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Apotheosis
02-11-2009, 05:37 PM
clearly this is an opinion piece, but it does bring up some interesting points.

vote libertarian next time, people.

http://www.bloomberg.com/apps/news?pid=20601039&refer=columnist_mccaughey&sid=aLzfDxfbwhzs

Feb. 9 (Bloomberg) -- Republican Senators are questioning whether President Barack Obama’s stimulus bill contains the right mix of tax breaks and cash infusions to jump-start the economy.

Tragically, no one from either party is objecting to the health provisions slipped in without discussion. These provisions reflect the handiwork of Tom Daschle, until recently the nominee to head the Health and Human Services Department.

Senators should read these provisions and vote against them because they are dangerous to your health. (Page numbers refer to H.R. 1 EH, pdf version).

The bill’s health rules will affect “every individual in the United States” (445, 454, 479). Your medical treatments will be tracked electronically by a federal system. Having electronic medical records at your fingertips, easily transferred to a hospital, is beneficial. It will help avoid duplicate tests and errors.

But the bill goes further. One new bureaucracy, the National Coordinator of Health Information Technology, will monitor treatments to make sure your doctor is doing what the federal government deems appropriate and cost effective. The goal is to reduce costs and “guide” your doctor’s decisions (442, 446). These provisions in the stimulus bill are virtually identical to what Daschle prescribed in his 2008 book, “Critical: What We Can Do About the Health-Care Crisis.” According to Daschle, doctors have to give up autonomy and “learn to operate less like solo practitioners.”

Keeping doctors informed of the newest medical findings is important, but enforcing uniformity goes too far.

New Penalties

Hospitals and doctors that are not “meaningful users” of the new system will face penalties. “Meaningful user” isn’t defined in the bill. That will be left to the HHS secretary, who will be empowered to impose “more stringent measures of meaningful use over time” (511, 518, 540-541)

What penalties will deter your doctor from going beyond the electronically delivered protocols when your condition is atypical or you need an experimental treatment? The vagueness is intentional. In his book, Daschle proposed an appointed body with vast powers to make the “tough” decisions elected politicians won’t make.

The stimulus bill does that, and calls it the Federal Coordinating Council for Comparative Effectiveness Research (190-192). The goal, Daschle’s book explained, is to slow the development and use of new medications and technologies because they are driving up costs. He praises Europeans for being more willing to accept “hopeless diagnoses” and “forgo experimental treatments,” and he chastises Americans for expecting too much from the health-care system.

Elderly Hardest Hit

Daschle says health-care reform “will not be pain free.” Seniors should be more accepting of the conditions that come with age instead of treating them. That means the elderly will bear the brunt.

Medicare now pays for treatments deemed safe and effective. The stimulus bill would change that and apply a cost- effectiveness standard set by the Federal Council (464).

The Federal Council is modeled after a U.K. board discussed in Daschle’s book. This board approves or rejects treatments using a formula that divides the cost of the treatment by the number of years the patient is likely to benefit. Treatments for younger patients are more often approved than treatments for diseases that affect the elderly, such as osteoporosis.

In 2006, a U.K. health board decreed that elderly patients with macular degeneration had to wait until they went blind in one eye before they could get a costly new drug to save the other eye. It took almost three years of public protests before the board reversed its decision.

Hidden Provisions

If the Obama administration’s economic stimulus bill passes the Senate in its current form, seniors in the U.S. will face similar rationing. Defenders of the system say that individuals benefit in younger years and sacrifice later.

The stimulus bill will affect every part of health care, from medical and nursing education, to how patients are treated and how much hospitals get paid. The bill allocates more funding for this bureaucracy than for the Army, Navy, Marines, and Air Force combined (90-92, 174-177, 181).

Hiding health legislation in a stimulus bill is intentional. Daschle supported the Clinton administration’s health-care overhaul in 1994, and attributed its failure to debate and delay. A year ago, Daschle wrote that the next president should act quickly before critics mount an opposition. “If that means attaching a health-care plan to the federal budget, so be it,” he said. “The issue is too important to be stalled by Senate protocol.”

More Scrutiny Needed

On Friday, President Obama called it “inexcusable and irresponsible” for senators to delay passing the stimulus bill. In truth, this bill needs more scrutiny.

The health-care industry is the largest employer in the U.S. It produces almost 17 percent of the nation’s gross domestic product. Yet the bill treats health care the way European governments do: as a cost problem instead of a growth industry. Imagine limiting growth and innovation in the electronics or auto industry during this downturn. This stimulus is dangerous to your health and the economy.

(Betsy McCaughey is former lieutenant governor of New York and is an adjunct senior fellow at the Hudson Institute. The opinions expressed are her own.)

To contact the writer of this column: Betsy McCaughey at Betsymross@aol.com
Last Updated: February 9, 2009 00:01 EST

radamanthys
02-11-2009, 06:36 PM
Why isn't Tom Daschle gone?

He's a fucktard.


(And, you gotta love Betsy McCaughey Ross)

Kuyuk
02-11-2009, 06:57 PM
yeah, not a huge fan, but I can see pros/cons of it.

Pro- helps inexperienced doctors, no matter where you go, you dont have to pay to have your doctor record transferred

con- big brother regulation, inhibits experienced doctors


K.

Mabus
02-11-2009, 07:17 PM
con- big brother regulation, inhibits experienced doctors
Other possible cons:
* Hackers.
* Inaccurate records.
* Insurance company (and other company) usage.

Overall I am for electronic record keeping for medical records, but the details of availability, security and inappropriate usage must be spelled out beforehand.

Apotheosis
02-11-2009, 07:48 PM
yeah, not a huge fan, but I can see pros/cons of it.

Pro- helps inexperienced doctors, no matter where you go, you dont have to pay to have your doctor record transferred

con- big brother regulation, inhibits experienced doctors


K.



Right.. there are def. pro's / cons to this issue.. maybe I could expand on both lists---



PRO'S-

Shitty doctor's get better guidance.
Convenience of universal health records.
Collective, potentially reliable information about which treatments work / don't work.


CON's / questions-

What about my choice to alternative healthcare?

"Health care rationing"

Where's my right to decide if I wish to go with an "experimental" treatment if faced with a life threatening condition?

Who has "access" to my records? (apparently, over 600,000 entities will have access to my records)

(excerpt from http://www.thenationalcoalition.org/TheHill40903.htm)

Jim Pyles, co-founder of the law firm Powers Pyles Sutter and Verville P.C., said he believes the privacy rule will eliminate citizens' rights to withhold their personal health information.

The privacy rule, coupled with a 2001 Supreme Court ruling (Bartnicki et al v. Vopper, aka Williams, et al) that found that media outlets are allowed to report information that is illegally obtained, will have a significant impact on future elections, Pyles said. "The 2002 election is the last election that medical records will not play a pivotal role," he said. "I don't think members of Congress and the administration are aware of this."

Pyles, who has testified before Congress and serves as counsel to several national home health, ambulatory care, and psychiatric associations, said the privacy rule will put more patient data in the hands of health plans, hospitals, and insurance firms, and other companies that meets the definition of "covered entity" or "business associate."

Therefore, an estimated 600,000 entities will have regulatory permission to use and disclose patient data, regardless of the wishes of the consumer, Pyles said. Physicians will not be able to withhold information that they believe should not be released because the insurance companies that pay these doctors will demand the data, Pyles added.

Could they possibly used to profile individuals with mental health issues, etc.?

Could the records be used to pre-screen for employment with State or Federal government, creating discrimination?

If I'm deemed "unfit for work" as a result of my health records, does this mean I have no recourse to earn a living for myself without handouts?

Does it guarantee EQUAL ACCESS to ALL HEALTHCARE for ALL US CITIZENS regardless of age, class, etc.??

I'll answer this one and say NOT A SNOWBALL's CHANCE IN HELL....

I mean, the big debate about socialized health care ends with (well, the rich will always be able to afford better health care, regardless)....



The problem is that.... provisions such as these are being RUSHED THROUGH without extensive debate to answer important questions..

ClydeR
02-11-2009, 08:23 PM
The person who wrote that Bloomberg article does not appear to have read the bill, despite the fact that she provided a link to the bill in her article. I'm going to quote some from the bill, and you tell me if it means what she says it means. The quoted part comes form pages 441-446 of the PDF print of the bill obtained from the link in the article, if you want to match it up with the page numbers cited in the article.


`(b) Purpose- The National Coordinator shall perform the duties under subsection (c) in a manner consistent with the development of a nationwide health information technology infrastructure that allows for the electronic use and exchange of information and that--


`(1) ensures that each patient's health information is secure and protected, in accordance with applicable law;

`(2) improves health care quality, reduces medical errors, reduces health disparities, and advances the delivery of patient-centered medical care;

`(3) reduces health care costs resulting from inefficiency, medical errors, inappropriate care, duplicative care, and incomplete information;

`(4) provides appropriate information to help guide medical decisions at the time and place of care;

`(5) ensures the inclusion of meaningful public input in such development of such infrastructure;

`(6) improves the coordination of care and information among hospitals, laboratories, physician offices, and other entities through an effective infrastructure for the secure and authorized exchange of health care information;

`(7) improves public health activities and facilitates the early identification and rapid response to public health threats and emergencies, including bioterror events and infectious disease outbreaks;

`(8) facilitates health and clinical research and health care quality;

`(9) promotes prevention of chronic diseases;

`(10) promotes a more effective marketplace, greater competition, greater systems analysis, increased consumer choice, and improved outcomes in health care services; and

`(11) improves efforts to reduce health disparities.

`(c) Duties of the National Coordinator-


`(1) STANDARDS- The National Coordinator shall review and determine whether to endorse each standard, implementation specification, and certification criterion for the electronic exchange and use of health information that is recommended by the HIT Standards Committee under section 3003 for purposes of adoption under section 3004. The Coordinator shall make such determination, and report to the Secretary such determination, not later than 45 days after the date the recommendation is received by the Coordinator.

`(2) HIT POLICY COORDINATION-


`(A) IN GENERAL- The National Coordinator shall coordinate health information technology policy and programs of the Department with those of other relevant executive branch agencies with a goal of avoiding duplication of efforts and of helping to ensure that each agency undertakes health information technology activities primarily within the areas of its greatest expertise and technical capability and in a manner towards a coordinated national goal.

`(B) HIT POLICY AND STANDARDS COMMITTEES- The National Coordinator shall be a leading member in the establishment and operations of the HIT Policy Committee and the HIT Standards Committee and shall serve as a liaison among those two Committees and the Federal Government.

`(3) STRATEGIC PLAN-


`(A) IN GENERAL- The National Coordinator shall, in consultation with other appropriate Federal agencies (including the National Institute of Standards and Technology), update the Federal Health IT Strategic Plan (developed as of June 3, 2008) to include specific objectives, milestones, and metrics with respect to the following:


`(i) The electronic exchange and use of health information and the enterprise integration of such information.

`(ii) The utilization of an electronic health record for each person in the United States by 2014.

`(iii) The incorporation of privacy and security protections for the electronic exchange of an individual's individually identifiable health information.

`(iv) Ensuring security methods to ensure appropriate authorization and electronic authentication of health information and specifying technologies or methodologies for rendering health information unusable, unreadable, or indecipherable.

`(v) Specifying a framework for coordination and flow of recommendations and policies under this subtitle among the Secretary, the National Coordinator, the HIT Policy Committee, the HIT Standards Committee, and other health information exchanges and other relevant entities.

`(vi) Methods to foster the public understanding of health information technology.

`(vii) Strategies to enhance the use of health information technology in improving the quality of health care, reducing medical errors, reducing health disparities, improving public health, and improving the continuity of care among health care settings.

`(B) COLLABORATION- The strategic plan shall be updated through collaboration of public and private entities.

`(C) MEASURABLE OUTCOME GOALS- The strategic plan update shall include measurable outcome goals.

`(D) PUBLICATION- The National Coordinator shall republish the strategic plan, including all updates.

So says Clyde.

Parkbandit
02-11-2009, 08:55 PM
What does this have to do with stimulus again?

Anyone?


Anyone?

Stanley Burrell
02-11-2009, 10:03 PM
According to Daschle, doctors have to give up autonomy and “learn to operate less like solo practitioners.”[/B]

Socialism of modern medicine will happen before this.

As long as there is an ounce of desire to triumph over another human being using your own liquid commodities to get a referral to someone who might not be covered under your insurance, but is a better doctor and can treat you with more niceties because you have a fatter wallet, then this idea is simply bullshit.

Apotheosis
02-12-2009, 10:52 AM
What does this have to do with stimulus again?

Anyone?


Anyone?

how unamerican of you to question this, comrade.

Parkbandit
02-12-2009, 11:38 AM
how unamerican of you to question this, comrade.


WHA!? I thought it was very patriotic to question your government.. especially a President that you didn't vote for?!?

Apotheosis
02-12-2009, 11:45 AM
WHA!? I thought it was very patriotic to question your government.. especially a President that you didn't vote for?!?


you're supposed to give him 100 days..... how very very UNKIND of you.. you're probably a mean conservative

Methais
02-12-2009, 01:10 PM
What does this have to do with stimulus again?

Anyone?


Anyone?

It stimulates that feeling Chris Matthews gets shooting up his leg when he sees Obama and anything to do with him.

Anyone that's actually for this bill....don't QQ when your mother gets sick and dies because this bill prevented her from getting the treatment she needed when it was needed.

Mighty Nikkisaurus
02-12-2009, 03:55 PM
WHA!? I thought it was very patriotic to question your government.. especially a President that you didn't vote for?!?

That doesn't apply when the President is black.

Clearly, you are a racist.

Parkbandit
02-12-2009, 04:09 PM
That doesn't apply when the President is black.

Clearly, you are a racist.


Dammit.. I need rulebook.

TheWitch
02-12-2009, 04:45 PM
Aside from obvious concerns about privacy....

I really don't have a problem alot of this, and that's very unlike me.

Here's why.

When my son had leukemia, you can only imagine the nightmare we went through with insurance, the billing departments, the doctors, etc etc etc. If you've been through a catastrophic illness, you know. It's a job, not part time, to keep all that straight. By the time all was said and done with his treatment protocol, which lasted 2 1/2 years (he's fine now, and has been declared "cured"), well over a quarter of a million dollars in billing and payments and deductables and copays and minimums and etc had been processed.

Everyone had to do the same tests over again, when he had to go to a specialist. Because there was no centralized record keeping. Every time we went to a new doctor, it was an hours worth of filling out forms in triplicate, because there is no centralized record keeping - with a sick toddler. I had to cart around xray films, because of no centralized record keeping. The list goes on. And how much of that 250k was wasted in duplicate testing, filing fees, record transfer fees, extraneous (and stupid, I might add) staff? I'm going to be generous and say only 1/5, but it could easily be more.

We were lucky: for much of his treatment we were double insured. When my COBRA ran out, we still had decent insurance through my husband.

I will absolutely grant that for your average person who gets bronchitis once a year, and just has a regular check up otherwise, this could present some unnecessary pains in the ass jumping through hoops.

But for people with chronic or life threatening conditions, which is where the big money in healthcare is spent, this really could make things easier for everyone.

EXCEPT. The government's in charge. So it will fail. Blargh.

Methais
02-12-2009, 04:48 PM
I really don't have a problem alot of this, and that's very unlike me.

Just wait til he gets old and can't get prescription strength immodium and diarrheas himself to death.