Considering how fond liberals are of "teachable moments," it was surprising that CBS's "60 Minutes" missed one on its Nov. 22 broadcast.
"60 Minutes" correspondent Steve Kroft took an in-depth look at one of the most expensive aspects of modern health care - the cost of end of life care. However, he didn't highlight the federal government's culpability in driving up those costs, or what it might mean for health care reform.
"Every medical study ever conducted has concluded 100 percent of all Americans will eventually die," Kroft said. "This comes as no great surprise. But, the amount of money being spent at the end of people lives probably will. Last year, Medicare paid $50 billion just for doctors' and hospital bills during the last two months of patients lives. That's more than the budget of the Department of Homeland Security or the Department of Education. And it's been estimated that 20 to 30 percent of these medical expenditures may have had no meaningful impact."
Despite those costs, Kroft said Congress and the President aren't addressing this "explosive" issue in the current proposals on the floor.
"Most of the bills are paid for by the federal government with few or no questions asked," Kroft continued. "Now you might think this might be an obvious thing for Congress or the President to address as they try to reform health care. But what used to be a bipartisan issue has become a politically explosive one - the perfect example of the costs that threaten to bankrupt the country and how hard it's going to be to rein them in."
However, Kroft ignored what's on the table now: a public option or some type of Medicare coverage for all, and how that alone could drive medical costs up to levels that end of life care has risen, spurred on by the easy availability provided under government-funded Medicare.
Dr. Ira Byock, past president of the American Academy of Hospice and Palliative Medicine, had a solution - subjectively choosing what patient deserves what end-of-life medical treatment.
"I think you can not make these decisions on a case-by-case basis," Byock said. "It would be much easier for us to say we simply do not put defibrillators in people in this condition - meaning your age, your functional status, the ability to make full benefit of the defibrillator. Now again, that's going to outrage a lot of people."
Kroft proposed that this stance was a version of "pulling grandma off the machine," one of the key ethical and moral dilemmas dismissed by the current detractors of health care reform as fear-mongering. But what he proposed has a real chilling effect for those on the verge of needing such health care.
"You know, I have to say, I think that's offensive," Byock replied. "I just - I spend my life in service of affirming life. I really do. To say we're going to pull grandma off this machine by not offering her a liver transplant or her fourth cardiac bypass surgery or something is really just scurrilous and it's certainly scurrilous when we have 46 million Americans who are uninsured."
David Walker, president and CEO of the Peter G. Peterson Foundation and the former Comptroller General of the United States and head of the GAO, weighed in. According to Walker, other countries ration health care when it comes to taxpayer funds, so why not the United States, he proposed.
"Every other major industrialized nation but the United States has a budget for how much taxpayer funds are allocated to health care because they've all recognized that you could bankrupt your country without it," Walker said.
The report ignored the much broader point - more government control of the health care industry would create a scenario where the individual has less choice and the government would have the power to ration. Walker wasn't making the case that employers and individuals should ration, but if the government were to seize control of one-sixth of the U.S. economy, the argument for rationing would gain strength.
"Listen, we ration now, we just don't ration rationally," Walker continued. "There's no question there's going to have to be some form of rationing. Let me be clear - individuals and employers ought to be able to spend as much money as they want to have things done. But when you're talking about taxpayer resources, there's a limit as to how much resources we have."
Editor at Large
Comments Policy
well hell. Let's just do what the tibetans do...
Mon, 11/23/2009 - 13:29 ET by Calypso Jonesdon't wait for them to die though...take them and place them out in the open to die of exposure. There. Now everybody's happy.
Unbelievable the cavalier attitude of these people. This is incrementalism....little by little, hearing this over and over, we'll eventually get to the point where starving and withholding liquids from our elderly and ill will be perfectly normal. Is this what we're leaving for our children?
That doc
Mon, 11/23/2009 - 13:33 ET by StarAZThat doctor who talked the most on there rubbed me the wrong way--so know-it-all supposedly matter of fact, no one gets it but him, he is the only one with common sense. He may have been at many a bedside of strangers trying to talk them into giving up or leaving the hospital (I am sure they would say "against medical advice"), but I wondered how it went with HIS mother--"Hey, Mom, face facts, it's over for you, everyone dies."
Oh, and by the way
Mon, 11/23/2009 - 13:35 ET by StarAZWhat would that guy charge for being a death panel of one? What would medicare reimburse?
Well, I sure wish this had
Mon, 11/23/2009 - 13:35 ET by ThisnThatWell, I sure wish this had been pushed on the Ft Hood murderer. How much did it cost to save his life? And now that he's paralyzed from the chest down, why are we continuing to spend precious resources on this A-hole? Come-on MSM, practice what you preach and get on the bandwagon for true rationing -- let this murderer die.
And while you're at it, MSM, why don't you also highlight the rediculous sex-change operations that are given to prisoners? Don't you think that rationing would be helpful here, also?
__________
"mmm, mmm, mm. Barrack-Hussain-Øbama↓." - The liberals coolaid drinking song
car accidents and gun shot calls
Mon, 11/23/2009 - 13:37 ET by seven911 processes many calls to injuries. They dispatch a helicoptor to take a victim to the ER. This costs a lot of money. should we wait to see if they die at the accident scene before wasting money taking them to surgery and having them pronounced dead on the OR table? Folks, this isn't just old people that cost a lot previous to dying.
Well Mr. Kroft, what's
Mon, 11/23/2009 - 14:17 ET by dscottWell Mr. Kroft, what's scurrilous is the idea that grandma and grandpa who PAID all their lives via the Medicare payroll tax should be thrust aside and be denied treatment in favor of a group of people who didn't pay for it. Of course you use an inflated number, the 46 uninsured you claim to create the pretense of a crisis. BTW- 15 million of them are illegal aliens who are here without our permission but racking up medical bills and draining social services at tax payers expense.
But that's socialism for you, the thuggery of the politically connected to sheer the sheep and feast on the lambs.
Nancy Pelosi and Harry Reid, starving the poor one gallon of ethanol at a time. Fill your tank with E85 and cull a village.
I agreed
Mon, 11/23/2009 - 14:22 ET by jbeeebI agreed with much of what Kroft had to say. And what he had to say is what is wrong with the to health bills that we have in front of us today.
These bills do nothing to elminate the "per procedure" billing methods we have today...methods that encourage doctors and hospitals to run tests whether needed or not. These bills do nothing to eliminate costly legal challenges that force the medical profession into CYA mode. These bills do nothing to make customers accountable, instead they will become less accountable for their health care as every cost will be picked up by either the government or the insurance companies.
"End of Life" Care
Mon, 11/23/2009 - 14:24 ET by Kingfish17Not spending money for "End of Life" Care is an idea that is depraved. End of life care only happens when someone dies. On many occasions the care that is given may save the individual's life. Does a pacemaker put inside an 82s year old that improves their quality of life and extend their life into their 90s qualify as "End of Life" Care? I don't think the individual receiving the pacemaker would term it that way.
But if they died during the operation procedure for the pacemaker, it could be argued that the care was not worthwhile and was a wasted "End of Life" expense.
So who is it going to be that makes that argument as to whether an individual should recieve care? When you take it out of the hands of the family, it's going to be rationed, and it's going to turn into a government cronism system. Bribes will be payed so Uncle Leo can get that operation. Corruption is just one of the many reasons why health care decisions cannot be left up to the government.
I can't help but think...
Mon, 11/23/2009 - 14:45 ET by inquiringmindI can't help but think had any of this rationing stuff been brought up by the Bush administration it would have been hammered 24/7 by the MSM.
Conumdrum
Mon, 11/23/2009 - 14:49 ET by Joe CamelI watched my wife's brother die from cancer there was not any hope of curing. They eneded up spending tons of dollars to no avail, did not increase his life one day. Hospice came in on the last 5 days of his life.
My wife had cancer, and it had a very high cure rate, which thankfully was cured.
Both times of watching this play out, I was amazed at the number of deathly ill people who received chemo and radiation, to the point of it literally killing the patient. Patients could not even sit up receiving it, knowing full well it would not cure.
As torn as I am about this, I still would not take away any hopes they may have/have had. I would hope they would feel the same about me. These pundandts who spout off about let granny die will be there one day. Maybe they will just kill themselves prior to getting there, and save us all some dollars. If enough liberals would do that, well, case solved.
Eliminating the Conundrum
Mon, 11/23/2009 - 15:11 ET by Kingfish17You make an excellent point. As long as care is provided by the government and there is no cost to the family or the individual, then there is no incentive to remove these costs. This is precisely why there has to some cost incentive restored to the individual and family involved in health care.
I have a high deductible health insurance policy to save on my premium costs. I pay the first $10,000 per year of all my medical expenses. Recently, my doctor recomended that I have a test procedure performed. I called a few local hospitals to inquir as to the costs. One hospital quoted me a cost of $2,596 for the test. When I told them I was going to pay for the procedure up front, they told me there would be a 58% discount! This is absurdity.
We have to figure out a way to incent elderly people to shop around and consider whether or not they should undergo certain types of treatements. It could be a system of "health care credits" or the like that they could pass on to the kids if they go unused. We have to get a handle on costs without allowing a "death panel" to dictate to us whether or not we get a procedure.
I agree Kingfish, we have a
Mon, 11/23/2009 - 15:32 ET by Radical1979I agree Kingfish, we have a plan similar to yours. I think everyone needs to feel some of the cost of their healthcare. Otherwise there are individuals who will abuse the system and drive up costs for everyone. Just another reason I hate this bill.
Yeah, you know we are all
Mon, 11/23/2009 - 16:29 ET by Dan The Man 2Yeah, you know we are all gonna die sometime but when is variable. How many of us would pay for our care if we knew it to be life or death. Or how many of us can afford to pay for it. The ability to pay for care has been and will continue to be the problem. How much and what kind of care should we recieve and who pays for it?
In the modern insurance schemes the cost of catastrphic proceedures are born by the collective of people that bought into the policies. And this method invaribly limits what and when the insurer will pay calculated on actuarial tables. The government works simiarly but at a different level; the one that stipulates all are covered no matter what.
Rationing is inevitable no matter if we have private plans or if we have a government plan and we are gonna pay through the nose with either.
It's only a financial
Mon, 11/23/2009 - 15:36 ET by dscottIt's only a financial conumdrum for bureaucrats in their zero sum games. Science is advanced by both successes and failures, this is no different for Medical science. Each patient undergoing treatment provides the basis of proving or disproving the validity of any given treatment during a specific phase of any given disease. Like it or not, medical science is a trial and error process. Like all such processes, the newest treatments are always more expensive and less effective than established ones since the R&D hasn't been fully amortorized.
What these thoughtless short sighted liberals fail to realize is in attempting to save grandma, medical science is advanced at some point in the future that treatments that are currently a crap shoot become a routine life saving regime. This is essentially true of every established medical cure/procedure we have today. In fact I would challenge these libs regarding the efficacy of Appendectomies. During the 1800s it was no more efficacious than do nothing. Your wife can thank all the people who died before her for the success of her treatment, just as your brothers wife will be thanked for her contribution to saving the lives of those yet to fight cancer.
BTW- in this same thought, how many of you think Alzheimers and Dementia could be cured if saved a couple billion of wasted dollars from the fraud occuring in Medicare and Medicaid the libs are so fond to claim they can prevent at some undetermined point in the future? Fully two thirds of nursing homes and ALFs could be emptied out by curing these two diseases and this is where the majority of Medicare spending occurs. Where's the rush to do so by libs?
Nancy Pelosi and Harry Reid, starving the poor one gallon of ethanol at a time. Fill your tank with E85 and cull a village.
The Post Office is
Mon, 11/23/2009 - 15:14 ET by deerjerkydaveThe Post Office is contemplating cutting Saturday delivery: RATIONING.
I wait in line for over an hour at the DMV to get any service: RATIONING.
Social Security eliminates cost of living increase: RATIONING
The list goes on and on....and health care is next.
I'm not sure I understand
Mon, 11/23/2009 - 15:29 ET by Radical1979I'm not sure I understand it. Government wants to take over healthcare. This means due to costs we may have to reduce care for elderly people because it's expensive etc. However, the government won't allow an elderly person to pay for the care themselves if they take over healthcare. So instead of some elderly people dying before they have to because they don't have the money for treatments, all elderly people will die before they have to, even if they have saved and can afford life saving procedures. Is that what this is saying?
god forbid somebody talk
Mon, 11/23/2009 - 17:13 ET by sajc05god forbid somebody talk about how expensive our health care system is. it costs half a million to keep a 90 year old man alive on a machine for 2 weeks? why can't he die naturally with his family or at hospice? why are we/future generations paying for that?
stop trying to scare people about death panels and let's have a honest debate about the costs of health care and how we can fix it. it's estimated that our debt including the money owed to medicare and especially medicare part D is 50 trillion. We can't afford that. but people here think it's the taxpayers duty to fund end of life care that in most cases is unnecessary and too costly.
saj... What pray tell
Mon, 11/23/2009 - 17:33 ET by bigtimersaj...
What pray tell makes you think it's any of your or the govt's business to decide what we all do...enough is enough...and I, for one have had enough, it's been bad enough all the years I've been alive to watch our freedoms eroded over the decades incrementally.
govt needs to butt out, get the hell out of our way, go home and shut the hell up.
I've past had my fill...this country is in the mess it is in because of the fed. govt...and it isn't going to get any better with what is coming///I guess freedom means nothing to you on the left...nothing at all...working people are going to be complete slaves, instead of part time now if this administration gets what they want accomplished.
Cradle to grave is what you lazy losers depend on...and people like you wonder why the word revolution comes up.
'Doubling down on stupid is not a particularly good idea'~Breitbart
I'll tell you why it's my
Tue, 11/24/2009 - 10:21 ET by sajc05I'll tell you why it's my business BECAUSE IT'S MY MONEY. who do you think funds medicare? you think it's free? nope, it's running deficits that are on ours and future generations shoulders.
Oh I see, what's yours is
Tue, 11/24/2009 - 11:29 ET by dscottOh I see, what's yours is yours, but what's mine is ours...so that's how that goes.
The libs have speciously claimed they will save billions in fraud and waste. So why haven't they acted on it all these years? You think it got that way over night? The very bureaucrats who administer the current system will also be the same ones administering the expansion of the Medicaid system to cover all the so called uninsured. What makes you think the same bureaucrats will suddenly turn over a new leaf by expanding the system? That's just plain naive.
The projections of deficits are based on the assumption if nothing changes in the way the system is run plus adding more people due to the baby boomers, the costs will go up proportionally. However, what the you and the liberals refuse to do is change the system. You people are so myopic you refuse to change the pardigm in order to adjust the population trends. Instead of lamely doing what you always do, that is let the bureaucrats (i.e. liberal make work program) run the system, you could bring in innovation by looking at how the money is spent in order to even see IF there is a way to do it more cost effectively. Here's a thought, instead of spending billions to administer the program why not spend the money instead on actually curing diseases??? Why that's just too radical for liberals, because it's just common sense to conservatives. The bulk of the Medicare costs is caring for people with Alzheimers and Dementia, fire a 1000 bureaucrats and spend the money on a cure. Your president odumbo is too stupid to figure that one out, that's why he ignorantly claims the most money is spent on that last years of life. Duh, if you cure the friggin disease you won't be spending the big bucks on trying to keep them alive. Novel isn't it?
Nancy Pelosi and Harry Reid, starving the poor one gallon of ethanol at a time. Fill your tank with E85 and cull a village.
We've been saying how to
Mon, 11/23/2009 - 17:37 ET by RR GOPWe've been saying how to fix it...tort reform to bring down medical malpractice insurance costs and de-regulation of health insurance companies so we can have the same choices we have now with car insurance...more competition = lower premiums.
One of the 34% who thinks George W. Bush was a great President. One of the 86% who wants to bring back the stock and pillory.
I love it when government
Mon, 11/23/2009 - 19:33 ET by deerjerkydaveI love it when government regulation chokes off an industry and the politicians and their lemmings blame the free market. The medical insurance industry is regulated up the wazoo!
Ronald Reagan had it figured out 30 years ago, "Government's view of the economy could be summed up in a few short phrases: If it moves, tax it. If it keeps moving, regulate it. And if it stops moving, subsidize it."
Yep DJD
Mon, 11/23/2009 - 20:12 ET by general companyI love to ask them "how". Just because it does, is the typical answer. I had a PHD tell me the other day, "that it's common knowledge" that capitalism doesn't work? 2 days now, and he still cant tell me "how".
My Gov. thinks I am dangerous, so be careful
"Television is a freak show" Bernie Goldberg
thats so wrong. first it's
Tue, 11/24/2009 - 10:18 ET by sajc05thats so wrong.
first it's been so widely documented (by non partisans) that tort reform, while something i agree with, is such small fraction of the costs that it would barely dent.
deregulate? they need regulation. they've already formed monopolies and you want to give them more freedom to rip off americans? why do you hate the american people so much that you feel they should be allowed to get ripped off by health insurance companies and denied coverage for bs reasons?
That's right, it's the old
Mon, 11/23/2009 - 19:58 ET by dscottThat's right, it's the old people's fault for living. Let's not keep our commitments and just because they're vulnerable let's cheat them out of all the money they paid into the system all their lives. Right??? You moronic leftist, let the government decide who lives and who dies based on their utilitarian value? How much are you worth to the government, I value you between jack and squat.
You ever heard of the 14th amendment? EQUAL TREATMENT UNDER THE LAW, you barbarian.
Nancy Pelosi and Harry Reid, starving the poor one gallon of ethanol at a time. Fill your tank with E85 and cull a village.
Because it's life
Mon, 11/23/2009 - 20:08 ET by general companyit costs half a million to keep a 90 year old man alive on a machine for 2 weeks?
So what? Whats it to you? Wonder how you will feel about this when and if your 90? Also it cost the same for a 80yr old, 70,60,40,20,10? Life is precious, not easily acquired, why should'nt we fight for every hour?
stop trying to scare people about death panels and let's have a
honest debate about the costs of health care and how we can fix it.
Yea, why scare them with death panels, when sajc05 thinks they shouldn't get the last 2 weeks anyway?
it's estimated that our debt including the money owed to medicare and especially medicare part D is 50 trillion.
You do understand this bill is medicare D on steroids? If you honestly cared about the cost of health care, you would help us get the fed out of it.
We can't afford that. but people here think it's the taxpayers duty to
fund end of life care that in most cases is unnecessary and too costly.
What the heck? So what is it? Should we provide HC for the unfortunate or not? Should it be selective, bigoted, stereotyped, because that is what the above statement suggest.
My Gov. thinks I am dangerous, so be careful
"Television is a freak show" Bernie Goldberg
dscott, gc, etc... People
Mon, 11/23/2009 - 20:19 ET by bigtimerdscott, gc, etc...
People like saj forget they too will age if they live long enough, that it may be themselves in the very position.
Time flies...life is but a fleeting moment in the long scheme of it all...it's natural to cling to those moments you have.
'Doubling down on stupid is not a particularly good idea'~Breitbart
At least the Marxists have
Mon, 11/23/2009 - 17:34 ET by RR GOPAt least the Marxists have the decency to soften the blow by releasing these things piecemeal...you know, getting into our minds how things are going to be.
While they're fattening us up, I guess they're hard at work manufacturing the mint jelly...in China of course.
One of the 34% who thinks George W. Bush was a great President. One of the 86% who wants to bring back the stock and pillory.
Medicare in super shape...
Mon, 11/23/2009 - 23:51 ET by ScrapironMedicare must be in super financial shape if President O'Dumbo and the congressional clowns can steal $500 billion from the seniors who paid into it all of their working life and give it to bums who never work or contribute. I keep hoping the terrorists will ration the life of all current congressional clowns to today only.
Old, Retired and glad of it.
Bingo, what's really going
Tue, 11/24/2009 - 11:11 ET by dscottBingo, what's really going on here is the Democrats don't want to pay back the money they stole for their so called investments. They stole both SS and Medicare funds and now they are blaming the intended recipients for costing too much money. I call that nerve. This would be like Bernie Madoff blaming the people he fleeced for demanding the return of their funds.
Nancy Pelosi and Harry Reid, starving the poor one gallon of ethanol at a time. Fill your tank with E85 and cull a village.
ice
Tue, 11/24/2009 - 03:45 ET by sudmufThe environmentally sound thing to do is ship grandma to Alaska and put her out on the tundra as polar bear food.
Like throwing polar bears
Tue, 11/24/2009 - 10:00 ET by apathy311Like throwing polar bears out of airplanes! I can see these commercials for healthcare. Kill 2 birds with 1 stone.
And you will cry out in that day because of your king whom you have chosen for yourselves, and the Lord will not hear you in that day...
Self Defeating
Tue, 11/24/2009 - 09:59 ET by apathy311"Let me be clear - individuals and employers ought to be able to spend as much money as they want to have things done. But when you're talking about taxpayer resources, there's a limit as to how much resources we have."
So as an "individual" I should be able to have whatever care I can pay for, but as a "taxpayer" I should be limited so others can get care as well. Last time I checked I thought individual citizens in the US were taxpayers...oh wait...unless you're an illegal alien. My bad.
And you will cry out in that day because of your king whom you have chosen for yourselves, and the Lord will not hear you in that day...