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In My Opinion
Lynn Paris

Who Cares About Health Care?

The last thing I wanted to do today was write another column on health care. In fact, I’m so sick of health care that I may just need some, and soon. I get extremely aggravated when I watch various democratic congressmen and women attempt to defend either the house or senate bill (because guess what, folks . . . there IS no Obama healthcare bill at the moment, regardless of what you’ve been told) and do a mediocre job of it. They haven’t done their homework and it shows. And I get even more aggravated watching a republican stand before a town hall meeting and call the bills government-run health care, or national health care, when that is NOT what is being proposed by anyone. For the love of God; there are liberals across this country and in congress fuming because this ISN’T nationalized or single payer healthcare. They think neither bill goes nearly far enough.

I’m a strong proponent of town hall meetings, open forums, healthy debate, opposing viewpoints, and the right to disagree with whatever is going on in government. After all, I disagreed with most of what went on from 2001-2008. That’s the joy, and privilege of being a citizen of the United States.  And I’m delighted that our often apathetic citizenry cares enough about this issue to get involved. I just wish more of them knew what they were fighting for, or against, before they pitched battle.

So, I spent most of today reading the two bills. Yes, it was laborious. But I couldn’t be the pot calling the kettle black anymore. I had to do MY homework. I read through hundreds of pages devoted to holding insurers, practitioners, hospitals etc. accountable for adhering to “best practices” in every conceivable situation. Just as many pages devoted to setting up the parameters for determining best practices in everything from rural health to chronic disease, from mental health to geriatric care. And again as many pages for eliminating waste, duplicative procedures, and detecting and punishing fraud. Imagine . . .asking those who are charged with safe-guarding our health to control costs, refrain from deceiving us, and be held accountable! Horrifying, I know.

The thing was, I was on a mission. I was looking for even the slightest hint of those infamous “death panels” Sara Palin warned us about. I wanted to discover the slippery slope I’ve heard described that would allow the government to dictate to me what I can eat, or how much couch time I was permitted to have. And I wanted to find some indication that I was about to lose my right to privacy, because a federal bureaucrat would be standing between my doctor and me. Right there in the office.

And guess what? I couldn’t find any of that. Here’s what I did find that sure scared the heck outta Sara and her followers concerning pulling the plug on Grandma. It’s Section 1233, starting around page 424 of the House version, entitled: “Advance Care Planning Consultation”. The following is taken directly from the bill:

The term ‘advance care planning consultation’ means a consultation between the individual and a practitioner described in paragraph (2) regarding advance care planning, if 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 powers of attorney, and their uses.
(C) An explanation by the practitioner of the role and responsibilities of a health care proxy.
(D) 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).
(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.
(F)(i) Subject to clause (ii), an explanation of orders regarding life sustaining treatment or similar orders, which shall include—
‘(I) 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 healthcare proxy).

There is absolutely NOTHING in there that is even the least bit offensive, much less suggestive of pulling anyone’s plug or condemning our loved ones to a government death panel. To suggest otherwise is to admit to not having read it. (Or, to being willing to lie about, counting on the fact that no one else has read it.)

The concept that people should be advised and informed about their rights so that their wishes can be carried out if they are medically unable to make them known is compassionate. It is an attempt to put the control over one’s treatment in the hands of the patient, rather than in the hands of the insurance company, hospital or doctor who might have to guess what the patient wants. It’s about letting people know all their options, including hospice, palliative care and life-sustaining care before, rather than after, they need it so that they can protect themselves.

And, it’s one of the items that will probably be eliminated from the final bill because the totally uninformed shouted louder than anyone else.

Now, about that slippery slope where the government winds up dictating my eating, smoking, nutrition, and exercise habits. Yes, under Title III: Improving the Health of the American People-Modernizing Disease Prevention, there are pages and pages of recommendations intended to come closer to achieving national wellness, health promotion, and public health goals. These recommendations do include reduction of tobacco use, sedentary behavior, and poor nutrition. Absurd, I know. I mean, why should our government care about whether or not we want to kill ourselves by inhaling toxins or by joining the epidemic of the morbidly obese? Haven’t they done enough damage taxing cigarettes? Leave us the heck alone!! What are they doing even suggesting the need for dissemination of information, training of health care professionals, outreach into underserved populations, public awareness or education on these self-destructive behaviors? I’m sure my pastor’s next sermon will cover this material anyway, so why do I need the government poking its head into church business?

Finally, when I began writing this yesterday, I was also looking for some fatal flaw in the “public option,” something that I might have missed that put a bureaucrat between me and my physician. I never understood this argument in the first place, because every decision my physician makes now is governed by the HMO bureaucrats to whom he must answer. What could be worse than that?

Nevertheless, I knew there must be something even more onerous about the public option that was causing all conservatives to freak out. I hoped it was more than their objection to providing an alternative—maybe even a less expensive, more competitive alternative—for health care, since no one could really oppose THAT. I also hoped it was not that old chestnut about the private insurers being driven out by the low-cost government-run public option. As I wrote in my last column, either the government is a big inefficient machine that can’t run anything right, as some critics say, or it’s so darn efficient that it will cause the private insurance companies to shut down, as the other half says. But it can’t be both! Just parenthetically, I can’t help but wonder if any of the hard-core conservatives I know is planning to turn down their Social Security and Medicare payments. It would sure make their arguments a whole lot more persuasive.

At any rate, I figured it must be more about the idea that some of the now almost 50 million uninsured (or let’s say, only 25 million since the conservatives are positive that half the uninsured WANT to be that way) might get something that resembled an “entitlement,” a word that is anathema to the right wing. (No one is entitled to anything unless they can afford to pay for it; that’s what makes this country great!)

Again, I couldn’t find anything scary about the public option, no matter how hard I tried. But it doesn’t really matter. It’s now looking like that will also be eliminated from the final bill, in an effort by the Obama administration to achieve any kind of reform of our current health care mess. The republicans did a great job scaring people. The democrats did a lousy job defending the proposed bills. And practically no one read the darn things. It’s a real shame.

Is it even remotely possible that Barack Obama, or some of the other politicians in Washington, D.C. actually believe that this country has some sort of moral obligation to provide quality affordable healthcare to all its citizens? Not free healthcare, mind you . . . just affordable and reliable. You know, like health insurance that doesn’t deny coverage because of pre-existing conditions, or drop you as soon as you actually get a disease? Is that even conceivable?

I know that this debate has been all about politics, and very little about health care reform. It made me remember something former President George H.W. Bush once said, which was that “politics is a noble calling.” For a very few, that’s probably true. But for the vast majority, there’s nothing noble about it.

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