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

LowDown said:
No doubt you find it difficult to live in a world in which it is assumed that a person can't even trust his or her own family.
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Do you???
 
LowDown said:
Sorry, I'm not following you.
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End of life conciliation is about information. That is what has been called a death panel here. So when you talk about here, that is what you're speaking to.
 
LowDown said:
Well, it's either a lost cause or they died because funding was pulled. You can't have it both ways.

As for patients who die because their funding was pulled, I know the answer: Hardly anyone. There are a lot of patients who have the expectation that anything they want will be funded whether it's likely to benefit them or not, but patients who don't get necessary things without which they die? No, doesn't happen. Not even in charity hospitals.
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Okay... and how is the weather up there on planet la la?

Are you seriously saying that there is not one person in the whole of the US in the (lets be generous) last 10 years, that has not died because ones insurance has run out and there was no funding for further care? Are you also saying that there are not people in the US that dont get care because they dont have the money and when they finally get put in the ER it is too late?
 
MaggieD said:
You are naive if you think this is a small problem.
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By all means, blow my mind with some cost statistics. I can't even fathom that it could cost more than rebuilding a few countries that we can't even ****ing stand.
 
RabidAlpaca said:
I am 100% pro-assisted suicide. If the sick and old want to go, that's their business. If they want to keep on living and some doctor makes that decision for them, it's killing for money, and that is a horribly morally bankrupted concept.
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It is not killing for money. The doctor receives no compensation for letting someone die as a natural course of their disease. When my father was diagnosed with an inoperable brain tumor back in the summer of '11, we knew that there was no cure. He had 6 weeks of radiation treatments to try and slow the growth of the tumor, but his prognosis was have a maximum of 1 1/2 years to live, if that. After his radiation treatments were finished, he became critically ill due to a bacterial infection, and was admitted to the hospital. My mother knew that he would never be cured of the cancer, and the natural progression of the cancer would render him unable to speak, eat, walk, or do anything. She made the decision to let him die from complications of the infection, with my full support. I have absolutely no regrets, and the decision was made based on the reality of his condition, and not with money taken into consideration.
 
PeteEU said:
Okay... and how is the weather up there on planet la la?

Are you seriously saying that there is not one person in the whole of the US in the (lets be generous) last 10 years, that has not died because ones insurance has run out and there was no funding for further care? Are you also saying that there are not people in the US that dont get care because they dont have the money and when they finally get put in the ER it is too late?
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Care is always available somewhere. It might not be posh, but it's available. And, I might add, won't be any more available than it is now when the PPACA kicks in.

As for insurance, I thought we were discussing a different issue, which is insurance, still in effect, not paying for necessary care.
 
Harry Guerrilla said:
About 25% of Medicare spending, is done on end of life care.

Medicare Beneficiaries
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Plus what we spend for end stage renal disease, which is not curable, and for which treatment can go for a substantial number of years.
Taxpayers pay exorbitant sums for these poor outcomes. The Centers for Medicare and Medicaid Services, which cover treatment for end-stage renal disease, even for the non-elderly, spent $24 billion on dialysis in 2007. Just one percent of Medicare beneficiaries who are on dialysis generated a whopping 5.6 percent of the agency’s bills. Moreover, the obesity epidemic guarantees that those numbers will only shoot up in the years ahead since more than 100,000 people are now entering dialysis ever year – more than the number that die from the one of the conditions that leads to kidney failure.
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Medicare's high cost end stage renal disease patients
 
Harry Guerrilla said:
About 25% of Medicare spending, is done on end of life care.

Medicare Beneficiaries
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So let's break that down. Medicare funding is about $835 billion, so x .25 we're looking at about $208 billion. According to your article, only 38% of medicare beneficiaries have some kind of nursing home stay in the last year of their life. Of that $208 billion, how much of that is actually going to keep alive patients labeled "terminal" or "not worth saving"?

lizzie said:
It is not killing for money. The doctor receives no compensation for letting someone die as a natural course of their disease. When my father was diagnosed with an inoperable brain tumor back in the summer of '11, we knew that there was no cure. He had 6 weeks of radiation treatments to try and slow the growth of the tumor, but his prognosis was have a maximum of 1 1/2 years to live, if that. After his radiation treatments were finished, he became critically ill due to a bacterial infection, and was admitted to the hospital. My mother knew that he would never be cured of the cancer, and the natural progression of the cancer would render him unable to speak, eat, walk, or do anything. She made the decision to let him die from complications of the infection, with my full support. I have absolutely no regrets, and the decision was made based on the reality of his condition, and not with money taken into consideration.
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Then we're not even talking about the same thing. SHE, his WIFE, made the decision, not some ***hole that didn't even know him.
 
RabidAlpaca said:
By all means, blow my mind with some cost statistics. I can't even fathom that it could cost more than rebuilding a few countries that we can't even ****ing stand.
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That's another thing RA..every month our government hand out billions of pounds..to help famine..build wells..fight AIDS..

It works out that the average British Taxpayer is spending..£137 a year on foreign aid..

When someone spends my money..I would like a receipt..and proof that this money has actually gone to enhance someone else's life...
 
RabidAlpaca said:
SoThen we're not even talking about the same thing. SHE, his WIFE, made the decision, not some ***hole that didn't even know him.
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The point is that in cases such as my father's, someone NEEDS to make these decisions, and there are many people in our society who cannot make them, based in reality. The reality is, nobody has a right to unlimited care on the taxpayer's dime. You know that I am a reality-based individual, who takes individual responsibility seriously. If a person wants unlimited care, he should be the one to pay for it- not the collective taxpayer. We simply can't afford to do it, and at some point, limits must be made, based on necessity.
 
Boo Radley said:
End of life conciliation is about information. That is what has been called a death panel here. So when you talk about here, that is what you're speaking to.
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So you agree that informed consent is necessary before a patient is put on a pathway that will end his or her life?

I don't have any problem with informing people of their options including things like this pathway, withdrawing life sustaining care, hospice care, etc.. That's a duty the caregivers have.

Still not sure I have your meaning.
 
RabidAlpaca said:
So let's break that down. Medicare funding is about $835 billion, so x .25 we're looking at about $208 billion. According to your article, only 38% of medicare beneficiaries have some kind of nursing home stay in the last year of their life. Of that $208 billion, how much of that is actually going to keep alive patients labeled "terminal" or "not worth saving"?


So do you not think that every time you go to the doctors..and he writes you a prescription for such and such medication..

That he is not getting a backhander from that particular drugs company??

D'oh...
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RabidAlpaca said:
So let's break that down. Medicare funding is about $835 billion, so x .25 we're looking at about $208 billion. According to your article, only 38% of medicare beneficiaries have some kind of nursing home stay in the last year of their life. Of that $208 billion, how much of that is actually going to keep alive patients labeled "terminal" or "not worth saving"?
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Those costs are ballooning because of baby boomers.
Medicare spending is going to be reduced, that is just one part of the over all reduction in spending and limiting of benefits, that will eventually happen.
 
lizzie said:
She made the decision to let him die from complications of the infection, with my full support. I have absolutely no regrets, and the decision was made based on the reality of his condition, and not with money taken into consideration.
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Two very wise and strong women, you and your mom.

My dad's wife and I were in 100% agreement on withdrawing treatment from dad...his step-daughter and daughter (my half-sister)? Notsomuch. We prevailed after much compassionate, but realistic, discussion.

After we made the decision, my dad's doctor took Pat and I aside and said, "I only pray to God that when my time comes, I have someone at my side to make the same tough decision you did." It meant the world to both of us.

We'd met with a team of doctors (w/the family) and each had their take...we heard them all out -- all optimistic as all get-out. His family doctor, who knew him, said little. (The others had never met my dad...never saw his life struggles...never knew his mind.) I finally asked him, "If it were your dad, Doctor, what would you do?" He said:

"It was my dad. Two years ago, my father spent six months in intensive care...on dialysis...one infection after another...on breathing support (which my dad was on, btw, I forgot to mention that). I wanted to end his suffering. The rest of my family did not. He lived for six months -- a horrible existence -- and then he died. If I had my way? He would have gone into hospice care shortly after he arrived. He was never going to leave the hospital."
 
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lizzie said:
It is not killing for money. The doctor receives no compensation for letting someone die as a natural course of their disease. When my father was diagnosed with an inoperable brain tumor back in the summer of '11, we knew that there was no cure. He had 6 weeks of radiation treatments to try and slow the growth of the tumor, but his prognosis was have a maximum of 1 1/2 years to live, if that. After his radiation treatments were finished, he became critically ill due to a bacterial infection, and was admitted to the hospital. My mother knew that he would never be cured of the cancer, and the natural progression of the cancer would render him unable to speak, eat, walk, or do anything. She made the decision to let him die from complications of the infection, with my full support. I have absolutely no regrets, and the decision was made based on the reality of his condition, and not with money taken into consideration.
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That's as it should be done. With due respect for the person's autonomy and a loved one acting in his behalf.
 
MaggieD said:
Two very wise and strong women. My dad's wife and I were in 100% agreement on withdrawing treatment from dad...his step-daughter and daughter (my half-sister)? Notsomuch. We prevailed after much compassionate, but realistic, discussion.

After we made the decision, my dad's doctor took Pat and I aside and said, "I only pray to God that when my time comes, I have someone at my side to make the same tough decision you did." It meant the world to both of us.

We'd met with a team of doctors (w/the family) and each had their take...we heard them all out -- all optimistic as all get-out. His family doctor, who knew him, said little. (The others had never met my dad...never saw his life struggles...never knew his mind.) I finally asked him, "If it were your dad, Doctor, what would you do?" He said:

"It was my dad. Two years ago, my father spent six months in intensive care...on dialysis...one infection after another...on breathing support (which my dad was on, btw, I forgot to mention that). I wanted to end his suffering. The rest of my family did not. He lived for six months -- a horrible existence -- and then he died. If I had my way? He would have gone into hospice care shortly after he arrived. He was never going to leave the hospital."
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**** I fear that, as a potential patient and/or spouse of a potential patient.
 
LowDown said:
That's as it should be done. With due respect for the person's autonomy and a loved one acting in his behalf.
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I agree, but what we seem to see often, is that the loved one is acting in his own behalf, and not that of the patient. Because of the emotional bonds, they can't stand the thought of letting go, as they can't stomach the thought that they may feel responsible for the death of their loved one.
 
lizzie said:
The point is that in cases such as my father's, someone NEEDS to make these decisions, and there are many people in our society who cannot make them, based in reality. The reality is, nobody has a right to unlimited care on the taxpayer's dime. You know that I am a reality-based individual, who takes individual responsibility seriously. If a person wants unlimited care, he should be the one to pay for it- not the collective taxpayer. We simply can't afford to do it, and at some point, limits must be made, based on necessity.
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The day will probably come when we are forced into frank rationing of medical care. When that happens it should be done in accordance with a national discussion of the issues and a procedure that has broad support.

Right now we don't have anything like that. What we have is bureaucracies that will operate without accountability that have been set up by a law that was narrowly passed along partisan lines and doesn't even have the support of a majority of the people. It's not sustainable.
 
LowDown said:
The day will probably come when we are forced into frank rationing of medical care. When that happens it should be done in accordance with a national discussion of the issues and a procedure that has broad support.

Right now we don't have anything like that. What we have is bureaucracies that will operate without accountability that have been set up by a law that was narrowly passed along partisan lines and doesn't even have the support of a majority of the people. It's not sustainable.
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No, it's being delayed more or less, by the doc fix.
Medical care is going to be rationed, at least for elderly people, in the very near future.
 
lizzie said:
I agree, but what we seem to see often, is that the loved one is acting in his own behalf, and not that of the patient. Because of the emotional bonds, they can't stand the thought of letting go, as they can't stomach the thought that they may feel responsible for the death of their loved one.
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Is that bad? They're the ones who are going to have to live with it.
 
lizzie said:
I agree, but what we seem to see often, is that the loved one is acting in his own behalf, and not that of the patient. Because of the emotional bonds, they can't stand the thought of letting go, as they can't stomach the thought that they may feel responsible for the death of their loved one.
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I agree that this is sometimes a problem. It is the responsibility of the care givers to help the decision maker see things clearly through an open and frank discussion of the situation, and this sometimes requires repeated discussions and time for development of trust. It should be explained that what the doctors need to know is what the patient would want for himself if he were able to tell them.
 
Monserrat said:
Is that bad? They're the ones who are going to have to live with it.
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Yes it's bad, because even though I truly feel for people loosing a loved one.
(I lost my grandmother, whom I loved dearly, to breast cancer that spread all over, about 4 or 5 years ago.)

There comes a time, when the person must let go and not continue to let their loved one suffer, plus cost the rest of us, to preserve a life that wants to end.
My grandmother wanted to quit her chemo, she was miserable, but no one would let her.
 
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