1 January 2011 We only want your bureaucrats out of health care

Conservative state lawmakers target abortion pills prescribed over Internet

“Conservative lawmakers in some states are taking aim at a practice that they say could greatly expand the number of women who choose to terminate their pregnancies: Abortion pills prescribed over the Internet.

State lawmakers in Iowa and Nebraska have announced their intention to try to ban telemedicine abortions, which allow women seeking abortions to go to a branch clinic to consult with a doctor located miles away via Internet videoconferencing. Then, with the push of a remote control, the doctor can open a drawer in the clinic that contains RU-486, better known as the abortion pill.

Currently, telemedicine abortions are available only in Iowa, where more than 2,000 women have taken advantage of the practice since 2008 through the state's Planned Parenthood affiliate. Previously, the organization provided abortions at a half-dozen clinics, concentrated in the state's larger cities. Because of the telemedicine program, women in the first nine weeks of pregnancy can obtain abortion pills at most of the organization's 19 centers, which are scattered across the state.

Supporters say the program provides a vital service to women in the state's rural reaches, where abortions can be virtually impossible to obtain. They say the process is identical to an in-person appointment.

"The only difference is the point in time when the physician gets involved and reviews all the material and asks if she's ready," said Kyle Carlson, director of legal and lobbying for Planned Parenthood of the Heartland. "This is the future of medicine in all fields, not just abortion."

http://journalstar.com/ap/national/article_3eccc436-e36d-5708-95f2-672cd0e3623b.html



'Death panels' are real -- brought on by budget pressures



By Norman J. Ornstein

Saturday, January 1, 2011

During the debate over health reform, Rep. Michele Bachmann (R-Minn.), Sarah Palin and others railed against the "death panels" that would result from the bill. Government bureaucrats, critics said, would decide who would die and when. The bill passed - and indeed there are death panels. But they do not come from the Patient Protection and Affordable Care Act, a.k.a. "Obamacare." They come from Republican administrations in states such as Arizona and Indiana.

http://www.washingtonpost.com/wp-dyn/content/article/2010/12/31/AR2010123102727.html?hpid=opinionsbox1





Cassi Creek: Here we arrive at the fork in the political road. The continual teavangelist demand, “Keep bureaucrats out of health care!” is becoming openly defined by ideology. The teavangelists and their bigger-moneyed GOPer leash-holders are letting it slip that some bureaucrats wedging in between patient and physician are not only OK but also desirable.

The sacred bond of patient confidentiality suddenly becomes less sacred if they can find anti-abortion bureaucrats to intrude for the purpose of obstructing and denying a patient’s right to obtain medical care without interference by outsiders. Those hated bureaucrats suddenly become instruments to deny health care decisions and procedures that the teavangelists oppose.

In the matter of the “Death Panels” thrown carelessly and incorrectly about by Palin, Bachman, and the other harpies, I’m still unable to see the harm in end of life counseling for aging patients and those with life-threatening, terminal, or merely debilitating conditions. In all instances, the patient’s wishes concerning how they wish to be cared for should be made known to the physician, and to the patient’s family, while the patient is capable of expressing those desires in a clear manner with full knowledge of what the decisions entail.

In my career, I have seen many patients doomed to a prolonged and unwanted existence on life support equipment because they did not make their objections known. Such care is expensive to use and maintain, does not normally offer any hope of curing the patient, does not usually eliminate pain, and may well condemn the patient to an agonizing, slow demise due to super-infections. Medicare will pay for such therapy whether or not the patient wishes it, if the physician orders it. The cost of such care is what makes the last three months of many patients’ lives so expensive.

Many doctors feel that they are obligated to order such care unless they have documentation that the patient does not want it. Other physicians feel that their religion requires them to order it even if the patient or patient’s family objects. The same bureaucrats who can’t wait to intrude in blocking abortion access are equally ready to intrude by refusing to pay for a physician-patient discussion of end of life concerns. Such a discussion is not a death panel until it is intruded upon by teavangelist-approved bureaucrats who are willing to have the government pay out exorbitant amounts for unwanted life-support but are all too willing to deny poor patients with no private insurance access to life-saving procedures.

Yes, bureaucrats do intrude in every aspect of health care when insurance companies and government bean counters have the final say in who gets care and who doesn’t. The teavangelists\GOPers are quite willing to forget their abhorrence of non-professionals intruding in what should be private matters as long as the intrusions match their ideologies and further the intrusion of evangelical Christianity into this nation’s political affairs. They are all too willing to organize their own "death panels” in order to prevent the poor being provided a decent level of basic health care. “Be rich or die quickly” must really be amusing to millionaire political candidates, office holders, and insurance executives. I wonder if they would find it equally amusing if they lost their pensions, salaries, book deals, and access to health care. The level of hypocrisy that exists around the teavangelists and GOPers is stunning. They all claim to be “Christians” but none of them seems to apply any aspect of the teachings of Jesus as written in their gospels to their dealings with their fellow citizens.

January arrived at Cassi Creek in the tightly wound isobars of a winter storm. Yesterday gave us 65 °F temperatures that melted the recent snow pack. The ground is bare, the creek brim full, and we have high winds that should exit tonight but leave falling temperatures behind.

We celebrated last night with a seafood Japanese hotpot dinner. Dessert was brie en croute avec marmalade, strawberries, and champagne – Veuve Clicot Ponsardin – at the magic hour. Today we will feast on our annual prime rib roast. I prepped it with a mustard-herb rub yesterday and it should be well flavored when it begins roasting. We’ll serve it with Yorkshire pudding.

Happy New Year to all.