Death Panel Originator completely debunked

[jfuh]

Video: Betsy McCaughey Pt. 1 | The Daily Show | Comedy Central
http://www.thedailyshow.com/watch/th...ccaughey-pt--2
http://www.thedailyshow.com/watch/mo...nterview-pt--1
http://www.thedailyshow.com/watch/mo...nterview-pt--2

The death panel originator Betsy McCaughey gets completely debunked by John Stewart.
Can we now call McCaughey a liar?

No longer are right wing fanatics going to use death panels, now it's "rationing healthcare".
These dramaqueens are still using the same tactics over and over and over again.

[donquixote99]

The death panel originator Betsy McCaughey gets completely debunked by John Stewart.

Actually, she wasn't. Well, maybe the phrase 'death panel' was. Everyone agreed rapidly that there are no death panels, and that wasn't what McCaughey said or meant.

BUT

McCaughey's real point is that doctors will be financially incentivized for both the creation of and adherence to orders for life-sustaining treatment. And I have to agree the second one bugs me. There could be a devil there, in details not yet written. Basically, if you've got a living will, and the doctor on his own initiative violates it, that should be a bad quality item. BUT, if you yourself (or your family as legal surrogates) decide to do something different, that absolutely should NOT be counted as 'non-adherence.' But will it be? That will depend on rules of measurement to be published by the secretary, later. So the door is left open for doctors to be incentivized to push for people not to change their minds, which they absolutely should have the right to do.

This is a little hypothetical, and the worst case is a far cry from 'death panels.' But I would be happier if 'adherence' was just dropped from the quality measures.

And I say the claimed debunking DID NOT HAPPEN. Stewart tried to insist that the phrase 'life sustaining' did not encompass 'possible withholding of life sustaining measures' in this context, when of course it does. No debunking there. And he tried to insist that the gathering of data on 'creation of and adherence to orders' would not affect Medicare reimbursement, but it would. We just don't know how much. So where was the wonderful debunking?

I expect this flaw to be fixed, and I'm still for the bill, but I fear the 'debunking' mainly happened in the mind of people like jfuh, as Stewart got in glittering general advocacy statements that did not actually answer McCaughey's point.

[donquixote99]

For reference, here's the text of the bit of section 1233 under discussion, including the paragraph refering to rulemaking on the exact measurement provisions to be done in the future by the Secretary of HHS.

(1) Physician’S QUALITY REPORTING INITIATIVE- Section 1848(k)(2) of the Social Security Act (42 U.S.C. 1395w-4(k)(2)) is amended by adding at the end the following new paragraphs:

‘(3) Physician’S QUALITY REPORTING INITIATIVE-

1‘(A) IN GENERAL- For purposes of reporting data on quality measures for covered professional services furnished during 2011 and any subsequent year, to the extent that measures are available, the Secretary shall include quality measures on end of life care and advanced care planning that have been adopted or endorsed by a consensus-based organization, if appropriate. Such measures shall measure both the creation of and adherence to orders for life-sustaining treatment.

‘(B) PROPOSED SET OF MEASURES- The Secretary shall publish in the Federal Register proposed quality measures on end of life care and advanced care planning that the Secretary determines are described in subparagraph (A) and would be appropriate for eligible professionals to use to submit data to the Secretary. The Secretary shall provide for a period of public comment on such set of measures before finalizing such proposed measures.’.

[Sir Digalot]

is that not the point of a living will? it is drawn up when you are of sound body and mind, it should not be able to be overridden by doctor court relative or even yourself should you be in such a state where you are deemed mentality unable to make coherant decisions.

if your living will has dnr on it then guess what do what it says, it is up to you as a person to suitably cover your bases when you are of sound mind and body to ensure that you do not screw this up.

like mnay things the doctors are encouraged to follow the law, this falls under the same premise as a pharmacy tech refusing to dispense medicince due to their own beliefs, it simply should not be up to them to make that decision.

[donquixote99]

Dig, I agree the doctor doesn't have the right to not adhere on his own initiative. I said that.

But as for the individual themself, I disagree totally. Certainly if you are non compos mentos, others must take over deciding. But the idea that one must bargain aways one's own right to change one's mind, or the right of duly-appointed surrogates to do so on your behalf, restricts one's individual rights in a very fundemental way. I am very suspicious of any scheme that allows others to decide for their own reasons not to treat you, even one as hypothetical as this is at present.

[Underhill]

Originally Posted by donquixote99

Dig, I agree the doctor doesn't have the right to not adhere on his own initiative. I said that.

But as for the individual themself, I disagree totally. Certainly if you are non compos mentos, others must take over deciding. But the idea that one must bargain aways one's own right to change one's mind, or the right of duly-appointed surrogates to do so on your behalf, restricts one's individual rights in a very fundemental way. I am very suspicious of any scheme that allows others to decide for their own reasons not to treat you, even one as hypothetical as this is at present.

What you are describing is extremely rare but necessary. On the OR table or in the ICU it isn't always possible to get the patients consent for every possible decision. This is why I consider a living will necessary for virtually everyone over 65.

[Sir Digalot]

this is probably the part that i do nit understand, i thought thats why you had a living will, i guess the only part is if you are compus mentus and you want to do something that contradicts your living will but i would imagine they are very rare..

i do see the point though... do the other sections that are referred to in 1233 say otherwise? i have noted these bills now tend to be like those adventure books and you have to flip to lots of different parts to get the full story

[jfuh]

Originally Posted by donquixote99

Actually, she wasn't. Well, maybe the phrase 'death panel' was. Everyone agreed rapidly that there are no death panels, and that wasn't what McCaughey said or meant.

BUT

McCaughey's real point is that doctors will be financially incentivized for both the creation of and adherence to orders for life-sustaining treatment. And I have to agree the second one bugs me. There could be a devil there, in details not yet written. Basically, if you've got a living will, and the doctor on his own initiative violates it, that should be a bad quality item. BUT, if you yourself (or your family as legal surrogates) decide to do something different, that absolutely should NOT be counted as 'non-adherence.' But will it be? That will depend on rules of measurement to be published by the secretary, later. So the door is left open for doctors to be incentivized to push for people not to change their minds, which they absolutely should have the right to do.

This is a little hypothetical, and the worst case is a far cry from 'death panels.' But I would be happier if 'adherence' was just dropped from the quality measures.

And I say the claimed debunking DID NOT HAPPEN. Stewart tried to insist that the phrase 'life sustaining' did not encompass 'possible withholding of life sustaining measures' in this context, when of course it does. No debunking there. And he tried to insist that the gathering of data on 'creation of and adherence to orders' would not affect Medicare reimbursement, but it would. We just don't know how much. So where was the wonderful debunking?

I expect this flaw to be fixed, and I'm still for the bill, but I fear the 'debunking' mainly happened in the mind of people like jfuh, as Stewart got in glittering general advocacy statements that did not actually answer McCaughey's point.

That's simple to answer, McCaughey tried to imply, as you are doing here, something being there that was never there.
You argue that it "could" be there. It isn't and you can't claim that it could be something when it's not written as such. You most certainly can not argue that something is there when it isn't there either.
This whole section is nothing but for the advocacy of a living will and that such consultation should it be provided be paid for through medicare, nothing more nothing less.
There is no mandate of any such consultation, either the patient can choose to or choose not to have such consultation.
A physician is of course going to be obliged to abide by the contents of a living will.
If on my will I write that I do not want the physician to do anything should such an instance that there's no cure to arise - ie pull the plug - that's absolutley what the physician is both ethically and legally needs to do.
If on the other hand that I say on the will do everything possible - again that's what the physician should do.
That is not to claim that if I were brought into an ER room suffering multiple gun shot wounds that the physician shouldn't do everything to save. Thus the consultation with a physician of what is and what isn't to be on such a will.
So yes, McCaughey was completely debunked for claiming something being there that absolutely wasn't.

[donquixote99]

Jfuh, the problem is with 'adherence' as a standard. That is there. You can't deny that.

What will count and not count against the doctor's quality rating, as non-adherence? Neither you or I can say. The rule will be written later. So you can't deny that the standards might rate a doctor down, if when the time comes, the patient says "Never mind the living will. Use the machine. Keep me breathing."

If you say that McCaughey implied more than this, I say an implication is a thin support for calling someone a liar.

[jfuh]

Originally Posted by donquixote99

Jfuh, the problem is with 'adherence' as a standard. That is there. You can't deny that.

What will count and not count against the doctor's quality rating, as non-adherence? Neither you or I can say. The rule will be written later. So you can't deny that the standards might rate a doctor down, if when the time comes, the patient says "Never mind the living will. Use the machine. Keep me breathing."

What you're doing here is arguing against what constitutes a will. Indifferent to a will that distributes property or assets the same applies to a living will.
If the person is still alive breathing and voices that they desire to live, than of course the physician is to go by a living will. It's absolutely absurd to even suggest the opposite of such.

Originally Posted by donquixote99

If you say that McCaughey implied more than this, I say an implication is a thin support for calling someone a liar.

Considering her lies during the 90's about Clinton healthcare and now Obama healthcare yes, she is a liar.

[Dawildman]

Can anyone get to the real underlying point here?

No?

The fact is that Betsy watsherass is a meritless GOP supporter who doesn't care how low she can grovel to misrepresent herself.

Jon Stewart said it perfectly when he called the biatch to task for hyperbole and that none of her "death panel" ideas are located in any of the bills currently being examined by Congress.

But Betsy (watsherass) is only typical of the lunatic GOP these days. They take a Democratic Party idea, add a false spin and sell the idea to their nutcase supporters. It didn't work well against Obama in teh election but it's getting some mileage in the mainstream media lately.

Ultimately i predict that it will crash and burn. As has all GOP ideas over the past couple years.

It's already got the bbitch fired from her job.

[Underhill]

Originally Posted by donquixote99

What will count and not count against the doctor's quality rating, as non-adherence? Neither you or I can say. The rule will be written later. So you can't deny that the standards might rate a doctor down, if when the time comes, the patient says "Never mind the living will. Use the machine. Keep me breathing."

There are virtually no cases of that. Almost all who are in a position to be kept alive aren't going to be saying much to the doctor. Even if they do, there is always the argument of, 'are they competent to make decisions?' because at that point they are usually on 15 different medications for pain.

[Sir Digalot]

i think if it came to the crunch in the end the doctor should.. and i repeat should do what he took an oath to do, regardless of funding, if he is worth his salt he may well say bugger my rating i am doing what needs to be done.

if the patient is for all purposes going to make a full recovery or are of sound body and mind and realise there is a treatment that helps that contravines their living will, and they are of sound mind, at least then the doc should do it regardless of his rating, sometimes you actually have to take a hit for the greater good.