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Denise
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25 posted 01-16-2011 03:03 PM       View Profile for Denise   Edit/Delete Message      Find Poems  View IP for Denise

Medicaid quality measurement program (Section 2701, p. 518)

Medicare value-based purchasing program (Section 3001(a), p. 613)

Medicare value-based purchasing demonstration program for critical access hospitals (Section 3001(b), p. 637)

Medicare value-based purchasing program for skilled nursing facilities (Section 3006(a), p. 666)

Center for Medicare and Medicaid Innovation (Section 3021, p. 712)

Medicare shared savings program (Section 3022, p. 728)

Demonstration project for payment of complex diagnostic laboratory tests (Section 3113, p. 800)

Independent Payment Advisory Board (Section 3403, p. 982)

Primary Care Extension Program to educate providers (Section 5405, p. 1404)


I would imagine that some or all of these agencies may have a direct impact on the health delivery decisions made under the new law.
Denise
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26 posted 01-16-2011 03:07 PM       View Profile for Denise   Edit/Delete Message      Find Poems  View IP for Denise

The bottom line, Uncas, is that the government has new an unprecidented powers that will effect our healthcare delivery.

They will hold the purse strings, they will mandate what doctors and hospitals can and cannot do, and for whom, under threat of fines and sanctions.

It doesn't take a rocket scientist to ascertain where this will lead.
Uncas
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27 posted 01-16-2011 03:53 PM       View Profile for Uncas   Email Uncas   Edit/Delete Message      Find Poems  View IP for Uncas

quote:
I would imagine that some or all of these agencies may have a direct impact on the health delivery decisions made under the new law.


You've had a bet and now you're imagining Denise?



quote:
It doesn't take a rocket scientist to ascertain where this will lead.


I agree, what it takes is someone to actually go through each of the points in the bill that you've listed and try and find evidence of this mythical death panel. Before I start is that your final list Denise? You aren't going to suddenly decide that the evidence is under the bed or hiding in the closet if I can't find it in the bill?

Denise
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28 posted 01-16-2011 04:06 PM       View Profile for Denise   Edit/Delete Message      Find Poems  View IP for Denise

Check out all or most of the other ones on the list if you'd like to.

No matter what you call it, death panel, advisory board, quality control commission, if the government has control to grant or deny care through regulation on healthcare providers or through the powers of the purse, then that is essentially a death panel, even though it isn't called that.
Balladeer
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29 posted 01-16-2011 04:24 PM       View Profile for Balladeer   Email Balladeer   Edit/Delete Message      Find Poems   Click to visit Balladeer's Home Page   View IP for Balladeer

You aren't going to suddenly decide that the evidence is under the bed or hiding in the closet if I can't find it in the bill?

Didn't take that long to  get back to the way it was, I see. Refraining from personal potshots or insults seems to be too difficult to do for some.
Uncas
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30 posted 01-16-2011 04:40 PM       View Profile for Uncas   Email Uncas   Edit/Delete Message      Find Poems  View IP for Uncas


If you have a complaint Mike then I suggest you report it, there's a button at the top right of each post.

quote:
Check out all or most of the other ones on the list if you'd like to.


What you're asking Denise is akin to claiming that pixies exist and then asking me to go catch you one to prove your case.



I'm a little dumb, but not quite dumb enough to go on a wild pixy hunt without at least a couple of clues as to their possible whereabouts.

I'll do a couple of searches relating to Death Panels and see if I can pinpoint which part of the bill prompted the claims, I'll let you know what I find.

.
serenity blaze
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31 posted 01-16-2011 04:46 PM       View Profile for serenity blaze   Email serenity blaze   Edit/Delete Message      Find Poems  View IP for serenity blaze

In the absence of a Living Will--which I believe should be accompanied by counseling in the form of information, an emergency situation forces the family of the person to become the 'death panel'.

It's difficult enough to lose a family member without bearing the guilt of such a decision, and one can never gasp at medical miracles again without second-guessing the entire nightmare scenario over and over. And over.
Balladeer
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32 posted 01-16-2011 04:47 PM       View Profile for Balladeer   Email Balladeer   Edit/Delete Message      Find Poems   Click to visit Balladeer's Home Page   View IP for Balladeer

Just an observation...no complaint. I'll simply wait for the forum to be closed again because of people unable to restrain themselves from tossing out personal insults and zingers.
Denise
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33 posted 01-16-2011 04:51 PM       View Profile for Denise   Edit/Delete Message      Find Poems  View IP for Denise

lol...I didn't ask you to do anything, Uncas, you offered! I accepted. If you don't want to, don't.
Uncas
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34 posted 01-16-2011 05:09 PM       View Profile for Uncas   Email Uncas   Edit/Delete Message      Find Poems  View IP for Uncas


I offered to check the list you supplied Denise but I get the feeling you're just going to suggest that it must be somewhere else in the text when I've finished the first list. If you can supply some solid evidence that at least points me in the right direction my offer to look at e evidence is still open.

If not I'll file the Death Panel remarks under "Unsubstantiated Claims" or "Hearsay".

serenity blaze
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35 posted 01-16-2011 05:18 PM       View Profile for serenity blaze   Email serenity blaze   Edit/Delete Message      Find Poems  View IP for serenity blaze

Well, I hope I didn't offend anyone--I confess I didn't read the entire thread--I'm having a bad head day.



And OH--Forgive me all for going off topic here--Reb, I wrote to you through Pipmail, but I guess I can ask you (or everyone) what happens to our Constitutional rights when Martial Law is put into effect?

(I'm not sure if I know the answer, since I only really know what I know by personal experience.)
Uncas
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36 posted 01-16-2011 05:24 PM       View Profile for Uncas   Email Uncas   Edit/Delete Message      Find Poems  View IP for Uncas

Thanks for the observation Mike.

I'll keep my eye open for zingers and personal attacks and report any I see, I suggest you do the same. Confronting people about comments you believe are unacceptable in the thread itself is probably a bad idea. I'm fairly hard to wind up but other folk may take it as an invitation to start a slanging match and hasten the thing you're so dead set against happening - the closure of the forum.

Then there's always the possibility that you might get it wrong Mike, that what you perceive as a zinger or insult turns out to simply be a bit of good humoured banter between people who have the greatest respect for each other. In that case your accusation is, in effect, an unwarranted attack on another member, or a false accusation, something I'm sure you'd rather avoided.

I think that the safest thing all round is to just report the abuse.


[This message has been edited by Uncas (01-16-2011 06:28 PM).]

Denise
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37 posted 01-16-2011 05:42 PM       View Profile for Denise   Edit/Delete Message      Find Poems  View IP for Denise

I took it as an offer to add to the list before you got started, Uncas. I guess I misinterpreted what you meant.

I think that this board would probably qualify as the most likey one to have the power to determine what is paid for and what is not paid for and for whom and therefore deny treatment based on a determination of quality of life/life expectancy formula:

Independent Payments Advisory Board

Do you believe that the government will not attempt to limit care to anybody once they are footing the bill? If not, then why the fines and sanctions on healthcare professionals who choose not to abide by the government issued protocols?

Karen, why would you have offended anyone? And why would Martial Law have to be put into effect?
serenity blaze
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38 posted 01-16-2011 05:48 PM       View Profile for serenity blaze   Email serenity blaze   Edit/Delete Message      Find Poems  View IP for serenity blaze

Hey Denise.

It is admittedly an off topic question and I probably should have formed it as a question in a separate thread. But when I start a thread, I feel compelled to follow it.

But trust that I have lived under Martial Law.

"It" Happens.
Ron
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39 posted 01-16-2011 06:19 PM       View Profile for Ron   Email Ron   Edit/Delete Message      Find Poems   Click to visit Ron's Home Page   View IP for Ron

quote:
I think that this board would probably qualify as the most likey one to have the power to determine what is paid for and what is not paid for and for whom and therefore deny treatment ...

When did we stop calling that "insurance company," Denise?

There's nothing wrong, I suppose, with conjecture. Except maybe when it's presented as fact? And when it's sole purpose seems to be to frighten people into doing what one wants?
Uncas
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40 posted 01-16-2011 06:24 PM       View Profile for Uncas   Email Uncas   Edit/Delete Message      Find Poems  View IP for Uncas


quote:
what happens to our Constitutional rights when Martial Law is put into effect?


Technically martial law is the temporary transfer of power of all three government branches to the military during a time when the local legal system and law enforcement is unable to function. It's basically a suspension of habeas corpus.  The highest-ranking military officer would, in effect, be the legislator of what constituted an offence as well as the judge, juror and, potential, executioner.

So under martial law your temporary constitutional rights would be whatever the military commander, or highest ranking officer on the ground, deemed them to be.

But it's a lot more complicated than that.



Louisiana was deemed to be under martial law after Katrina, though Louisiana doesn't have any reference to martial law in its statutes - Instead it's called something like " A state of public emergency". At that time the Governor took on the mantel of commander.

Several other impositions of martial law have resulted in the mobilisation of military forces in the US while maintaining civil control.

Lincoln put the whole country under martial law during the civil war, but the Supreme Court judged that it was unconstitutional to suspend habeas corpus in areas where the civil authorities could still function. So full martial law is unlikely.

Oh! Only congress can suspend habeas corpus and therefore impose martial law, however the president can impose it in an emergency but it needs to be agreed or rejected by congress at the soonest possible time. It's one of those checks and balancey thingys.

Hope that helps.
Denise
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41 posted 01-16-2011 06:33 PM       View Profile for Denise   Edit/Delete Message      Find Poems  View IP for Denise

No problem, Karen. Let me know what you find out?

That's one of the new government boards, Ron, not an insurance company.

Conjecture? Sure, I guess you can call it that, but can we safely assume that with all the new government powers created under this new law that they won't exercise any of that power when the money is under their control? Are they issuing mandates on healthcare providers and levying fines for lack of compliance to government protocols just because they have nothing better to do, or do you think it might have something to do with the money aspect and how and for whom they want it spent?

serenity blaze
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42 posted 01-16-2011 06:42 PM       View Profile for serenity blaze   Email serenity blaze   Edit/Delete Message      Find Poems  View IP for serenity blaze

Thank you, very much, Uncas.

(My apologies for the intrusion, too, Reb.)

I really should start a Karen's Krazy Kwestions thread...and OH--I don't really think that my pocket copy of The Constitution will get me through a National Guard checkpoint, but I carry it anyway.



Love to all.
serenity blaze
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43 posted 01-16-2011 07:17 PM       View Profile for serenity blaze   Email serenity blaze   Edit/Delete Message      Find Poems  View IP for serenity blaze

Hmmm.

Even on a bad head day, I still have questions.

I am confused (or mentally ill) depending on the definition.

I do hope no one takes offense at my questions, but I am wondering, as we learn more about mental illness, regarding how the gap between mental illness and physical illness is bridged.

The human brain (definitely physical) is subjected to so many trials during a lifetime, and the last information I'd read in science daily is the remarkable ability for some people's brains to overcome trauma, while others are fraught with emotional frailty.

If we must talk about "death panels" I assert that we must also talk about, in the context of these trying times, of "sanity panels".

As I hear protests of socialized medicine, I can't help but think of places with names such as "Pathways", "Promises" and yep, I even heard of one called "Serenity" which basically assists people who are deemed to be in need of social skills. These places are government sponsored and rely on communal contribution.

This means, although I have never been directly involved in such a place, that if a person is "involuntarily committed" by the authorities (deemed as dangerous to themselves or the general public) and thereafter, during treatment, show promise of being able to become a contributing member of society yet again, they are sent to what we deem "Halfway Houses".

These houses (one of which looks like any other home around the corner to me) operate with the support of government funding, as well as by seizing whatever privately owned funds or material objects to subsidize the "household". If someone has no such alternate funding, counselors are provided to apply for unemployment, disability, or welfare--each according to the applicant's need.

Applicant.

Sounds voluntary, and sometimes it is.

Where is the cry of "slippery slope" of socialized medicine in these cases? If I'm wrong about this being a form of socialized medicine, somebody please be patient enough to explain to me what the difference(s) might be.

Such places have been around for half of my life now, which happens to be nearing a quarter of a decade. In spite of all of my efforts otherwise. ?
Uncas
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44 posted 01-16-2011 07:28 PM       View Profile for Uncas   Email Uncas   Edit/Delete Message      Find Poems  View IP for Uncas

quote:
Independent Payments Advisory Board


Denise,

Would that be the same Independent Payments Advisory Board that is restricted, by law, from acting anything like a death panel?

"The proposal shall not include any recommendation to ration health care, raise revenues or Medicare beneficiary premiums under section 1818, 1818A, or 1839, increase Medicare beneficiary cost sharing (including deductibles, coinsurance, and copayments), or otherwise restrict benefits or modify eligibility criteria."

Would you care to take another guess?


Ron
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45 posted 01-16-2011 07:31 PM       View Profile for Ron   Email Ron   Edit/Delete Message      Find Poems   Click to visit Ron's Home Page   View IP for Ron

quote:
Conjecture? Sure, I guess you can call it that, but can we safely assume ...

Safely assume? LOL. Those two words would should never be used together, Denise. Of course, I call it conjecture, Denise. I'd even go so far as to call it wild conjecture. Every single thing you've said about national health care (a misnomer for insurance) applies to private health care (i.e., our current insurance industry) and has for something like a hundred years. You haven't offered one single thing that isn't conjecture and guesses. Not one thing.

quote:
Are they issuing mandates on healthcare providers and levying fines for lack of compliance to government protocols just because they have nothing better to do ...

No, they're doing it, Denise, because our present health care is system is broken. They "think" they know how to get the costs back under control, but nothing will work so long as there are outliers who refuse to cooperate.

Here's just one example of what I mean.

Let's say you and nine other people become a state. You and eight of those people agree to fund a program to cover everyone's health insurance. Doing so manages to drive down the cost of health care a little bit for everyone. But there's that tenth guy standing over there doing nothing. He doesn't pay into the fund. He does, however, soon enough get sick. Do you let him die? Of course not. That wouldn't be humane. So you pay for his care when he gets sick -- and the savings you thought you had are very quickly gone.

That's pretty much our current system. Your only two choices are to let him die or FORCE him (you used the words mandate and fine) him to cooperate with everyone else and pay his fair share into the fund.

The government thinks cooperation will help bring costs down for everyone. It would be nice if that cooperation was unanimously voluntary, but I suspect you and I both stopped believing in fairy tales a long time ago, Denise.


Denise
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46 posted 01-16-2011 08:05 PM       View Profile for Denise   Edit/Delete Message      Find Poems  View IP for Denise

Something just came to mind, Uncas. There was a provision inserted into the Stimulus Bill creating a Federal Health Care Panel to decide which medical treatments and drugs were medically necessary and cost effective. That's probably what was in the back of my mind. It's not part of the main healthcare law, but law nonetheless.

Ron, I was thinking more of the mandates, fines and sanctions against physicians and other healthcare providers who don't come into compliance with the government's regulations regarding electronic medical records and treatment protocols.

Ron
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47 posted 01-16-2011 08:38 PM       View Profile for Ron   Email Ron   Edit/Delete Message      Find Poems   Click to visit Ron's Home Page   View IP for Ron

Again, Denise, they're simply mandating cooperation. The doctor who keeps your records on the back of an envelope in the top drawer of his desk raises costs for everyone when you inevitably have to see another doctor.

In a free enterprise system, all the doctors and all the patients could do anything they wanted. The market would cull all those outliers and force costs into line. But we don't have a free enterprise system and we won't unless you and everyone else agrees to start paying your own bills. No one seems to want to do that, though, do they?

The alternative, at least the way our government sees it, is to eliminate this partial-not-quite-Socialist-cooperate-if-you-want-to system that clearly isn't working and go to one where everyone cooperates whether they want to or not. Sort of like the IRS, you know?

Denise
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48 posted 01-16-2011 08:57 PM       View Profile for Denise   Edit/Delete Message      Find Poems  View IP for Denise

So far the courts are saying that the cooperate whether you like it or not is unconstitutionl regarding the purchasing of a good or service. We'll have to wait to see how that all turns out. The system won't work without it.

Maybe they will go back to the drawing board, repeal this mess, including the provision they snuck into the Stimulus Bill, and start over with more market-based solutions. I know it won't be a true free market based system but they have to come up with something better than this socialist one.

One thing they could do, and I don't know why they don't, is to make Medicare voluntary. Not everyone needs it, and yet as the law stands, there is no choice...boom...once you hit 65 you are on Medicare and your own private insurance becomes your secondary insurance.

They might also consider making Social Security means tested...not everyone needs that either.  
Ron
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49 posted 01-16-2011 10:08 PM       View Profile for Ron   Email Ron   Edit/Delete Message      Find Poems   Click to visit Ron's Home Page   View IP for Ron

quote:
... and start over with more market-based solutions. I know it won't be a true free market based system but they have to come up with something better than this socialist one.

Why not just advocate for that true free market based system, Denise?

Free enterprise, to mangle an old cliché, is a bit like being pregnant; there is no half-way. Rent control, price fixing, and insurance don't just make a mockery of Capitalism, they eviscerate it. Maybe those things could actually work if done correctly; I don't really know, in large part I suppose because they've NEVER been done correctly. We've never had a society smart enough to improve on a free market. And every time they've tried, they've just gummed up the works.


 
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