Tuesday, August 18, 2009

Caution: House Healthcare Bill 3200 Means What It Says

President Obama, ever-present in every form of media imaginable, continues to struggle mightily to articulate what exactly he means by healthcare reform.

I’m not impressed, because I don’t think the President knows what he means - the messages are just too garbled.

Ditto his cabinet and top party officials, who routinely issue statements that are quite contradictory, both to each other, and to the President, and are then followed by the usual retractions, clarifications, or by attacking the messenger.

This message mess is understandable, because the President has delegated what his reform means to the lawmakers who have drafted several sets of legislation both in the US Senate and the House.

The proposal drawing the most interest has been H.R. 3200, which aims to:

To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes.

Unlike my President and many lawmakers, I’ve read the bill. It’s not that difficult to understand, and no, you really don’t need to be a lawyer to understand it. It’s boring reading, but hardly incomprehensible.

Many of us don’t like what we see.

But proponents keep insisting that what the bill actually says is, well, not what it says, and that many of us who know exactly what it says (and implies) are perpetuating “myths” or “misinformation.”

Really? Let’s look at just one example:

Proponents of H. R. 3200 insist that the now-notorious Section 1228 of the bill, beginning on p. 424, describing ‘advance care planning consultation,’ is not mandatory. It’s simply, so they say, that the bill provides for people to discuss their end-of-life preferences with their doctor, and that this consult will now be paid for by the government.

I searched the bill. The word “voluntary” appears 7 times.

Now, that leads me to think that the word “voluntary” is written those 7 times because the bill means for those particular parts of the bill to be, well, not mandatory. Ergo, voluntary.

However, there’s absolutely no “voluntary” mention in the section related to ‘advance care planning consultation.’

In fact, at the very least, even if we can explain away the rest of the “voluntary’ canard in the bill, read this, from page 428 (italics mine):

(B) An advance care planning consultation with respect to an individual may be conducted more frequently than provided under paragraph (1) if there is a significant change in the health condition of the individual, including diagnosis of a chronic, progressive, life-limiting disease, a life-threatening or terminal diagnosis or life-threatening injury, or upon admission to a skilled nursing facility, a long-term care facility (as defined by the Secretary), or a hospice program.

See any mention of ‘voluntary’ in Section B?

Yes, folks, even if you can somehow dodge the end-of-life consultation while you’re at home, once you’re admitted to a medical facility that is reimbursed by Medicare, you’re going to get it whether you like it or not.

Is it really too much of a stretch to think that if something, in proposed legislation, is meant to be voluntary, that the legislation so stipulates, and that where something is not voluntary, that the word “voluntary” (or the clear implication of voluntariness) is absent?

If you think it is, indeed too much of a stretch, go read the bill.

Show me where it stipulates, in black and white, that the ‘advance care planning consultation’ is voluntary.


Judy said...

This scares me to no end. I feel like things are bad enough now, without moving more in the direction of having the gov. decide who and when people should die. I realize most people don't believe this. but when you are talking about what you will and won't pay for based on how sick you are and if it's necessary - well, that's the same as deciding when someone will die. My brother-in-law's brother(who had schizophrenia) died of kidney failure because, of course, he was not worthy of a new kidney. I'm not sure he was even put on dialysis. He lived in a home his entire life, with his family only going to visit him every few(or several) years. Other than that they had no contact.
People with disabilities have not been able to get kidney transplants, and other transplants...well, forever. This is bad enough. And this is only one example of what is refused to people with disabilities. Now they're going to tell them how long they can live too. And my mom is 74. When she is old, and possible sick, will we, as a family, have the right to decide when she should go? or will the gov. tell us when to pull the plug? (obviously this is if she can't decide herself)

This whole thing terrifies me. My husband and I haven't had healthcare in years and we really need it, but I don't want to sacrifice my daughters medical care, through the gov., just so we can get it too. My daughter racked up about $100,00 in surgeries in the past couple months. I'd say she needs it worse....and what if they gov. were to be telling us they would no longer be paying for some of those surgeries because they are not life and death surgeries?

Too scary to think about.

Dr. Mark Mostert said...

Judy, thanks so much for your heartfelt post - yes, this is a desperate time. We all need to stand up and oppose the dire, very dark implications of what the President is proposing.

Every life, irrespective of what some think of as "useless," is precious, and no jabbering about how the government will take care of us (or, more accurately, not take care of us) will make us believe otherwise.

Be vocal - call your representatives, write letters to the editor of you local paper, badger your TV stations to hear your story.

We have the truth, we will succeed.


Judy said...

Well you are right about making your story known. Every time I have brought up the subject people seem to be at a loss for words, even though before that they had plenty to say. I don't know if it's because it's not PC to get in a debate with a woman with a child with a disability or, more likely, they really don't know what they're talking about to begin with.

As a rule I have only heard people debating whether we should spend money or not or whether everyone should have healthcare or not. This seems to be as far as the discussions go. This seems rather silly to me. If you ask me if I want everyone to have healthcare I would say "hell yes". I am a self-proclaimed liberal and all of my friends are backing Obama on this 100%
I voted for Obama and I'm glad I did, but this healthcare thing could stand to ruin many many lives if it passes as it is written right now.

It is typical to have people with disabilities be the first to suffer when laws are changed. Although the elderly suffer also, people do talk about the elderly somewhat, but I never ever hear anyone talking about the people with disabilities...and I don't just mean on this issue. When the local news reports that the governor(who has been outrageous in cutting programs/money for people with disabilities due to his anticipation in running with Sara Palin for president next term), the news never mentions cuts to people with disabilities, even though their money is the first to go and the hardest hit. They list all kinds of things being cut and never even mention the largest minority in the country? It boggles my mind. People aren't even aware of how people with disabilities get screwed over on a regular basis. It seems to me that some things should be sacred when making budget cuts, but it seems that the things I think are most sacred are the first to go.

I certainly am doing my best to educate my friends. Whether you're an Obama fan or not you can't let that stop you from looking for the truth in all things. Blind faith is a scary thing, regardless of who/what you are talking about.

I believe Obama's philosophy is to sacrifice the few for the many. This reeks of communism to me. I've always felt like I leaned toward the socialism side, but in reality it really isn't as romantic as it sounds. People's choices and rights are taken away in the process.
I have never believed in sacrificing the few for the many, and I don't care what issue you are talking about. It's just plain wrong!

And if anyone says - if you don't like it here why don't you move? - remember that people with disabilities are not allowed to move to other countries. They are not accepted due to the financial cost of their healthcare, etc. They are seen as a burden. If you have a child with down syndrome and you think you're moving to Canada I got news for you - no you're not!

So, like it or not we have to stay here and fight so we better get to fighting!