD said:

We simply have to learn that death is a natural part of life. And we have to learn to have these discussions without people insinuating that those who wish to have these discussions are heartless.

If you want to live on a breathing machine having food pumped into your stomach through a hole in your side while you lie helpless in bed for months on end waiting for your heart to give out or your kidneys to fail? Bed sores infecting? Breathing tube infecting? Stomach tube infecting? Intractable pain. That's on you. As for most of the rest of us?? That's a scene from a very scary horror movie. And money has nothing to do with it.

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Death is a natural part of life, but life is precious, and should not be squandered or extinguished against someone's will, simply because the government and lobbies have ruined our medical system and mismanaged our senior's contributions. If it's not about money, as you just claimed, then it comes down to you just wanting to make a life and death decision for someone else. That is NOT your decision to make.

RabidAlpaca said:

I never said to "treat" a dying man, I said to not off them to save cash if he doesn't want to be offed. I'm not suggesting we start forking out huge expensive surgeries for someone who's more than likely going to die. A breathing machine, some medication, and a cot are not that expensive.


Precisely why our medical system is broken. In the rest of the world none of those things cost anywhere near that much. Here in Germany everybody is treated for everything, and the doctors still "make it rain". *The entire system costs half as much, and they dont' put anybody down like dogs.

That's not your decision to make. You don't get to decide when someone is done living, THEY do. I don't know what your faith is, and I'm not trying to assume with this statement, but I find that most religious people hold to the thought that "Well, if he dies now he'll be in a better place, in heaven, having a great time." I don't see life that way. In my view, when you die, you are dead, and that is it. Any experience is better than not existing in my opinion. I would never force anyone to continue living against their will, just as I would never force anyone to die against their will. That is the fundamental difference between you and me.


Death is a natural part of life, but life is precious, and should not be squandered or extinguished against someone's will, simply because the government and lobbies have ruined our medical system and mismanaged our senior's contributions. If it's not about money, as you just claimed, then it comes down to you just wanting to make a life and death decision for someone else. That is NOT your decision to make.

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It is impossible to have a meaningful discussion with someone who continually assumes another is coming from a wicked place. Most of what you have assumed about me in this post is incorrect. But frankly? It's 3:15 AM here in Chicago; I should be asleep. So. Tomorrow is another day.

MaggieD said:

It is impossible to have a meaningful discussion with someone who continually assumes another is coming from a wicked place. Most of what you have assumed about me in this post is incorrect. But frankly? It's 3:15 AM here in Chicago; I should be asleep. So. Tomorrow is another day.

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That is EXACTLY what you have been saying from the beginning. You think people should be euthanized against their will because it's more "humane" and cost effective.

MaggieD said:

Dang. I almost Liked your post. This last paragraph? Well, I think I'm just going to have to accept that you and I will never agree.

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It does not matter whether you agree with American culture or not. But you are powerless to stop Americans from being Americans and trying to make the country better after all its in our heritage.

The time is now near at hand which must probably determine whether Americans are to be freemen or slaves; whether they are to have any property they can call their own; whether their houses and farms are to be pillaged and destroyed, and themselves consigned to a state of wretchedness from which no human efforts will deliver them. The fate of unborn millions will now depend, under God, on the courage and conduct of this army. Our cruel and unrelenting enemy leaves us only the choice of brave resistance, or the most abject submission. We have, therefore, to resolve to conquer or die.

GEORGE WASHINGTON, address to the Continental Army before the battle of Long Island, Aug. 27, 1776

You have given in to submission. Personally I cannot give in and I cannot be broken. I had a conversation with my Dad right before he went into surgery to remove most of his intestines that has died because of the reaction to tainted Chinese manufactured heparin. At the end of that conversation he told me that he was not giving up that he "was going to beat this".

Resolve is what America is about not submission. Defeatism is when someone(s) have no resolve to make things right. I am sure that you personally do not want another person to die its just that you lack the resolve to find a way to help them.

RabidAlpaca said:

That is EXACTLY what you have been saying from the beginning. You think people should be euthanized against their will because it's more "humane" and cost effective.

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I don't believe she said that, but I agree with you if in fact the LCP is not informing the patients or their families before putting them in LCP. But it does seem that only The Daily Telegraph have been making these claims.....

"...In 2009 The Daily Telegraph wrote that the pathway has been blamed by some doctors for hastening the death of some mortally ill patients, and possibly masking signs that the patient is improving.[20] This story was criticised by the Association for Palliative Medicine and the anti-euthanasia charity Care Not Killing as inaccurate.[2][21] In contrast, The Times welcomed the pathway as an attempt to address patients' wishes and warned about "alarmist" press coverage of the scheme.[22][23]..."

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But the doctors, nurses, researchers and the families of the LCP patients seem to tell a different story.....

"...Initial assessments of the effects and value of the pathway were largely positive. A 2003 study published in the International Journal of Palliative Nursing found that nurses saw the pathway as having a generally positive effect on patients and their families.[7]

A 2006 study published in the same journal found that, despite some "initial skepticism", the doctors and nurses who were interviewed saw the approach as having a valuable place in hospice care,though its use on 'dying' patients on general wards was not addressed.[8] A multi-centre study was published in 2008 in the Journal of Palliative Medicine that found that nurses and relatives thought that the approach improved the management of patients' symptoms, but did not significantly improve communication.[9] The authors concluded that they "consider LCP use beneficial for the care for dying patients and their family."[9]

A 2009 study published in Journal of Pain and Symptom Management studied the impact of the pathway on the end-of-life care of over three hundred patients and found that it produced a large decrease in the use of medication that might shorten life and increased patients' involvement in their medication and care.[10] A 2009 survey of 42 carers providing the pathway was published in the Journal of Palliative Medicine, it found that 84% were "highly satisfied" with the approach and that it enhanced patient dignity, symptom management and communication with families.[11]
Liverpool Care Pathway for the Dying Patient - Wikipedia, the free encyclopedia

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The Daily Telegraph is know for it's outrageous and sensationalized claims and editorials, is it not? Because it seems a bit of stretch that 60,000 patients and families didn't know that they or their loved ones were put in LCP without their knowledge, especially if the families were there by their bedsides and free to ask the doctors and nurses questions. Of course, it is possible that it might happened to a handul of patients and their families, but to say it's a cronic problem or policy then I'm somewhat skeptical...especially when considering the source of the allegations, Rupert Murdoch's, The Daily Telegraph.

Moot said:

I don't believe she said that, but I agree with you if in fact the LCP is not informing the patients or their families before putting them in LCP. But it does seem that only The Daily Telegraph have been making these claims.....



But the doctors, nurses, researchers and the families of the LCP patients seem to tell a different story.....



The Daily Telegraph is know for it's outrageous and sensationalized claims and editorials, is it not? Because it seems a bit of stretch that 60,000 patients and families didn't know that they or their loved ones were put in LCP without their knowledge, especially if the families were there by their bedsides and free to ask the doctors and nurses questions. Of course, it is possible that it might happened to a handul of patients and their families, but to say it's a cronic problem or policy then I'm somewhat skeptical...especially when considering the source of the allegations, Rupert Murdoch's, The Daily Telegraph.

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It isn't particularly important whether this story is true or not to me, because it's happening in the UK, and if they want to murder their old people, that's their problem. I'm here to argue the premise. She said from the beginning that the OP (which she took at face value to be true) was a great step forward. The stance of the people I've been arguing with in this thread so far has been that it will simply cost the taxpayers too much to keep terminal people on life support, so we should "put them out of their misery" in order to save some bucks.

FreedomFromAll said:

It does not matter whether you agree with American culture or not. But you are powerless to stop Americans from being Americans and trying to make the country better after all its in our heritage.

The time is now near at hand which must probably determine whether Americans are to be freemen or slaves; whether they are to have any property they can call their own; whether their houses and farms are to be pillaged and destroyed, and themselves consigned to a state of wretchedness from which no human efforts will deliver them. The fate of unborn millions will now depend, under God, on the courage and conduct of this army. Our cruel and unrelenting enemy leaves us only the choice of brave resistance, or the most abject submission. We have, therefore, to resolve to conquer or die.

GEORGE WASHINGTON, address to the Continental Army before the battle of Long Island, Aug. 27, 1776

You have given in to submission. Personally I cannot give in and I cannot be broken. I had a conversation with my Dad right before he went into surgery to remove most of his intestines that has died because of the reaction to tainted Chinese manufactured heparin. At the end of that conversation he told me that he was not giving up that he "was going to beat this".

Resolve is what America is about not submission. Defeatism is when someone(s) have no resolve to make things right. I am sure that you personally do not want another person to die its just that you lack the resolve to find a way to help them.

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Good thing some of the people in this thread weren't the ones deciding whether or not your father should have had this surgery. Some of them might have deemed him too expensive, and too old to be worth it.

j-mac said:

typically a barbiturate, paralytic, and potassium solution are always more cost effective than providing informed consent so that proper decisions can be made....Good grief.

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What are you raving about?

cado20 said:

This IS what happens when you put the Government in-charge of healthcare, this IS what could happen in America. Its sad.

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What is it that you think is happening? What do you fear for the inferior US "system"?

MaggieD said:

It is a great step forward, in my opinion. When someone has a terminal disease and is in the last stages, it is absolutely foolish to keep spending tens of thousands -- hundreds of thousands -- prolonging the inevitable. It is horribly difficult on the person as well as on their families. There is only one reason for doctors to treat clearly-terminal illnesses: they make more money keeping you interminably alive than by letting you die a peaceful death.

As for paying them a bounty. That's just pejorative bull****.

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I agree, but it should be left up to the individual if they want to keep fighting or not. It's wrong when the government or doctors start stepping in and making those kinds decisions for us without our input.

RabidAlpaca said:

It isn't particularly important whether this story is true or not to me, because it's happening in the UK, and if they want to murder their old people, that's their problem. I'm here to argue the premise. She said from the beginning that the OP (which she took at face value to be true) was a great step forward. The stance of the people I've been arguing with in this thread so far has been that it will simply cost the taxpayers too much to keep terminal people on life support, so we should "put them out of their misery" in order to save some bucks.

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I think it does matter whether it's true or not, in fact that is the point that seems to escape you because you want to believe so badly that article is true, when it doesnt appear that is.

Nor do I believe Maggie took the article at face value. What I think she said and I'm ad libing, was that keeping the terminally ill alive with false hope, enormous suffering, useless and painful surguries, or to die an undignified death with tubes coming out every oriface, not to mention the financial burden that destroys entire families....was more cruel and inhumane than letting a person die a natural and peaceful death with hospice care and/or in the comfort of their own home surrounded by their family.

Good thing some of the people in this thread weren't the ones deciding whether or not your father should have had this surgery. Some of them might have deemed him too expensive, and too old to be worth it.

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It's difficult to tell if you have an biased agenda or just blind to fact and reason by letting your emotions get the best of you.

Btw, it costs taxpayers $55 billion a year to keep the terminally ill alive. Personally, I think that money would be better spent helping to keep those that are not terminally ill, alive and healthy to go on and live productive lives.....

Taxpayer Cost of Keeping the Terminally Ill Alive

"Every medical study ever conducted has concluded that 100 percent of all Americans will eventually die." I hope that isn't news to you, RabidAlpaca.