Healthcare

“Death Panels Do they Exist?  You Decide”
-A contribution from Blue Eyes

The American people are learning more and more of the pervasive half truths being put out in defense of H.R. 3200! Friends, half truths are the only information being disseminated by the Administration and Congress and if taken as the whole truth will cause you to make the most tragic mistake of your life to allow this bill to become the law of the land. Follows is a discussion of facts and analysis of the issues surrounding health care rationing, eugenics and care limitation that are in the system in or contemplated in this reform package.

First let me apologize for the incessant use of acronyms, but that is an aspect of discussing government laws. The Feds love to create long winded friendly sounding names for bills and actions and then reduce these descriptions to workable substitute short names that create the idea of “alphabet soup.”

During the last week, ending August 16th, 2009, it was called to the peoples attention by a high profile public figure that there was provision in HR 3200 healthcare reform creating a "Death Panel" that would choose who received access to vital medical services and who did not. On Saturday August 15th., the Administration began from President Obama down, media spin and pressure stating there is no such thing as a "Death Panel" in the HR3200, and in fact that as the half truth is correct. It is not in HR3200 specifically, but it is provided for in HR 3200. But that HR3200 not having specific provision for these atrocious provisions doesn’t mean that such “Death Panels” are not going to be in the final plan if passed. The shocker is the other half of the half unspoken truth is that Death Panels already exist and their leaders are hard at work as I write the column!

Let’s examine this claim. We had crammed down on us by the Speaker Pelosi’s Congress the “American Recovery and Reinvestment Act of 2009” (ARRA or “Porkulus”) but more on that later. This reform bill is the operative vehicle for the creation of a new entity knows as CERC and was established to devise limitations on and the rationing of medical treatment and is already at work establishing these guidelines! This innocuous new entity “Comparative Effectiveness Research Committee.” newly formed and somewhat secreted work does not now have an implementation arm until after passage of HR3200. However, CERC is charged with obtaining implementation of its recommendations down to the doctor-patient relationship, (links provided below.) This effort awaits the establishment of the national health care reform in what ever form it might take to implement its mandated agenda.

The Administration claims in a “false flag” half truth defense that all that is being suggested in HR3200 is that doctors be paid for counseling patients on how to medically plan their end ... of life. Who could argue with that it’s challenged. This counseling could include final directives. The counseling is to be available, if patient requested, every five years. I believe this advise is far better left to the family and the patients attorney (IMO and I'm not an attorney.) However, the Feds, with much forceful verbiage has sought to discredit the claim of Death Panels in the reform and to further persuade the public that dissent against the Reform Plan is a pressed by a cabal of “right wing nuts.”

That is the true half of the defense, the BIG LIE is that the entire rationing and treatment control mechanism has already been placed in motion and waits to be merged into the reformed heath system as a “Plug In.” The “dark provisions" were not included in the reform package true, but the lie is they instead slipped in to the ARRA in the late night passage of a bill touted to be an emergency bill to which no Democratic Congressional Representative read and no Republican representative was allowed to read before voting! Getting the picture here?

There is not such Death Panel in the Bill …. Under their breath it already exists!

Why was the newly created CERC needed? Good question! Especially when within the National Institutes of Health exists the long established agency named now “Agency for Healthcare Research and Quality, or ACHQ.” This existing and currently funded agency is well ensconced in the NIH and has been tasked for years to perform the highly similar role of the newly created CERC. Why a new entity? To be funded by the NIH AND AHCQ as opposed to just having the ACHQ take on the duties contemplated? The Administration and Congress claim that the AHCQ was not now equipped to do the work and would not be able to react quickly enough to have a positive timely impact on their goals of obtaining fast cost reductions in the nation’s healthcare delivery system. Thus, ostensibly the CERC was created to be a lightning strike force to get things moving quickly while AHCQ ramped up. The reality is the newly formed agency CERC has no resources, no staff and one is to believe that, within the US Government structure and the Beltway, it is expected to get to work faster than an existing arm of government already charged with doing the exact work for many years?

Well when on looks deeper we see that the CERC has a deep and wide panel of medical professionals AND an Ombudsman to be appointed by the Whitehouse. A Dr, Ezekiel Emanuel, brother to Rahm Emanuel, Chief of Staff to President Obama, is Head of the Department of Bioethics at The Clinical Center of the National Institutes of Health and a breast oncologist. Dr. E. Emanuel is also special advisor to President Obama on medical and health care matters as well holds two key positions as health-policy adviser at the Office of Management and Budget and a member of Comparative Effectiveness Research Committee, yes the CERC!

Dr. Ezekiel Emanuel is pejoratively referred to as Doctor Death in the press. Link as to why the good doctor might have brought such a name to himself is reflected in the links listed below. His scholarly papers, speeches are indicative of his opinions and advise to the President and are very germane to this discussion. You research his stated work and decide if this is the man you want governing your care, but for now, let’s just state that he espouses the belief that the young, the impaired and the elderly should not receive care to prevent their early death. (I can’t make this up). This writer suggests to you that the motive for creation of this new CERC was to quickly “end around” the existing established authority on treatment efficacy studied and published by the ACHQ in order to directly set public policy from the Whitehouse under the banner of NIH. By placing the full weight and authority of the Whitehouse on the deliberations of blue ribbon panel in this work, Dr. Emanuel could impose his dark views on the panel on the behalf of the President. Dr. Emanuel could not do this from his existing position inside the NIH, and the President could not lawfully exert such pressure as well, hence the need to exert direct control of the healthcare delivery system from the Whitehouse under a false flagged out of the mainstream civil process in the form of a Blue Ribbon independent effort of the NIH. Getting a clearer picture? The payoff to the NIH and the Dept of health and Human Services was a huge $1.10 Billion dollar budget increase to do what they were already funded to do!

This Half Truth is there is no agency "Death Panel" in the HR3200 bill. True. But, the BIG LIE is it already exists!

With that back ground let’s look at what is to be in the system if passed that would deal with benefits levels and terms and how they get to you and your doctor.

In the HR3200 new entities are created which are:

"Health Choices Administration or "HCA": HCA is established to govern in totality all health care benefits that can be included in insurance offered through the "Health Insurance Exchange or HIE". The HIE is an “insurance mall” allowing individuals to purchase a plan from among many offered in the HIE. Some plans would be through insurance companies, some plans may better fit ones needs than others, but all meet the minimum floor of coverage and policy term requirements. Including in the plans to be offered will be the much distrusted concept of the Public Option Plan, “POP.” If no coverage is provided from any HIE plan, the individual MUST accept the PO, there is no choice as it is mandated that no person will be allowed to live uninsured. The HCA will establish all aspects of what services are allowed to be provided, who may receive benefits in a plan, and any services not to be provided under any plan. No services are to be allowed which are not apart of a Qualified Plan under HCA design and mandate.

All healthcare insurance plans must be obtained from the HIE or the Public Option Plan after 2012, including employer sponsored plans. (It is unclear if employer swill be allowed to offer group plans after 2012.)

In designing the minimum standards for care to be provided by insurance companies and medical service providers the HCA will obtain its base line Comparative Effectiveness Research Data from, the CERC from past studies as promulgated by ACHQ who will be re tasked under HR3200. Again ACRQ is a division of the National Institutes of Health. The ACRQ was vaguely referenced in ARRA but received a huge separate funding. Given, ACRQ not now being authorized for policy decisions at this time it must be re tasked in HR3200. To give it a fast start under HR3200, the CERC established and funded under the American Recovery and Reinvestment Act of 2009 (ARRA or to many “Porkulus”.) The monies to boot strap this effort was $1.1 Billion dollars allocated as follows: $400.0 mil to the National Institutes of Health, $300.0 Mil to AHRQ ($700.0 Mil to the NIH), and $400.0 Mil to Secretary of Health and Human Services (Which manages the NIH). These three entities are to feed data and money to the CERC. Remember, the ACHQ has been in existence for some 10+ years its role in healthcare has been directed to the research and dissemination of healthcare treatment effectiveness information to the entire medical community. The seemingly redundant CERC panel is composed mostly of medical professionals (their individual backgrounds remain UN researched in time for this work), other than a high profile member and emissary of President Obama, again Dr. Ezekiel Emanuel.

(CERC is the Brain Child of Dr. Ezekiel Emanuel brother to Rahm Emanuel the Whitehouse chief of Staff, Dr E Emanuel is the modern father of eugenics and denial of medical care to the young, impaired and the elderly.)

So, we have a new set of agencies that are to be a permanent fixture in such a newly reformed Healthcare Management system. The three entities appear to function as follows: The effectiveness of health care treatments and regime’s are studied and advanced (allowed) or not endorsed (denied) by the CERC and passed on to the ACHQ who then will set treatment guidelines (limits) that will be communicated over to the HCA who will set these guidelines (reimbursement limits) and established health care treatment specifications and operative limitations within every Certified Plan included in the Healthcare Insurance Exchange. Thus, the CERC will set treatment limitations as to the treatments allowed base don cost and “Future Useful Life Years,” who in society can receive these treatments. These decisions are to be sent to ACHQ to establish mandates and controls and the HCA will codify into your policy. The “Death Panel” and the rationing will begin at the CERC and carry into the ACHQ and then to the HCA policy terms that will limit what you and your doctor may include in your treatment. Your doctor will be the one who can tell you if a treatment exists, and if the Healthcare System will allow you to have it.

My dear friends, that’s the facts.

Don’t like it? You aren’t alone, millions of citizens are incensed. Many aren’t sure why they don’t like this bill other than it just doesn’t feel right. Over time, the American People are really good at ferreting out rats. This work might just help others focus their gut feelings on why they have such discomfort. So please link this work to your friends, cut and paste it, but just get it out there.

Want to do something more about it, personally? Start here, demand your Congressional Representatives stop dodging you and explain the specific role and limitations of these four entities CERC, ARCQ, HIE and MCA, make sure they explain in specifics how each agency will work and wow that agency will affect your life. Demand to know if these agencies have authority to establish limits of care for the young, the impaired and the elderly and perhaps even those who have low potential worth to society, and judge for yourself if there is, in fact, a “Death Panel.”

To get the answer you seek you must ask the right question. This Administration will not tell you what you need to know. The will only give you the “Glittering Generalities” to poorly composed questions. Their goal is to pass this grossly flawed bill and will only give you veiled answers to what you ask if you let them. Ask the question poorly and you will mislead yourself!

Want the scales to fall from your eyes? Ask Congress and the President IF:

1. As planned in this set of reforms, as exist now or as planned, if a medically proven treatment is available but not to be reimbursed by a Insurance Policy or the a Public Option will I still be permitted to pay for it individually, not just now but after implementation in 2013.
2. Is there any provision in any reform that now exists in the bill or to be legislated in the bills under consideration (the reforms) which would prevent any administrator or regulator from instituting direct or de facto rationing for any citizen for any proven medically effective treatment for any disorder?
3. If private insurance companies will be able to compete inside the Healthcare Exchange based upon meeting the established guidelines for coverage and terms based upon price?
4. Who will determine the costs of these plans offered in the HIE or the Public Option?
5. If a Public Option is to exist will Congress mandate full cost recovery from insured’s and as well reimburse medical service providers at the same rates as the private insurance firms in the Healthcare Exchange and avoid cost shifting to other insured’s as the Federal Government has undertaken in the Medicare/Medicaid reimbursements? (If the public option discounts reimbursements to providers, then the citizens in the private insurance plans in the exchange will have to pick up the difference.
6. Will I have a trained professional licensed local insurance agent/consultant that will help me understand the choices and to make the selections in the Exchange or Public Option that is best for me?
7. Will my employer be allowed to purchase a group style plan and provide these benefits to me as I generally now receive after 2012 and who would such group plans be purchased?
8. If I purchase a personal plan from the HIE, can I arrange for my employer to deduct my portion of the cost, if any, and remit that to the proper collection entity?
9. Will the proposed reforms include reimbursement for abortions on demand with out limit or number, and if so, will there be any mandated counseling for the patient. Any penalty for abuse?
10. What efforts have been taken by Congress to work out reforms solely in the private insurance industry, to reform the “doughnut hole” in Medicare and to fully fund Medicaid?
11. Will all plans be required to provide the latest proven care to citizens with Aids regardless of age?
12. Will the regulations require covered non citizens to pay for their coverage, if not how does the Administration and Congress plan to pay for these individuals.
13. Will the plans allowed in HIE to offer coverage better than the “minimum” standard which could include excluded therapies: for drugs and courses of treatment disallowed by the MCA or other agencies charged with effective rationing? If not, why not?

When you’ve got these answers I believe you will see that this bill can’t be fixed, but only killed. We need healthcare Reform, but this approach is UN American.