Throwing Grandma Under the Train

At some point, the "debate" about health care ceased to be political, and instead grew into something diabolical:

Subject to paragraphs (3) and (4), the term ‘advance care planning consultation’ means a consultation between the individual and a practitioner described in paragraph (2) [ed: one's physician] 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:

(A) An explanation by the practitioner of advance care planning, including key questions and considerations, important steps, and suggested people to talk to.

(B) An explanation by the practitioner of advance directives, including living wills and durable 9 powers of attorney, and their uses.

(C) An explanation by the practitioner of the role and responsibilities of a health care proxy.

[snip]

(E) 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.

[ed: from Section 1233 of the bill]

Let's cut through the Congress-speak, and translate two key elements:

Section (A) means that discussions regarding important legal issues involving end-of-life decisions are to be held with a doctor, not a lawyer. Whatever one may think of the legal profession as a whole, certainly one's attorney is is a far better position to advise one on such potentially critical documents.

But it certainly paves the way for Section (E), which seems to clear the way for folks like Dr Kevorkian to practice their craft. Really, does our political class think so little of our intellect that they don't believe we'd see through this? Class warfare is, of course, nothing new, but pitting one generation of Americans against another is beyond the pale.

Or should be.

[Hat Tip: Red State]

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POTUS vs. Susan Boyle

In an effort to peddle his health care plan, Obamaman is facing stiff competition from Susan Boyle.

PresBO wanted to do his snake oil pitch at 9 PM Wednesday but the networks, except for the Katie Couric channel, were reluctant to give up the ad revenue to carry Barry and TOTUS.

CBS, which airs only repeats that evening, agreed early Monday to cover the conference.

But for NBC, Fox and ABC, the decision was tougher. During a summer that's otherwise strewn with repeats, Wednesday includes all of their top-rated reality programs.

Fox declined outright to air the news conference.

The stakes were particularly high for NBC, which airs the most-watched show of the summer, "America's Got Talent," at 9 p.m. This week, the reality hit includes a heavily promoted interview with "Britain's Got Talent" singing sensation Susan Boyle.

So there you have it.

America's Got Talent with Susan Boyle, or POTUS and TOTUS.

No contest.

Smaller cars, bigger health insurance, Poppa Washington.

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A Mysterious Grand Rounds

Detective Doc Gurley solves the puzzle of an enigmatic Grand Rounds, but it's no mystery that the good doctor's deduced how to present a myriad of clues to enlighten us all.

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4 No sweat Health and Fitness Tips

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Counterpoint: Revenue-Neutral Health care "Reform"

In the comments, longtime reader and frequent commenter Rick takes me to task for my use of Congressional Budget Office estimates of the estimated costs of the administration's pet health care proposal. Rick has demonstrated his credibility on this issue before, so in the interests of fairness, here's what he has to say:

The least we could do at IB is get the stenography right.

The CBO said the total SPENDING of the health plan would be $1 trillion over 10 years. The actual DEFICIT over 10 years would be $239 billion, or $23.9 billion a year, give or take. There have already been almost $800 billion found in various offsets and revenue sources to pay for the legislation -- which, we will all note, does nothing about cost containment.

Now, $239 billion is not nothing over 10 years. But at least it's accurate.

And it's a helluva lot less than we spent off-the-books on the War on Terror (until this year, when the President insisted that all the war costs actually be budgeted).

Here's the CBO quote from California Healthline:

"The estimate -- released late last week -- puts the gross cost of the bill at $1.04 trillion between 2010 and 2019.

Spending provisions in Medicare and Medicaid would reduce spending by $219 billion over that period, while a surtax on individuals and families with high incomes would increase federal revenues by about $583 billion, totaling $802 billion of the cost of the $1.04 trillion package, leaving the plan $239 billion short.

CBO said the biggest savings would come from a proposal to make permanent reductions to the annual updates to Medicare's payment rates for nearly all services in the fee-for-service program besides physicians' services.

That would reduce spending by $196 billion over 10 years, the CBO estimated."

See for yourself here.

So, all that being said, $239 billion over 10 years is highly "find-able" savings, if the Congress-critters can actually strap on a pair and call for some real cost containment.

Sounds like we're on the path to a revenue-neutral bill. Can the promised land of declining medical cost trends be far beyond?

P.S. I don't know if the $219 billion in cost savings from Medicare and Medicaid includes the $155 billion hospitals pledged to cut in the name of healthcare reform, or the $80 billion the pharmaceutical manufacturers promised to the effort. If the CBO scoring does NOT include these, then we may already have a revenue-neutral bill. How cool is that?"

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Abortions? No One is Saying . . .

The latest fly in the ointment of health care reform is whether the new plan(s) will cover abortions.

No one want's to handle that hot potato.

An Obama administration official refused Sunday to rule out the possibility that federal tax money might be used to pay for abortions under proposed health care legislation.

Peter R. Orszag, the White House budget director, asked whether he was prepared to say that “no taxpayer money will go to pay for abortions,” answered: “I am not prepared to say explicitly that right now. It’s obviously a controversial issue, and it’s one of the questions that is playing out in this debate.”

Why all the secrecy?

Or is it just ignorance?

Either way, we have a right to know how our tax dollars will be spent.

In an analysis of the House bill, the National Right to Life Committee said that ordinary principles of administrative law could allow the Obama administration to determine what would be included in the benefits package. “There is no doubt,” the group said, “that coverage of abortion will be mandated, unless Congress explicitly excludes abortion from the scope of federal authority to define ‘essential benefits.’ ”

"No doubt" may be an accurate assessment or just inflammatory rhetoric. I can't say one way or the other.

What I don't like is Washington telling me what kind of policy I must buy and what kind of benefits it must cover.

Susan M. Pisano, a spokeswoman for America’s Health Insurance Plans, a trade group, said that most insurance companies offered benefit packages that included abortion coverage but that many employers decided not to buy such packages.

That may no longer be an option under the change you can believe in health insurance plan.

Since 1976, Congress has imposed sweeping restrictions on the use of federal money for abortions. The Hyde Amendment, for instance, prohibits the Medicaid program from spending federal money on most abortions.

If abortions have been debated for 33 years you would think the folks in Congress would be able to answer a direct question.

Apparently not.

Smaller cars, bigger health insurance, Poppa Washington.

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