Obama discusses deathbed measures

[notesdev]

Obama discusses deathbed measures

At a healthcare town hall, he says stopping futile procedures for the terminally ill can lower costs.

By Peter Nicholas
June 25, 2009

Reporting from Washington -- President Obama suggested at a town hall event Wednesday night that one way to shave medical costs is to stop expensive and ultimately futile procedures performed on people who are about to die and don't stand to gain from the extra care.

In a nationally televised event at the White House, Obama said families need better information so they don't unthinkingly approve "additional tests or additional drugs that the evidence shows is not necessarily going to improve care."

He added: "Maybe you're better off not having the surgery, but taking the painkiller."

Obama said he has personal familiarity with such a dilemma. His grandmother, Madelyn Dunham, was diagnosed with terminal cancer and given less than nine months to live, he said.

She fell and broke her hip, "and the question was, does she get hip replacement surgery, even though she was fragile enough they were not sure how long she would last?"

Obama's grandmother died two days before he was elected president in November. It was unclear whether she underwent the hip-replacement surgery.

The event, hosted by ABC News' Charles Gibson and Diane Sawyer, gave Obama a prime-time forum to promote his healthcare overhaul. A total of 164 guests were invited. ABC pre-screened questions, though the White House was not made aware of what they would be.

-- snip!--

rest here: http://www.latimes.com/news/nationworld/nation/la-na-health25-2009jun25,0,1978875.story

[notesdev]

1. op note

I found this remarkable since I haven't heard anyone else talking about it, and I've been pointing out that there is no way to get health costs under control without addressing it. Obama +2 for seriousness and maturity.

[babylonsister]

2. Obama will most likely get a lot of criticism for that remark,

but I agree with you and him. End-of-life issues need to be addressed.

[sui generis]

3. and he should.

When administrators and politicians start deciding how much health care is too much in a for-profit system it's just creepy.

Give us the right to make our own choices, don't take them away. That's not being liberal any more. I'm sending Obama back to remedial liberal school for additional training.

[Why Syzygy]

4. I hope what his intended meaning

is that individual patient needs should be primary, and not profit margin for involved professionals.

[sui generis]

8. who is paying the bill?

that's who stands to profit. It's not whether they are or are not doing the procedure, it's who profits from doing or not doing the procedure.

I agree with the statement that families should have enough information to make an informed choice, but in reality they do. Many families and patients already decide to forgo further treatment, so is this aimed at people who make choices or at people who opt for additional treatment even if they are well informed?

Cutting acute and emergency healthcare costs means improving preventative and chronic health care. It is that simple. Take insurance companies out of the equation for basic healthcare and formulary. Take employers out of the insurance administration business. Take insurance out of your "benefits" plan. Take the cost of basic health care out of our taxes. I'd buy that for a dollar a day in additional taxes - that's about 73 billion a year for basic healthcare and not every person paying a dollar a day would use more than 100 dollars a year in annual physicals and checkups.

Employers would have more revenue and be able to hire/retain more people. Some version of that - that's what Obama needs to be talking about, not end-of-life acute care. He's the president, not a doctor.

[jaxx]

9. The pukes are talking about it.

As in elites will live and the rest will die. We should know that they are going to take this to the max, just like they do everything else. Freakin perverts.

[sharesunited]

5. Seniors are the sleeping giant here.

Medicare for All will result in compromises to stretch the benefit, and that will mean less gold-plated care for the elderly at taxpayers expense.

Seniors actually pose one the greatest political threats to universal coverage.

The little old lady who sees her senator at the airport and grabs him by the lapel:
"You'd better not let the government get its hands on my Medicare!"

[patrice]

6. VERY sensitive issue here, especially given the MANY legal uses of morphine.

There MUST be a completely open dialogue on this issue - FOR ALL - one of the thornier questions is what we do about people who have no one to advocate for them.

Personally, I think, as true dialogue develops, we are going to find that the REAL issues surrounding Deathbed Measures have much more than anything else to do with the Quality of Care and the Quality of Life leading up to Deathbed situations.

Both on the macro and the micro scale: If we have done right by folks, letting Nature take its course is going to be a whole different experience than if we have not done right by them.

[patrice]

7. P.S. Voice of experience here.

[Fire_Medic_Dave]

10. This will be referred to as rationing, I doubt that was his intent.

[Celebration]

11. of course it is rationing

Any time he talks about "evidence based medicine", it is rationing. We won't have any national health care system without rationing. Why? We can't afford it. In fact, he promised to veto any measure that did not address the cost structure. He would like to see our health care costs as a nation be similar per capital to those in other industrialized nations. Believe me, to do that, health care is rationed, one way or another.