FEDERAL HEALTH CARE LAW
Senate Bill (H.R. 3590) was unveiled on November 18, 2009 by Senate Majority Leader Harry Reid. Three days later, the Senate voted 60 – 39 to begin debate on the measure. The final version of H.R. 3590 passed in the Senate on December 24, 2009 by a vote of 60 – 39. On March 21, 2010 the bill was approved in the House of Representatives with a vote of 219 – 212.
The Patient Protection and Affordable Care Act was signed into law (Pub. L. No. 111-148) on March 23, 2010.
The new law makes specific reference to assisted suicide in only one section. It does not explicitly prohibit assisted suicide participation, promotion or encouragement. Instead, it contains a “prohibition against discrimination on assisted suicide,” stating that individuals or institutional health care entities may not be subject to discrimination if they do not provide items or services for the purpose of assisted suicide (Sec. 1553). Such wording seems to imply that assisted suicide is acceptable and expected, although not something in which health care providers must be involved.
In a July 7, 2010 recess appointment, President Obama named Dr. Donald Berwick to head the Centers for Medicare and Medicaid. Berwick’s past statements have led to extreme controversy. Among them was one in a 2008 article in which he wrote:
“Rational common interests and rational individual interests are in conflict….The stakes are high. Indeed, the Holy Grail of universal coverage in the United States may remain out of reach unless, through rational collective action overriding some individual self-interest, we can reduce per capita costs.”
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Articles
“Obama’s breach of faith over contraceptive ruling”
(Washington Post — January 29, 2012)
One of Barack Obama’s great attractions as a presidential candidate was his sensitivity to the feelings and intellectual concerns or religious believers. that is why it is so remarkable that he utterly botched the admittedly difficult question of how contraceptive services should be treated under the new health care law.
“Attacking religion”
(New York Post — January 22, 2012)
Friday’s ruling by the department of Health and Human Services proved yet again that ObamaCare’s critics are right. It’s a breathtaking attack not only on the first amendment’s guarantee of religious freedom, but also on the separation of church and state.
“PCORI: Funny acronym, serious work”
(Washington Post — January 18, 2012)
The health reform law established the Patient-Centered Outcomes Research Institute (PCORI) as an independent advisory board with a #3 billion budget to support comparative effectiveness research….But comparative effectiveness research can be tricky. Study methods can be faulty and results contradictory: a particular medical intervention may work for one subset of patients but not for a larger population. These studies can also be controversial, and they sometimes meet with accusations of rationing.
“Health Official Takes Parting Shot at ‘Waste’”
(New York Times — December 3, 2011)
The official in charge of Medicare and Medicaid for the last 17 months says that 20 percent to 30 percent of health spending is “waste” that yields no benefit to patients, and that some of the needless spending is a result of onerous, archaic regulations enforced by his agency.
“Mediscare: The Surprising Truth”
(Wall Street Journal — May 27, 2011)
The Obama administration has repeatedly claimed that the health-reform bill it passed last year improved Medicare’s finances. Although you’d never know it from the current state of the Medicare debate –with Republicans being portrayed as the Medicare Grinches — the claim is true only because ObamaCare explicitly commits to cutting health-care spending for the elderly and the disabled in future years.
IPAB Is an Acronym for ‘Death Panel’”
(American Spectator — April 22, 2011)
The Independent Payment Advisory Board (IPAB) was created pursuant to section 3403 of the Patient Protection and Affordable Care Act, and its ostensible purpose is to “control costs.” In reality, it will do nothing at all about costs. Instead, the board’s fifteen “experts” will impose old-fashioned price controls.
“The case for rationing healthcare”
(Los Angeles Times — April 21, 2011)
An 82-year-old woman suffered a massive heart attack while visiting her daughter…Her doctors quickly concluded that her prognosis was dismal…Yet she remained awake, alert and chatty…The daughter began paying close attention to clinical details. She questioned the doctors about their intentions. The doctors, in turn, grew annoyed…Four weeks later, the 82-year-old patient left the hospital on foot…But as a society, we also have to set limits when it comes to individual treatment.
“Don’t take health care for granted”
( Star Tribune – - February 6, 2011 )
Responding to a commentary about health care rationing, Nussbaum writes,”Dale repeatedly belittles the high quality of our health care system….I suspect the tens of thousands of survivors who are now five-plus years free of breast cancer, lymphoma or childhood leukemia — diseases which not that long ago carried uniformly fatal prognoses — would beg to differ.”
Federal District Court Judge Roger Vinson declares the health care law unconstitutional (1/31/11). In his decision, Vinson ruled that the law’s mandate that everyone must carry insurance or pay a fine is outside Congress’ Commerce Clause power and that the entire law “must be declared void.”
“You have to choose”
( Star Tribune – - January 22, 2011 )
Minnesota pathologist Virginia Dale writes, “The new health care law may be a fine first step, and it is high time we took a first step. But we continue to ignore the elephant in the room. We should ration health care so everyone can have some. And we should limit health care so we can have more well-being.”
“Feds to decide what benefits health insurers must cover”
( McClatchy Washington Bureau – - January 10, 2011 )
Even as House Republicans vow to repeal the health care law, government advisers are preparing this week to wade into one of the most contentious questions the legislation raises. What benefits must insurers cover? The answer will affect tens of millions of Americans….While the law outlines 10 broad categories of coverage, it leaves specifics to the government.
Author of advance care planning provision is hopeful in spite of setback
“Blumenauer hits another wall on end-of-life planning”
( The Oregonian – - January 5, 2011 )
Once again, Portland Congressman Earl Blumenauer is on the losing end of his fight to get Medicare to allow doctors to be paid for doing advance planning on end-of-life care….Blumenauer said he understands the administration’s reluctance to engage in a fight over advance planning but said he’s hopeful Medicare can eventually get the regulation in place.
The assisted-suicide advocacy group, Compassion & Choices has acknowledged its work with Blumenauer to promote end-of-life provisions in the original House Bill. Blumenauer also drafted provisions in Obamacare relating to patient decision aids.
“A Physician’s Take on the ‘Death Panel’ Revelation”
( Reason Magazine – - January 5, 2011 )
“As a physician, I can tell you that we doctors do routinely have end-of-life discussions with our patients.But we do it when it is appropriate and indicated by the clinical situation.,, The whole idea [of required end-of-life counseling] is to get younger, healthier Medicare patients to give advance directives that will be used at a later time to deny them care.”
Advance care planning out only days after it went into effect (1/04/11):
“U.S. Alters Rule on Paying for End-of-Life Planning”
( New York Times – - January 4, 2011 )
The Obama administration will revise a Medicare regulation on end-of-life planning. This reversal takes place only days after the new policy took place on Jan. 1. “We will amend the regulation to take out voluntary advance care planning,” explained an administration official.
“State ‘Death Panels’ Attributable to Single-Payer”
( National Review – - January 3, 2011 )
Medicaid budget limits lead to what some call “death panels.” Medicaid is a single payer system in which budgets are limited. When the money runs out, people’s options shrink. Government can get away with treatment restrictions that would never be countenanced within a market-based system in which regulators would be on the side of patients, rather than the government funder.
“Has Regulation Put an End to Rule of Law”
( Investor’s Business Daily – - December 27, 2010 )
An end run around the Constitution put “end of life consultations” back into the new health care law. Congressman Earl Blumenauer, an author of the original provision that was later dropped from the legislation, expressed his pleasure with the development but warned: “While we are very happy with the result, we won’t be shouting it from the rooftops because we are not out of the woods yet.” In other words, don’t let the masses know about it.
Advance care planning out only days after it went into effect (1/04/11):
“U.S. Alters Rule on Paying for End-of-Life Planning”
( New York Times – - January 4, 2011 )
The Obama administration will revise a Medicare regulation on end-of-life planning. This reversal takes place only days after the new policy took place on Jan. 1. “We will amend the regulation to take out voluntary advance care planning,” explained an administration official.
“Obama Returns to End-of-Life Plan That Caused Stir”
( New York Times – - December 25, 2010 )
End-of-life planning that caused a political storm over “death panels” was dropped from the health care plan that passed, but now it’s back through the rule-making process. Rep. Earl Blumenauer of Oregon authored the original end-of-life planning section that was deleted. Blumenauer is pleased to see the provision back in but cautioned supporters to keep it quiet. “The longer this goes unnoticed, the better our chances of keeping it,” he wrote in an e-mail.
“Our New Obamacare Masters: Meet the Independent Payment Advisory Board”
( Weekly Standard – - November 29, 2010 )
Peter Orszag asserted that the Patient Protection and Affordable Care Act is a money saver. “Perhaps most important, the legislation creates an Independent Payment Advisory Board” that will look for more ways to improve Medicare’s cost-effectiveness. Orszag said, “Under the law, any policy that the board issues takes effect unless legislation to block it is passed by Congress and signed by the president.”
“Real death panels coming our way”
( Jewish World Review – - November 24, 2010 )
During a discussion on balancing the federal budget, Nobel Prize winner in economics Paul Krugman said that the way to solve the problem of budget deficits is though deeply cost-effective health care rationing. Some years down the pike,” he said, “we’re going to get the real solution, which is going to be a combination of death panels and sales taxes.”
“Killing Marcus Welby”
( New York Post – - October 18, 2010 )
Under ObamaCare, an Accountable Care Organization (ACO) is supposed to take accountability for local Medicare patients, who in turn get most care from providers working inside the ACO’s network. In many ways, the ACO concept builds on the 1990s approach to “capitation.” The concept lowered spending but was unpopular with patients, leading to a backlash against managed care.
“The Deadly Pact: How ObamaCare will ‘Save’ Money”
( American Thinker – - August 9, 2010 )
Although media reports covering ObamaCare have centered mainly on the health insurance mandate and hidden tax increases, the real danger of ObamaCare is the limit imposed on hospital readmissions for those using Medicare.
“We Don’t Need Health-Care Rationing”
( Kitsap Sun – - August 4, 2010 )
Obamacare is dependent on cutting nearly $500 million from Medicare in order to partially fund the rest of the new health-care system. With his embrace of the British rationing model, Dr. Berwick may be the right person to achieve that objective.
“Obamacare Only Looks Worse Upon Further Review”
( Bloomberg News – - August 1, 2010 )
Based on the administration’s own numbers, as many as 17 million people might have to change their health plans by 2013 as their employer-provided coverage loses its grandfathered status and becomes subject to the new Obamacare mandates.
“Welcome to Washington, Dr. Berwick”
( The Leaf Chronicle – - July 18, 2010 )
Dr. Donald Berwick, the new administrator of the Centers for Medicare and Medicaid Services. praised the British National Healthcare System (NHS) at its 60th anniversary meeting for implementing a socialized health care system – rather choosing America’s plan. But a 2009 NHS audit found that health care managers put cost cutting ahead of patient care and cited that “appalling standards of care” may hae contributed to the deaths of up to 1,200 people in just one hospital.
“Cash crisis in NHS leaves patients lying on operating tables”
( Telegraph – - July 18, 2010 )
A cash crisis in the NHS leaves patients lying on operating tables before doctors realised vital equipment had not been ordered….Women in labour have been forced to wait while epidural equipment was borrowed from other hospitals….vital equipment is regularly not ordered.
“In special deal, charity gives rationing advocate Berwick health coverage for life”
( Washington Examiner – - July 14, 2010 )
Donald Berwick, recess-appointed by President Obama to head Medicare and Medicaid, is a well-known advocate of health care rationing and admirer of Britain’s National Health Service. As it turns out, Berwick himself does not have to deal with the anxieties created by limited access to care and the extent of the coverage. Berwick and his wife will have health coverage “from retirement until death.”
“Health Care Rationing Obama Believes In”
( Real Clear Politics – - July 12, 2010 )
Nat Hentoff, a nationally recognized authority on the First Amendment and the Bill of Rights, discusses Donald Berwick. Berwick, as the new head of Medicare and Medicaid, will be involved in the government-controlled health care of more than 100 million Americans.
“GOP says Obama avoiding questions about CMS head’s ties to industry”
( The Hill – - July 8, 2010 )
A Republican memo charges the Obama administration with avoiding questions, including whether Donald Berwick had links to Compassion and Choices, the former Hemlock Society.
“The President’s One-Man Death Panel”
( Investor’s Business Daily – - July 8, 2010 )
Donald Berwick has praised the U.K.’s health system. If he wants to imitate Britain’s model, perhaps he can explain whybreast cancer in America has a 25% mortality rate while in Britain it’s almost double at 46%. Prostate cancer is fatal to 19% of American men; in Britain it kills 57% of those it strikes.
“White House recess-appointed Berwick after questions about $49M nonprofit group”
( Washington Examiner – - July 8, 2010 )
Three days after Donald Berwick was asked for detailed information about the Institute for Healthcare Improvement (IHI), a nonprofit organization he founded and for which he serves as CEO, President Obama used a recess appointment to place Berwick in charge of Medicare and Medicaid. As CEO of the IHI, Berwick received $2.3 million in compensation in 2008. Sources of funding for the multi-million dollar organization are not known.
“Obama’s New Medicare Head: A Fan of Health Care Rationing?”
( Forbes – - July 8, 2010 )
David Berwick has commented on where Comparative Effectiveness Research (CER) fits into national health policy. When asked if it would lead to rationing of health care, he said that the social budget is limited….The decision is not whether or not we will ration care – the decision is whether we will ration with our eyes open.
“Obama to Bypass Senate to Name Health Official”
( New York Times – - July 7, 2010 )
President Obama is bypassing Congress, naming controversial Dr. Donald Berwick in a recess appointment to run Medicare and Medicaid. Berwick has supported efforts to ”reduce the total supply of high-technology medical and surgical care” and has expressed great admiration for the British health care system.
“Obama nominee heralded despite ‘honorary’ titles”
( Washington Times – - July 6, 2010 )
When the White House announced Dr. Donald Berwick as President Obama’s choice to lead the $800 billion Medicare and Medicaid agency in April, officials hailed his long list of credentials. But Dr. Berwick hasn’t seen a patient for years.
“Debating health care through nominees in waiting”
( Washington Post – - July 3, 2010 )
Donald Berwick, President Obama’s choice to head up the Centers for Medicare and Medicaid Services, has said, ”Most people who have serious pain do not need advanced methods; they just need the morphine and counseling that have been available for centuries.”
“Rethinking Comparative Effectiveness Research”
( Biotechnology Healthcare – - June 1, 2009 )
Asked if Comparative Effectiveness Research will lead to rationing of health care, Dr. Donald Berwick said, ”The decision is not whether or not we will ration care – the decision is whether we will ration with our eyes open.”
“Health care rationing is bound to come”
( Desert Dispatch – - June 29, 2010 )
Critics of Obamacare were severely attacked for using allegedly overheated rhetoric such as “death panels.” But given the fact that an 18-member Independent Payment Advisory Board will be established to set “quality and efficiency” standards that doctors will be forced to follow after 2015, that rhetoric does not appear to be so overheated after all.
“Special Report: Health Care Law: New Words, Same Meaning”
( ITF Update - – June 2010 )
Words that caused a firestorm during the debate over health care reform can’t be found in the law as passed, but the practices they referred to are in the law. New words, same problem.
“Why Donald Berwick is Dangerous to Your Health”
( Real Clear Politics – - May 26, 2010 )
President Obama’s nomination of Donald Berwick M.D. to head HHS’s Center for Medicare and Medicaid Services eliminates any lingering doubt he seeks to impose state-run medicine and a European style health care system on America. According to Berwick, “Any healthcare funding plan that is just, equitable, civilized and humane, must redistribute wealth…. There needs to be global budget caps on total healthcare spending for designated populations.”
“ObamaCare High School: Reading, Writing, and Suicide Assistance?”
( American Thinker – WA, USA- April 14, 2010 )
In Washington State, an 18-year-old high school senior could be “qualified” for assisted suicide at a school-based health clinic. Within two weeks, she could be referred to an assisted suicide advocacy group and provided with a prescription for a lethal drug overdose. She could take it. And die – without her parents even knowing she was ill. It would all be perfectly legal.
“Special Report: In the name of health care reform”
( ITF Update - – February 2010 )
Senate and House bills contain expansive social programs.
“Deja vu a nightmare for Dems?”
( Politico – - January 31, 2010 )
Senate and House leaders looking at three different options to gain approval for health care overhaul. More
“Democrats quietly working to resuscitate healthcare overhaul”
( Los Angeles Times - January 30, 2010 )
The campaign to overhaul the nation’s healthcare system is officially on the back burner as Democrats turn to the task of stimulating job growth, but behind the scenes party leaders have nearly settled on a strategy to salvage the massive legislation. More
“Talking Seniors to Death”
( American Thinker – September 6, 2009 )
Seniors will have less money to spend next year but they may not have to live on such meager funds for long. The government is going to help them plan how they want to die….Section 1233 of the current House bill (HR 3200) didn’t just show up on the doorstep of health care reform, but was packaged and delivered by Compassion & Choices, the assisted-suicide advocacy group previously known as the Hemlock Society. More
Can we afford “America’s Affordable Health Choices Act”?
What does Section 1233 of HR 3200 do? What does the “continuum of of end-of-life services” mean? Why is Compassion & Choices (the former Hemlock Society) leading the charge for Section 1233?
