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

The government has the right, to not pay for any of it.
Sustaining life is debatable.

If a person is brain dead, keeping them on life support is sustaining an empty vessel.
It's like leaving a car running, with no driver.


Having work in the medical field have seen countless times of those hard decisions.

You can see both sides of the argument. That is someone's family member and death is painful no matter what.

But somehow one has to be realistic. Have seen them put a $60,000 medical equipment into someone who dies within a month.
The good part of that is the operation is a billable item for the hospital and physician. The bad part is an ill body is forced through another operation. Even a young able body person going through a non-emergent operation is going to suffer some. Yes, the patient got to live a couple more weeks due to the operation maybe but was it worth it.

There are just so many variables that nothing is black and white. There are only so many available medical dollars available. Do we spend them on someone who has not taken medical advice to help their own body? Do we spend them on someone in prison? It just goes on and on. The bottom line is the cost. We have all paid into Medicare but no individual has paid that much to cover the potential unlimited medical procedures we can offer them.
 
Sure, as long as they pay for it, without using Medicare.
If you disagree, how much should Medicare pay to sustain one life for one year.

Is that number infinity dollars?

I don't believe patients who are going to die should be allowed to pursue any expensive option they want. An 85 year old with cancer all over his body originating in the lungs shouldn't have Medicare paying $500,000-$1,000,000 for him to have a lung transplant (assuming he could get one). I don't think any insurance company should throw vast amounts of money at those who's death is imminent because they want to grab for a hope at living that really isn't there. People when faced with death become desperate and some will want to spend any vast amount of money to have their own perceived chance at life. If they want to they can pay for it privately. My statement was that no one should be denied the option of life saving care, not that it should always be paid for by government insurance.

I think each case needs to be evaluated. However, I do not approve of liberally applying a pathway to a comfortable death on patients that to have a reasonable shot at life (meaning, roughly a a greater than 20% chance at survival). Medical insurance should be treated as insurance, meaning when something goes wrong there is a set amount of money there for you to get treatment. The limit should depend on your plan. I would like for Medicare to be reformed to be more of a life insurance type thing where if you get terminally ill you pick a policy with a cap. Your plan may insure you for $350,000 but once that is over they have met their obligation and you should be expected to pay the rest.
 
Perhaps I've just been spoiled by Germany when it comes to health care. Whether looking per capita, or as a percentage of GDP, costs here for the entire medical system are about half of what it is in the states. Here nobody who gets cancer is told to **** off, they don't kill their old people who cost too much, and everyone who is sick gets treated.

Everyone is going to be treated, it's just that they're going to do things that will ration based on likely outcomes.
You're not going to get the most advanced care possible, it's going to be the most cost effective.

That means if you're completely brain dead, you're not going to be left on life support for 2 years.
It's not cost effective and not likely to bring a person back to functionality.

I didn't make these programs and I've argued that they shouldn't exist, in the first place.
With all that said, people are not going to accept ending these programs and costs have to be controlled.
Welcome to the world of unrealistic entitlements.
 
I don't believe patients who are going to die should be allowed to pursue any expensive option they want. An 85 year old with cancer all over his body originating in the lungs shouldn't have Medicare paying $500,000-$1,000,000 for him to have a lung transplant (assuming he could get one). I don't think any insurance company should throw vast amounts of money at those who's death is imminent because they want to grab for a hope at living that really isn't there. People when faced with death become desperate and some will want to spend any vast amount of money to have their own perceived chance at life. If they want to they can pay for it privately. My statement was that no one should be denied the option of life saving care, not that it should always be paid for by government insurance.

I think each case needs to be evaluated. However, I do not approve of liberally applying a pathway to a comfortable death on patients that to have a reasonable shot at life. Medical insurance should be treated as insurance, meaning when something goes wrong there is a set amount of money there for you to get treatment. The limit should depend on your plan. I would like for Medicare to be reformed to be more of a life insurance type thing where if you get terminally ill you pick a policy with a cap. Your plan may insure you for $350,000 but once that is over they have met their obligation and you should be expected to pay the rest.

That's a solid way to look at it.
 
Perhaps I've just been spoiled by Germany when it comes to health care. Whether looking per capita, or as a percentage of GDP, costs here for the entire medical system are about half of what it is in the states. Here nobody who gets cancer is told to **** off, they don't kill their old people who cost too much, and everyone who is sick gets treated.

I suggest you do some reading on German healthcare. Look, if you haven't been personally involved with a terminally-ill dying loved one in Germany, you have no idea what's being done. And nobody anywhere is telling dying people to **** off.

Here's a start to educate yourself: How German palliative care physicians act at the end of life
 
Having work in the medical field have seen countless times of those hard decisions.

You can see both sides of the argument. That is someone's family member and death is painful no matter what.

But somehow one has to be realistic. Have seen them put a $60,000 medical equipment into someone who dies within a month.
The good part of that is the operation is a billable item for the hospital and physician. The bad part is an ill body is forced through another operation. Even a young able body person going through a non-emergent operation is going to suffer some. Yes, the patient got to live a couple more weeks due to the operation maybe but was it worth it.

There are just so many variables that nothing is black and white. There are only so many available medical dollars available. Do we spend them on someone who has not taken medical advice to help their own body? Do we spend them on someone in prison? It just goes on and on. The bottom line is the cost. We have all paid into Medicare but no individual has paid that much to cover the potential unlimited medical procedures we can offer them.

I'm just really bothered by the fact that people are so resistant to this, that it will delay cost containment.
That's going to hurt a lot of younger generations, who need funding for education, effective medicine programs, etc.

To me, it makes 0 sense to devote most of our revenue on the elderly, rather than the young.
I'm not trying to be crass or evil, but the government has to serve a reasonable utility function.
Investing in younger people, makes much more sense, than people who have already lived their lives.
 
Everyone is going to be treated, it's just that they're going to do things that will ration based on likely outcomes.
You're not going to get the most advanced care possible, it's going to be the most cost effective.


That means if you're completely brain dead, you're not going to be left on life support for 2 years.
It's not cost effective and not likely to bring a person back to functionality.

I didn't make these programs and I've argued that they shouldn't exist, in the first place.
With all that said, people are not going to accept ending these programs and costs have to be controlled.
Welcome to the world of unrealistic entitlements.
Every experience I or my family members have had with the healthcare system here in Germany has been absolutely stellar. We are doing something fundamentally wrong in the US that our medical system costs twice as much and we still have to whack people to save money.
 
Every experience I or my family members have had with the healthcare system here in Germany has been absolutely stellar. We are doing something fundamentally wrong in the US that our medical system costs twice as much and we still have to whack people to save money.

Blame the US gov and a lot of US citizens, they haven't been anything, but a banana peel in making pricing clear, in the US medical system.
They suck.
 
The op is from an unreliable source, thus not worth taking at all seriously.

That's a cop out. If you have evidence that the statements of fact, quotes from the Health Minister and the report, are not true then you ought to provide it rather than relying on bias against a particular publication.

Meanwhile, the basic facts are confirmed in the NHS's own house organ:

What is the Liverpool Care Pathway? - Health News - NHS Choices

There are two issues here getting mixed up. One is whether the Liverpool Care Pathway is ever ethical. I'm of the opinion, and mainstream medical opinion in the US supports this, that patients have a right to refuse any and all care, including feeding and hydration, so I have no problem with the Care Pathway if a patient so chooses. The other issue is whether doctors have the right to impose this on people who have not been told and their families have not been told that the doctors are doing it. That's a violation of the same right to autonomy and unethical.
 
I suggest you do some reading on German healthcare. Look, if you haven't been personally involved with a terminally-ill dying loved one in Germany, you have no idea what's being done. And nobody anywhere is telling dying people to **** off.

Here's a start to educate yourself: How German palliative care physicians act at the end of life
From the article: The researchers found that physicians alleviated symptoms in 78 percent of patients and limited medical treatment with possible life shortening effects in 69 percent of cases. In 10 cases medication had been administered by the physician (9) or the patient (1) to deliberately hasten death.
So they refused further treatment in some cases, and hastened death in 10 cases. I'm willing to bet most or all of those 10 cases the patient or family requested that. It wasn't a rogue doctor who decided killing would be best. I'm not suggesting we pay for expensive surgeries for terminal patients, I'm just suggesting we don't off them. Give them some meds and let them die on their own terms if they want to.

But by all means, educate me on something you have likely never had any experience with whatsoever.

My mother in law is sitting 5 feet from me right now. She used to work in a nursing home. When I asked her about killing terminal patients against their will she was disgusted and outraged. That does NOT happen here.
 
Yes, they do. If people want to hold on to their family members so bad, why do they warehouse them in nursing homes where care is marginal at its very BEST?? So they can visit them for an hour every two weeks and complain about the awful care they're getting? Are they there feeding them three times a day? Changing their diapers? Holding their hands when the pain is overwhelming? Then when they go into the hospital with pneumonia, these same people want them on life support, artificial feeding tubes, etc., etc., until their loved ones slowly wither away. Pick 'em up and take 'em the hell home. Feed them. Change them. No? I thought not. Throw them to the taxpayers and then call the rest of us heartless.

People have the right to call you heartless if you think it's okay to decide the value of someone else's life or the value that their family members place on it. I'm wary of universal healthcare at this moment and place in time because I don't think it's right for you or anyone to be deciding the fate of someone else you don't know and have never met. Every situation is different, not all nursing homes are this horrible place where old people go to be stored away for the last few years of their life. I had a grandmother in a nursing home, we found a good one for her, she was happy their, we visited often, the caregivers there were amazing devoted people. We did what was right for her at that time and in her situation. Another grandmother (both greats) was very ill and suffering for years and she never set foot in a nursing home. Her family took care of her took her to the hospital when needed and took her back home afterwords and did this until the day she died. In both cases they were cared for loved and given the best option for them.

So when I hear people talking down about nursing homes or extending care to people who are very ill it makes me wonder if they've really given all that much thought to each individual case. The right solution is not going to be the same for everyone. Same goes for 'pulling the plug' so to speak, if they're ready to go they should be allowed to.
 
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I suggest you do some reading on German healthcare. Look, if you haven't been personally involved with a terminally-ill dying loved one in Germany, you have no idea what's being done. And nobody anywhere is telling dying people to **** off.

Here's a start to educate yourself: How German palliative care physicians act at the end of life

Another fun quote from your article:
In Germany, the Federal Court of Justice (Bundesgerichtshof) states that while limiting medical treatment and alleviating symptoms with possible life shortening consequences is lawful if it is the patient's will, it is illegal for physicians to administer substances which cause death even if the patient wants them to.

You do read your own sources, right?
 
Read the article.

I did. Of course I think patients should have a say about their treatment. On the other hand, being fed with tubes is no life, and not many people would honestly choose to live like that. These are people with no hope of recovering any meaningful quality of life. Do you suggest that they should be kept alive indefinitely despite the bleak chance of recovery? Also, this sort of situation always arises with managed healthcare. You get what you pay for.
 
Well, there are a huge amount of people that won't do that.
So the government is going to put a ceiling on end of life care.

Is this a prediction or are you speaking of something in the PPACA?

A lot of people get disgusted by this though, but how much money should the government pay to extend one life, by one year?
$10k, $100k, $1mil, $1bil?

For you maybe $10k. For me a $billion might not be enough. ;)
 
Perhaps I've just been spoiled by Germany when it comes to health care. Whether looking per capita, or as a percentage of GDP, costs here for the entire medical system are about half of what it is in the states. Here nobody who gets cancer is told to **** off, they don't kill their old people who cost too much, and everyone who is sick gets treated.


And what are your tax rates for say $50K per year income?
 
And who are you to judge me? The doctors did not tell your mother she was terminally ill in 1998. That may be what you heard, but that's not what they said. COPD is a progressively and debilitating fatal illness. That is a very different thing from terminal brain cancer or terminal lung cancer. I'd suggest you understand that other people besides yourself have compassion for people. And sometimes? The most compassionate thing we can do??? Is to let them go. If you don't get that? That's on you.

Stop judging others with a broken yardstick.
What the **** you want me to do send you the ****ing papers stating when she was diagnosed as being terminal? And I did not say that you were not being compassionate because of your own experiences with your loved ones. Im not even sure how you jumped to that conclusion. What I am asserting is that you cannot possibly know the circumstances and wishes of individuals that you will never meet or even hear their cases.

All I am doing is objecting to your assumption that all terminally ill people should be allowed to die and that no one should waste money on them because you assume that everyone will want to die without giving a fight even if that fight is hopeless. There is no one size fits all care for the terminally ill. Each individual case has its own dynamics and your generalizations are of no help to any of those people. I agree that there are cases where the time to let go is appropriate and I never said otherwise.

You seem to be more worried about money than anything here, most likely you were not that way with your own loved ones. But from you have said it sounds like you dont apply that to other people.

ANd dont even attempt to school me on COPD it is a genetic defect in my family I will most likely die the same way that my Mom did. Which was the same way that her Mom, sister and brother died. All of which I was witness too as well.



ANd to the people asserting that dying people have no right to demand that other people pay for their care, I hope you end up the victim of your own assertions.
 
And what are your tax rates for say $50K per year income?
What does it matter when the entire medical system costs half per capita and half the percentage of the GDP than the US? The high taxes here go to welfare recipients and the Greeks.
 
What the **** you want me to do send you the ****ing papers stating when she was diagnosed as being terminal? And I did not say that you were not being compassionate because of your own experiences with your loved ones. Im not even sure how you jumped to that conclusion. What I am asserting is that you cannot possibly know the circumstances and wishes of individuals that you will never meet or even hear their cases.

All I am doing is objecting to your assumption that all terminally ill people should be allowed to die and that no one should waste money on them because you assume that everyone will want to die without giving a fight even if that fight is hopeless. There is no one size fits all care for the terminally ill. Each individual case has its own dynamics and your generalizations are of no help to any of those people. I agree that there are cases where the time to let go is appropriate and I never said otherwise.

You seem to be more worried about money than anything here, most likely you were not that way with your own loved ones. But from you have said it sounds like you dont apply that to other people.

ANd dont even attempt to school me on COPD it is a genetic defect in my family I will most likely die the same way that my Mom did. Which was the same way that her Mom, sister and brother died. All of which I was witness too as well.



ANd to the people asserting that dying people have no right to demand that other people pay for their care, I hope you end up the victim of your own assertions.

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.
 
What does it matter when the entire medical system costs half per capita and half the percentage of the GDP than the US? The high taxes here go to welfare recipients and the Greeks.


I am not trying to be difficult here, I am interested. Just tell me, What are your Taxation rates for income levels at $50K per year?
 
First you kill unborn babies, then partial birth babies,then old people, then retarded people then Jews and gypsies.

hy·per·bo·le
/hīˈpərbəlē/
Noun
Exaggerated statements or claims not meant to be taken literally.
Synonyms
exaggeration - hyperbola - overstatement
 
Shouldn't be too hard to prove its a lie. Yes?

Has been repeatedly. Don't you remember it was even lie of the year. They spell it out pretty well, as do others. Surely you don't need these links repeated?
 
That's a cop out. If you have evidence that the statements of fact, quotes from the Health Minister and the report, are not true then you ought to provide it rather than relying on bias against a particular publication.

Meanwhile, the basic facts are confirmed in the NHS's own house organ:

What is the Liverpool Care Pathway? - Health News - NHS Choices

There are two issues here getting mixed up. One is whether the Liverpool Care Pathway is ever ethical. I'm of the opinion, and mainstream medical opinion in the US supports this, that patients have a right to refuse any and all care, including feeding and hydration, so I have no problem with the Care Pathway if a patient so chooses. The other issue is whether doctors have the right to impose this on people who have not been told and their families have not been told that the doctors are doing it. That's a violation of the same right to autonomy and unethical.

Then don't use poor sources, and seek clarification and not weak links between un similar things.
 
First you kill unborn babies, then partial birth babies,then old people, then retarded people then Jews and gypsies.

You forgot the lumberjacks. The lumberjacks come between old people and the retarded.
 
What the **** you want me to do send you the ****ing papers stating when she was diagnosed as being terminal? And I did not say that you were not being compassionate because of your own experiences with your loved ones. Im not even sure how you jumped to that conclusion. What I am asserting is that you cannot possibly know the circumstances and wishes of individuals that you will never meet or even hear their cases.

All I am doing is objecting to your assumption that all terminally ill people should be allowed to die and that no one should waste money on them because you assume that everyone will want to die without giving a fight even if that fight is hopeless. There is no one size fits all care for the terminally ill. Each individual case has its own dynamics and your generalizations are of no help to any of those people. I agree that there are cases where the time to let go is appropriate and I never said otherwise.

You seem to be more worried about money than anything here, most likely you were not that way with your own loved ones. But from you have said it sounds like you dont apply that to other people.

ANd dont even attempt to school me on COPD it is a genetic defect in my family I will most likely die the same way that my Mom did. Which was the same way that her Mom, sister and brother died. All of which I was witness too as well.

ANd to the people asserting that dying people have no right to demand that other people pay for their care, I hope you end up the victim of your own assertions.

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.

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.

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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