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H.R. 3200: Government Assisted Suicide
By Dr. Richard Swier | 07/30/09 | 08:38 AM EDT | 20 Comments
Recently President Obama appeared at a town hall meeting with members of the AARP concerning healthcare. During the meeting Mike Cuthbert, the AARP moderator, brought up “the infamous page 425” of H.R. 3200. Mike asked President Obama, "I have been told there is a policy there that everyone that's Medicare age will be visited and told they have to decide how they wish to die…The infamous page 425."
President Obama responded by saying, “Nobody is going to be forcing you to make a set of decisions on end-of-life care based on, you know, some bureaucratic law in Washington."
Senator Chuck Grassley (R-IA) had a different take when he said, “Think about it when you're 50 years old [you will be required by the government to consider end of life options] instead of when you're 85. What sort of care you want…And that's where a lot of people fear that some of these ideas in these bills can lead you to. And that's unethical as far as I’m concerned."
According to NewsPusher.com, “When the Bush Administration expanded Medicare reimbursement to cover Hospice care, which is less expensive than hospital care, Hospice care grew 240%.”
So what does the “infamous page 425” actually say? Well I read more than just page 425 to understand what is really in the bill and it is more frightening than even I or Senator Grassley thought. To understand this issue you really need to read SEC. 1233. ADVANCE CARE PLANNING CONSULTATION, which starts on page 424 and ends on page 434.
Here are key excerpts from SEC. 1233 of H.R. 3200:
The term ‘advance care planning consultation’ means a consultation between the individual and a practitioner [physician, nurse practitioner or physician’s assistant] described in paragraph (2) regarding advance care planning, if, subject to paragraph (3), the individual involved has not had such a consultation within the last 5 years.
Such consultation shall include the following:
- An explanation by the practitioner of advance care planning, including key questions and considerations, important steps, and suggested people to talk to.
- An explanation by the practitioner of advance directives, including living wills and durable powers of attorney, and their uses.
- An explanation by the practitioner of the role and responsibilities of a health care proxy.
- The provision by the practitioner of a list of national and State-specific resources to assist consumers and their families with advance care planning, including the national toll-free hotline, the advance care planning clearinghouses, and State legal service organizations (including those funded through the Older Americans Act of 1965).
- An explanation by the practitioner of the continuum of end-of-life services and supports available, including palliative care and hospice, and benefits for such services and supports that are available under this title.
Subject to clause (ii), an explanation of orders regarding life sustaining treatment or similar orders, which shall include— the reasons why the development of such an order is beneficial to the individual and the individual’s family and the reasons why such an order should be updated periodically as the health of the individual changes; (II) the information needed for an individual or legal surrogate to make informed decisions regarding the completion of such an order; and ‘‘(III) the identification of resources that an individual may use to determine the requirements of the State in which such individual resides so that the treatment wishes of that individual will be carried out if the individual is unable to communicate those wishes, including requirements regarding the designation of a surrogate decision maker (also known as a health care proxy).
Finally SEC 1233 states:
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.
The provisions of H.R. 3200 clearly extend beyond simply providing information; it interjects the federal government using doctors, nurses and PAs as proxies to push palliative care on all Americans. This bill necessarily pushes people toward ending their life earlier rather than later. The question is why? I believe it is in the title of the bill, which in part is to, “…reduce the growth in health care spending and for other purposes.”
I remind doctors who may support this bill of these words from their Hippocratic Oath:
I will apply dietic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice.
I will neither give a deadly drug to anybody if asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art.
If I fulfill this oath and do not violate it, may it be granted to me to enjoy life and art, being honored with fame among all men for all time to come; if I transgress it and swear falsely, may the opposite of all this be my lot.
(Emphasis added)
Government assisted suicide to cut medical costs is the primary purpose of SEC 1322 of H.R. 3200. I beg all doctors to fulfill their solemn oath and first do no harm.
TAGS: Obamacare, healthcare, rationing, taxes, government assisted suicide
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20 Comments | Related Topics »FLORIDA | National
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Comments
Hi All, The information on Advance Care Consultation Planning starts on page 424 of the bill. The Physician has to offer advice on why an Living Will or Advanced Care Directive is suggested, how to go about setting one up, who is available and qualified to set up the Living Will and have Medicare pay for part of setting up such a document. Check out Factcheck.org, AARP.org or Snopes.com to get more information. The bill does not say you "HAVE" to set up an Advanced Care Directive. This sort of misinformation is being spread around to try and scare people into being afraid of the Healthcare Bill.
In President Obama's own words from a Town Hall Meeting on July 28, 2009 "Obama, July 28: I think that the only thing that may have been proposed in some of the bills – and I actually think this is a good thing – is that it makes it easier for people to fill out a living will. … And if you don’t want to fill out a living will, you don’t have to. But it’s actually a useful tool I think for a lot of families to make sure that if, heaven forbid, you contract a terminal illness, that you are somebody who is able to control this process in a dignified way that is true to your faith and true to how you think that end-of-life process should proceed. You don’t want somebody else making those decisions for you. … But, Mary, I just want to be clear: Nobody is going to be knocking on your door; nobody is going to be telling you you’ve got to fill one out. And certainly nobody is going to be forcing you to make a set of decisions on end-of-life care based on some bureaucratic law in Washington."
"Nuf said" CliK
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|Thanks for reading my column. I quote again to you and Mary that part of SEC. 1233 that mandates counseling. Note the word "shall" which means must. The term ‘advance care planning consultation’ means a consultation between the individual and a practitioner [physician, nurse practitioner or physician’s assistant] described in paragraph (2) regarding advance care planning, if, subject to paragraph (3), the individual involved has not had such a consultation within the last 5 years. Such consultation shall include the following: * An explanation by the practitioner of advance care planning, including key questions and considerations, important steps, and suggested people to talk to. * An explanation by the practitioner of advance directives, including living wills and durable powers of attorney, and their uses. * An explanation by the practitioner of the role and responsibilities of a health care proxy. * The provision by the practitioner of a list of national and State-specific resources to assist consumers and their families with advance care planning, including the national toll-free hotline, the advance care planning clearinghouses, and State legal service organizations (including those funded through the Older Americans Act of 1965). * An explanation by the practitioner of the continuum of end-of-life services and supports available, including palliative care and hospice, and benefits for such services and supports that are available under this title. :
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|Dr. Swier,
I have read section 1233 of Bill H.R. 3200. It does state that the patient is to be OFFERED a "Advance Care Planning Consultation" by his or her Physician. The Bill does NOT state that the patient is required to have an Advance Care Directive put in place. It states the Physician will offer information that is important, in order to make an informed decision on a very personal and significant document. You made a pretty far-reaching statement to call this valuable service "Government Assisted Suicide". Stop trying to scare people into believing such poppycock. If you have to scare people in order to get your point across, you must have a weak arguement. CliK
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|As a matter of fact, it is a matter of routine in New York State to complete advanced directives which is exactly what this part of the bill proposes. This has not led to rationing of health care nor the unwanted removal of life saving services. Rather, it has allowed patients the opportunity to decide their life choices, so that someone else will not.
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|Doctor, you are making ridiculous distortions and leaping to absurd conclusions. The counseling is VOLUNTARY. I suspect your motivation is to protect your own income streams.
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|Somehow I doubt a retired man with a doctorate in education is looking to protect his income by opposing this bill. But I guess some people just can't hold back their own self-assurances and be pricks, especially when nobody has to know their name.
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|Anonymous, I hold a Doctorate in Education. However, in my column I present the exact language from the healthcare bill. I suggest you read it and understand what it says. Thanks for visiting RedCounty.com and reading my articles.
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|Swier simply discounts himself when he puts up egregious misinformation. I don't bother to read his stuff because of that. I do take interest in the debunking comments.
On the other hand, I do read carefully your posts, Matt. I find them to be scrupulously fair and balanced.
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|Lee, The information I provide is language taken directly from the healthcare bill. I provide a link to the government web site where you may read the entire ten pages of this section on mandated counseling on end-of-life options. I also point out that there are options for counseling when a person's health changes dramatically. This could affect any American regardless of age, including children under SHIP. I hope you read more carefully my column as the information is factual and taken directly from the bill. Thanks for reading my column and Matt's great commentaries.
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|It is not the requirement for consultations with your physician in this section that is so troubling, in fact it is a good idea. Discussions and arrangements for "palliative care and hospice" in place of treatment intended to prolong life and instead, focusing on pain relief until death for the terminally ill is benificial and reasonable. But this section does not confine itself to necessarilly fatal illnesses. This section contains broad and abstract conditions described as "chronic", "progressive" or "life-limiting". Now, this section empowers doctors to make an "actionable medical order" to "limit some or all specified interventions." This, in effect gives the government the power to determine that a life limiting condition demands the witholding of treatment. At least that's the way it appears to me if you really scrutinize these provisions.
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|This Dr. Richard Swier ought to have his license pulled for such unprofessional and UTTERLY MISLEADING interpretations of H.R.3200. This section merely allows for the advice that every lawyer in this country gives to his or her clients to be given to all patients without having to incur legal fees. It's a fantastic provision and a great service to all patients. It does not mean what this disreputable doctor says it means. He ought to be ashamed of himself and I find it difficult to believe that there is anyone so ignorant or fear-filled that they would believe him.
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|Really? What part of 'explanation' needs, well, an explanation? Okay, I'll bite, and take a crack at dumbing it down for y'all.
You can break pg 425 down to saying that a doctor has to tell you about living wills, why making decisions before you are a vegetable is probably a good idea, etc.
Nothing in any normal reading of the words 'shall' and 'explain' would lead a sane and literate person to think that someone's out to kill old people.
BTW, I lilke that this site has to explain math in the captcha, hehe..
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|Can you argue the merits of this issue without creating lies and scare tactics out of whole cloth? This is evil. Pure evil. Claiming to be doing this in the interest of our rights as Americans, claiming to be interested in our freedoms and health and the lot, but the truth is that you are a liar. A calculating liar. Nothing in this provision says anything of the sort, you have taken the idea of a Living Will being optional and for the first time the consultation with your OWN DR to pay for the discussion and twisted it into a partisan, outright lie. What makes you need to lie in order to try to win and argument? Why have you left out that this was co-written by a surgeon, a Republican surgeon at that. There is nothing in here to infer government aided suicides. You sir, are a liar.
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|Dear Dr. Swier,
You clearly don't understand what you read. Why didn't you ask someone before you posted this misinformation instead of making yourself appear ignorant and uninformed? For someone holding a doctorate in education, I should think you would know better. Of everything you posted, including the bolded parts, nothing could be misconstrued as promoting assisted suicide. Nothing. Shame on you.
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|THE PRESIDENTS PHONECALL
My name is Brian O'Reilly I worked at Massachusetts General Hospital as a computer technician,I received a phone call from President George Bush JR at the whitehouse,I was told to leave my job, pay my bills, change my name, and leave the area,and never mention a word of this to anyone, people I worked with were there when the president called, People I worked with kept asking me If I knew him,and asked me why he called,I then contacted my manager and submitted a transfer to the Charlestown facility that M.G.H has,I was so nervous after receiving that phone call from Bush I left my job and left the state,and ended up homeless,all because of a phone call from the whitehouse that I had no explanation for,president George Bush Jr turned me into a homeless person on purpose.and used his position as president to do so, I have witnesses to verify he called.this is wrong considering that I don't work for the whitehouse or the president,I am sure that no one would like this done to them,he had no right to do this to me,I also found out I was under Surveillance, I am making sure everyone knows that BUSH did this,including the press,I want justice....please send this to other people,thank you.
brian o'reilly,the pine street inn shelter,444 harrison ave,Boston,MA
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|It is interesting to note that as governor of Alaska, Sarah Palin on April16, 2008, issued a Proclamation announcing that date as Health Care Decision date, which included: "WHEREAS, one of the important goals of Health Care Decision Day is to encourage hospitals, nursing homes, assisted living facilities, continuing care retirement communities, and hospices to participate in a statewide effort to provide clear and consistent directives, as well as to encourage medical professionals and lawyers to volunteer their time and efforts to improve public knowledge and increase the number of Alaska's citizens with advance directives" (Living Wills)
And, Newt Gingrich on 7/2/2009in the Washington Post, wrote:
Now they are calling these actions assisted suicide. Do you see something fishy about this?
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|It is interesting to note that as governor of Alaska, Sarah Palin on April16, 2008, issued a Proclamation announcing that date as Health Care Decision date, which included: "WHEREAS, one of the important goals of Health Care Decision Day is to encourage hospitals, nursing homes, assisted living facilities, continuing care retirement communities, and hospices to participate in a statewide effort to provide clear and consistent directives, as well as to encourage medical professionals and lawyers to volunteer their time and efforts to improve public knowledge and increase the number of Alaska's citizens with advance directives" (Living Wills)
And, Newt Gingrich on 7/2/2009in the Washington Post, wrote:
Now they are calling these actions assisted suicide. Do you see something fishy about this?
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|Yes, I read the section and, Dr. Swier, your ramblings are sheer nonsense.
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|I've read H.R. 3200, and the section you describe above does not say what you are implying. It deals with a consultation requested by a patient for explanatons by their medical care provider of what advance care orders (of the patient) are and how they are implemented.
The 5-year reference is to a time frame during which consultations requested by a patient will be paid for by the health care plan. It is not a mandatory five year "death panel" interview. There is no mandatory 5 year death decision or euthanasia requirement. It simply is not in the bill. Period. It is questionable why you would perpetuate such grossly incorrect information. If, as I suspect, you are affiliated with the insurance industry, then your motivation is obvious. That being the case I do not expect to see my comments posted, you simply aren't honest enough to post opposition to your agenda.
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|My father, at 89 years of age, has started reading internet blogs which, unlike this one, are perpetrated by the fanatic right-wing ultra-conservative lunatic fringe! He is frightened out of his poor old head because of the way these people are using scare tactics, and I believe some are just getting their kicks out of doing exactly that. I can read nothing into this that sounds like what my dad is saying people are telling him on the internet. He has been told he's going to be euthanized by his doctor because the Obama law is going to force the doctor to do it! What have these people done - without once thinking what they're doing to those who are easily swayed and easily scared? My thanks go out to all of the people who infuse everything they read with horror for making the last couple of years of my father's life a living hell. Anyone can put any kind of "spin" on the written word (do you realize how convincing - and how horrifying because of it - Hitler's book Mein Kampf was? It led all of those people right by the nose and it was all, all, ALL just insane).
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