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Berwick Sets Up Death Panels By Fiat

By on 12.28.10 @ 6:09AM

Palin, Boehner vindicated as Obama ignores Congress; regulation effective January 1. How will the new Congress respond?

“If they would rather die they had better do it, and decrease the surplus population.” — Ebenezer Scrooge in Charles Dickens’ A Christmas Carol

Sarah Palin was right.

John Boehner — make that Speaker-elect of the House John Boehner — was right.

While Americans were busy celebrating with family and friends and presumably not paying attention to the news, the New York Times, in a story ironically dated Christmas Day — a holiday celebrating the birth of the Prince of Peace — reported the following: 

Obama Returns to End-of-Life Plan That Caused Stir

WASHINGTON — When a proposal to encourage end-of-life planning touched off a political storm over “death panels,” Democrats dropped it from legislation to overhaul the health care system. But the Obama administration will achieve the same goal by regulation, starting Jan. 1.

In other words, the 2009 charge leveled by former Alaska Governor Sarah Palin and the then-House Minority Leader Boehner that Obama fully intended to set up what Palin termed government “death panels” — panels that Boehner said would set the government on the road to euthanasia — is no longer a charge.

It’s reality. By executive fiat — in this case a new Medicare rule issued by Obama Medicare chief Dr. Donald Berwick.

Palin, who made the charge on her Facebook page on August 7, 2009 during the health care debates, came under a fusillade of scornful and demeaning political attacks from political opponents after pointedly saying this about the prospect of death panels:

And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care. Such a system is downright evil.

Her famous sharp criticism was enough for the plan to be quickly dropped by Congress.

Now, with Americans absorbed in a festive holiday and ignoring Washington momentarily, the Obama administration has found a way to achieve its death panel goal anyway, as the Times now admits. Says the paper of the new Christmas death panel regulation that replaces medical science and voluntary private judgment with the inevitable pressure of politicized health care :

Congressional supporters of the new policy, though pleased, have kept quiet. They fear provoking another furor like the one in 2009 when Republicans seized on the idea of end-of-life counseling to argue that the Democrats’ bill would allow the government to cut off care for the critically ill.

Which is another way of saying something else:

Governor Palin has been vindicated. Speaker Boehner has been vindicated.

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About the Author

Jeffrey Lord is a former Reagan White House political director and author. He writes from Pennsylvania at jlpa1@aol.com.

Letter to the Editor View all comments (333) |

henry| 12.28.10 @ 7:09AM

Aldous Huxley would have been quite at home with these developments. This is Brave New World stuff. I wonder if the trend is irreversible?

Deborah D | 12.28.10 @ 10:10AM

Good question, henry. I think the only way this is reversible is with a return to God. I do believe G.K. Chesterton had it right: "When people stop believing in God, they don't believe in nothing -- they believe in anything." Thus, we're being "ruled" by a group of people who believe they can do anything and nothing bad will happen in the future. Some outcomes are beyond human beings' control -- that's what gets lost when those in charge "believe" in themselves too much and in God too little.

Chris | 12.29.10 @ 12:54PM

I agree Deborah, this country is so far removed from God, he is just looking at US and shaking his head in disgust!! The majority of people in this country (79%) say they are Christian, but we are the Silent majority!! That has to change if we are going to change America back to God!! We have allowed the liberals, left wingers, homosexuals dictate to US...Well, its past time to put a Stop to that!! Christian Americans need to be heard, if we are to get our country back on the Right track, back to God!! Here's a good place to start: http://www.PatrioticChristiansToday.com and join with other American who have joined forces and united together to get our message and Voice heard!! Waste No Time...

billy bob| 12.30.10 @ 1:11PM

So Chris those of us who are not christian..... I find it detestable that you are just as bad as the jihadis what with stuff your own brand of religion down a non christians throat..disgusting... this has absolutely nothing to do with christianity...

Elaine Suhre| 12.30.10 @ 1:44PM

Billy Bob, perhaps Chris should have used the term "thinking, moral" Americans? I do hope you are one of them?

Milo| 12.30.10 @ 4:12PM

Elaine, "thinking" is the problem. The majority of American voters share their political acumen with the earthworm and derive their beliefs from Saturday Night Live and Comedy Central.

Poppakap| 12.30.10 @ 1:49PM

So how, Billyboy, is Chris stuffing anything down your throat by encouraging like-minded Christians to unite and make their voices heard? Methinks you protest too loudly and for logically weak-at-best reasons.

Why is it that when Christians encourage political action, non-Christians are apoplectic and resort to nonsensical rhetorical claims? Perhaps because they are unable to honestly and convincingly engage the debate otherwise? Or is it just good old-fashioned hate? I am tempted to believe the latter, but my Christian beliefs encourage me to hope that Billyboy's ilk are just intellectually lazy as opposed to the alternative posed in the previous sentence.

But of course, I'm just stuffing my belief's down little Bill's throat by merely expressing an opinion.

Frank| 12.30.10 @ 2:26PM

Poppakap....the lines "That has to change if we are going to change America back to God!! We have allowed the liberals, left wingers, homosexuals dictate to US...Well, its past time to put a Stop to that!! Christian Americans need to be heard, if we are to get our country back on the Right track, back to God!! "

Notice the call to return America to God (occurs twice). This is similar to the Jihadists mentioned by BillyBob. Encouraging Christians to address issues etc is different than calling to "return the country to God!". This is a religious call to arms, and excludes any not of that religion.

I am conservative by nature, retired military, and not Christian. And when I see what the Religious zealots have done to various conservative movements, I can understand why non-Christians end up flocking to the parties that do not reject them out of hand or call for them to be marginalized. Same with racial and ethnic minorities...when you spend your time demonizing or at least marginalizing a group, eventually they look elsewhere.

Of course, most who call themselves "Christian" are actually Paulists who apparently prefer to practice their beliefs cafeteria style, and pick and choose which parts they like. They will quote Leviticus in regard to Homosexuals, yet eat pork, wear cloth of mixed fibers, etc. Seems like they really don't practice what they preach, IMO.

Charie| 12.30.10 @ 3:40PM

Frank, Christians do not adhere to those Old Testament beliefs. Christ Jesus said dietary laws weren't necessary. Please don't come at us with picking a few verses out of the Bible to prove your point.

Further, I think you'll find more Jihadist ready to murder and torture than Christians. There have been some in the past who did just this but still nowhere near what Christian-hating groups do.

These over-the-top accusations are getting to the point of plumb silliness!

Frank| 12.30.10 @ 4:06PM

Charlie...you obviously did not read what I wrote. If they do not follow Leviticus (and nowhere did Jesus say to not follow Leviticus), then why do they quote Leviticus as a basis to discriminate against Homosexuals? And, Jesus said NOTHING about homosexuality. Paul does...but not Jesus. My point was that CHRISTIANS are frequently pulling verses out of context to prove their point and then do as you did to defend "true Christians"(tm)(pat pending) saying that "x" isn't done because Jesus said so....without even giving the reference!!

As far as "Christians" not wanting to torture and kill others....have you looked at the history (including the last 20 years) of Christians. The KKK are "good Christians" according to their members, as were the Nazis (this topic has already been Godwinned, so I have no remorse using it here). And so on. Haven't seen too many Buddhists out rampaging and killing folks. Nor too many Wiccans or Druids.

Majjohn| 12.30.10 @ 10:54PM

In the last 20 years the KKK has not had any sort of an impact on this society. They were pretty much put out of business 3/4 of a century ago. Anti-trust legislation pretty much bankrupted them. And the Nazis? The believed in the old Norse gods and all that mumbo jumbo. So Christian, hardly. It's a straw man arguement to make the statement that there aren't any Druids, et al, running around killing people. No one said there were. Non Christians can and usually are moral beings. So this artilce raises moral issues, death panels. It makes no statement that one group is more ethical than another, however, I have a hard time finding the moral compass of the current administration.

Frank| 12.31.10 @ 12:19PM

I guess math is not your strong suit...3/4 of a century is 75 years ago....which would put it at about 1935 or so...which was when they were pretty much at a peak in the south. And the cases of Jordan Gruver v. Imperial Klans of America (closed in 2008 for actions in 2006), which suggests they are not exactly gone away either.

Hitler was a devout Catholic, and the majority of Nazis were Lutheran, Catholic, etc. All Christian groups. You may want to avoid the propaganda out there trying to link the Nazis as devout Pagans...the truth is they considered themselves good Christians.

As for Moral Compass....isn't bearing false witness a violation of Christian law? Yet the previous administration did so frequently, and did so to attack another nation. Now, I can think of many reasons to invade Iraq....but would have done so AFTER we had finished in Afghanistan.

But to declare "Death panels" exist? Really? As I have said many times...insurance companies have been death panels for years. They decide who continues to get care and who doesn't on a daily basis and yet people who claim to be Christians see nothing wrong with that?!?

1prophetspeaks.com | 1.15.11 @ 10:54AM

You're wrong about the nazis They were occultists; devil worshippers, who did not cut ties with the catholic church because they didn't want to alienate the christian germans until they had more control. they intended to wipe out the christian church down the line. The hitler youth sang a song that said "we have no need of Christian virture, Adolph Hitler is our savior"- i got this from Jonah Goldberg's book Liberal Fascism.

old white guy| 12.31.10 @ 6:30AM

frank. no one in the kkk was Christian. you seem to lack critical analysis skills. calling yourself a Christian and being one are two different things.

Frank| 12.31.10 @ 12:25PM

OWG....please tell me what a non-Christian is supposed to do then? If someone says they are Christian, is there a reference site that tells me who or what is a real Christian?

After all, there are so many denominations out there, from AME to Baptist to Catholic to Episcopalian to Greek Orthodox to....well, you get the idea. Or is the rule that if they are bigoted in some way they are not Christian? Does that eliminate the Southern Baptists as they split from the Baptists over racial differences?

What about if they are not racist, but anti-Gay and call for their deaths citing Leviticus? Or do we ignore them because they are using the Old Laws and Jesus said those were no longer applicable?

Or????

Mick| 12.30.10 @ 7:40PM

I would hate to be in your shoes when you meet GOD.

MacAdams| 12.31.10 @ 12:14AM

billy bob...
Where do you think our fore Fathers got the basis for all of our laws and our Constitution? The Bible is the rule book to live by. You can choose to live by the parameters and moral laws set forth inside... or you can choose to live by whatever "you" feel like is right or wrong. And you "will" choose to do one or the other. If you could prove yourself to be wiser than the Bible, then you would probably recognized for your deep wisdom and would be pushed into politics, maybe even the Presidency. People from all over the world would hail you, follow you and seek you out for advice and wisdom. You speak the word "christian" as if it is a repulsive person. Christian means that a person sees that he or she is powerless and actually ignorant without God. They choose to give up their rights and life to follow someone who has proven to the best one that has ever lived. .... But even if I try to explain it to you, if you choose not to accept God, you could never understand what I am saying. A good saying for you to remember is: even a fool when he is silent seems wise.

Frank| 12.31.10 @ 12:30PM

MacAdams...to answer your question regarding the Constitution...the founding fathers got their ideas from the Greeks and Native Americans (mostly the Greeks though). Please show me the reference to the Bible or God in the Constitution or Bill of Rights. In fact, the exact opposite exists in Article 6 and the 1st Amendment. Also, the Treaty of Tripoli, which was ratified by many founding fathers specifically states that the US was not founded on religious basis.

Charles | 1.1.11 @ 8:19AM

"We hold these truths to be self-evident. That we are endowed by our CREATOR with certain unalienable rights.....

dld| 12.31.10 @ 1:43AM

uh-not really-is he an advocate of beheading infadels? get real please.

old white guy| 12.31.10 @ 6:25AM

billy bob. who is shoving anything down your throat other than obama.

Sheri| 1.6.11 @ 3:33PM

The members of both political parties are guilty of implementing intrusive and unethical "rules" to micromanage every aspect of our lives. This really isn't a problem of left or right; this is a problem of power-hungry, megalomaniac elitists that are only interested in "control" and hoarding evermore money for themselves. They are motivated by their own self-interests and do not hold the interests of the average American citizen at heart. I really don't think that all liberals & left wingers are atheists, just as I don't believe that all right wingers & conservatives are Christians. If they were, they wouldn't have set up the police state that they did during the Bush Administration. I ask in earnest for more people to please join the Independent movement and fight for the return of our freedoms, rights, civil liberties, and our money. Being on either side of the fence is dividing our country and nothing is getting resolved. Each side has been implementing such draconian and extreme policies that we are drowning in massive black hole of debt and pretty soon everyone will be convicted of some contrived felony.
Right = War; Left = Nanny
They both stink.

Jean | 12.30.10 @ 10:01AM

You are so right.We are watching the sciptures coming forward.Those that know have nothing to fear just prepare and stay very close to GODS PROTECTION and keep the GOSPEL ARMOR ON. There are somethings we cannot do anything about it is in GODS overall plan but he does expect us to stand where he wants us to stand and not waver.Keep praying and GOD BLESS YOU for truth.

Lorraine | 12.31.10 @ 11:42AM

You could not have said it better! The only way we are Going to solve the grave status our nation is in, the mess is to RETURN FULL SPEED to BASICS, seeking GOD! Then again potus is NOT A Christian, & he does not care! Nor do these THUGs that work in this CRAZED, out if touch , out of the reality of what it truly is to be A tax paying Law abiding, mostly CHRISTIAN US Citizen govenment.They need to STOP forcing islam accepting clang Now!

IzeHavitt| 1.1.11 @ 6:09PM

In the first place, the so-called "Dr." Berwick should be asked to resign. If he won't, then let the clamor begin for the same. It is because these people, and their ilk, don't believe in the true God, that they don't believe in His abundance. There are always resources, ideas, money, to care for the sick, the elderly, the weak. But it is the bureaucratic mindset that the Dr. Berwicks and his cohorts have been infected with that disallows them from grasping this. So their adopted viwpoint seems oh, so logical to them..... until it happens to them. As it is written: "As ye sow, so shall ye reap". And, of course, the words of Jesus of Nazareth shall never pass away. From a politically practical perspective though, our task, O America, is to rid ourselves of these bureaucrats and their evil intents. It's a daunting task, oh yes. But Thomas Jefferson did warn us that "the price of liberty is eternal vigilance".

AJW| 1.6.11 @ 3:24PM

I really don't intend to insult anyone but religion is only a position to view the world, & just looking around you'll see thousands & thousands of different religions, even under Christianity there are thousands of different forms. These positions are not believed based on true & false even though people seem to think that way. I truly am disappointed with the belief that man has domain over everything unknown, it all revolves around the mystery of death, when truly it is the domain of the unknown that rules over man. The ability to pick and choose information to skew it into peoples own world view is a mistake, & historically been shown to kill more people then anyone would truly want to admit. Now just because I don't believe in God doesn't mean I don't believe in anything. There is a fundamental observation seen in the universe for knowledge, how is it galaxies appear so similar? why are planets and stars always spheres? How is it light can be a wave and a photon? Without light, without the sun we wouldn't be here, for in truth we are the universe, a consciousness (which by the way still hasn't been defined) of knowledge that can work with its environment.
Being wrong isn't bad, in fact it is one of the best ways of learning.

Chicken Little "I'm terrified"| 12.28.10 @ 12:50PM

The death panels are coming! The death panels are coming! The death panels are coming! The death panels are coming! The death panels are coming! The death panels are coming! The death panels are coming! The death panels are coming! The death panels are coming! The death panels are coming! The death panels are coming! The death panels are coming! The death panels are coming! The death panels are coming! The death panels are coming! The death panels are coming!

And I'm frightened out of my wits! I'm running around warning all the barnyard animals.

But let me pause briefly and wish all of you AmSpec hogs a Happy New Year!

Happy New Year, hogs!

tj| 12.28.10 @ 1:56PM

Another answer from a childish troll... soon dears will be 2012 and our country will be on the mend and you "people" will be back under your rocks....

Widow Twanky| 12.28.10 @ 2:16PM

He could have at least used GM. Fiat isn't even an American company.

The Blue Collar Man| 12.29.10 @ 8:28PM

Hey now! I don't know GM cars, but am an expert on Fiat. In fact, I work on Fiat cars all day, and nothing else! And, I'm American. Figure that one out if you can.

Fiat Fan| 12.30.10 @ 1:25PM

FIAT: Fix it again Tony.

jstwndring| 12.28.10 @ 4:50PM

Don't worry, we'll protect you Dims from yourselves....... ;)

Round 2 in 2012 people! Take the Senate and Executive branch. In the meantime, use Congressional Review to strip this inhumane rule out.

Take that, Nazi Party, USA!

Negro X| 12.28.10 @ 5:12PM

Everyone grows old, and no one is immune to sickness. Sooner or later they will come for you clown.

Shar| 12.29.10 @ 4:18PM

Get in line first then, Negro X.
Go on. You are so smart and brave.
I applaud you. You take the "change".
I will keep my life as long as I can. Thank you.

Occam's Tool| 12.30.10 @ 4:21PM

I think you misunderstand Mr. X, Shar. He is responding to the troll MINIMIZING the Death Panels. He is opposed to them. He is NOT in support, as neither am I.

mzk1| 12.29.10 @ 1:37AM

First they came for the elderly....

Sometimes the sky does fall. Ask the Germans; this is how it started, more or less.

Elaine Suhre| 12.30.10 @ 1:49PM

And remember EVERYTHING in Germany was done legally.

ThomNJ| 1.6.11 @ 1:36PM

no, not everything.

Damian| 12.29.10 @ 1:47PM

We need to start with you first.

Determined | 12.30.10 @ 10:04AM

There are people who GOD has put a stupper on for their protection and I believe you are one.I'll keep you in my prayers.I wish you a Healthy,Blessed New Year.

Joseph| 12.30.10 @ 12:57PM

Don't look now,but your limited education is showing! Have you got past Peter Pan yet?

Charie| 12.30.10 @ 3:42PM

See what I meant by my first post?

Ewen Allison| 12.30.10 @ 3:44PM

The dirty little secret about end-of-life counseling is that it actually gives patients the option of insisting on full care during their final days. This is not a matter of a "panel" of bureaucrats deciding whether someone is worthy of being kept alive. Shame on American Spectator for perpetuating Palin's myth.

Charie| 12.30.10 @ 8:25PM

People have the option to do this throughout their lifetime. There is no need for government to stick their big ugly noses into it at all!

"I'm from the government and I'm here to help!"
Good grief!

Charles| 1.1.11 @ 8:29AM

That's the whole point that everyone is missing. Where in the constitution does it give the government the authority the right to even be involved in such acts. The constitution was written to limit the powers of the government and protect the rights of the people, not the other way around.

Occam's Tool| 12.30.10 @ 4:19PM

Work as a senior medical consultant in an NHS, troll. Then you will know something that will terrify you. Or, better yet, go to The New Zealand Herald website, and check the term District Health Boards. Happy reading, troll!

LGA| 12.30.10 @ 9:37PM

Chicken Little refuses to recognize reality!Facts have no effect on fools!

old white guy| 12.31.10 @ 6:33AM

hey litte, i hope you live long enough to gain some insight.

Mike| 1.3.11 @ 12:07AM

Little Chick, as time continues forward, unless you leave this ole world instantly, you may be inclined to feel a little differently.

Sheri| 1.6.11 @ 3:45PM

You're an ass.

Sheri| 1.6.11 @ 3:49PM

(Above comment directed @ Chicken Little)

Dave | 12.28.10 @ 6:23PM

Not to worry, kids. If I know my RINOS (and I do) our guys leading the trench troops will find a way to ... tweek, twist and work with Obama's death czars. And as far as "overturning all of it?" Well, that wouldn't be in the spirit of bi-partisanship and the congressional rule of ... give and take, now ... would it?

Of course, the "take" part only applies if your a hard Left Democrat. The "give" part is still hanging the Boehner Bunches hall closet.

Nope, when you finally trim through the -- Don't cut me off the D.C. "A" party list" -- Little Mitchie and Weepin' Johnny B. will be right there ... cutting another of their famous go-along-get-along schemes, while telling the rest of us ... what a really keen deal it is for America

So, whatzitallmean?

Well, from this section of the cheap seats, it MEAN that some ol' fellow with advanced cancer and in need of a potential life extending medical proceedure will be granted an extra week to get his affairs in order before the Medicare Death Fairy come-a-knockin'.

Or as Bob Barker used to say: Let's make that Deal. Next!

Alan Brooks| 12.28.10 @ 6:31PM

Well perhaps your wealthy grandparents are getting too much. We will see; but the jig is up, if Bush's "compassionate [statist] conservatism" didn't cut the mustard, then GOP tweaking of the medico-gerontocracy wont hit a home run, either.
But not to mix metaphors.

mzk1| 12.29.10 @ 1:35AM

Wow! A completely meaningless statement! Do you write copy for the Obama administration?

Bruce| 12.29.10 @ 12:37PM

Surprised at Brooks comment? You shouldn't be - that is what he does. Daily, unfortunately.

Steve| 12.28.10 @ 6:55PM

Anyone ever read the book 'Term Limits' by Vince Flynn? Great book!

Determined | 12.30.10 @ 10:05AM

Yes he is a great writer have read most of all his books fantatic.

Isak Waran| 12.30.10 @ 2:41PM

I'm as right-wing as most of you all put together, but Vince Flynn is a hack who gins up enthusiasm for neo-conservative interventionist folly by positing an all-powerful American intelligence apparatus. The "top" US intelligence staff in Afghanistan all got themselves blowed up about 18 months ago because they let a suicide-vest-wearing double agent walk unfrisked right into the middle of their compound. That's our intelligence capability for you. Government workers in the intelligence community are no worse, but also no better than FEMA workers after Katrina. They're still government workers, but they're burdened by an inflated belief in their own capabilities. We have about two Pashto speakers on payroll and we can't trust either of them. Vince Flynn does his "research" by talking to some desk jockeys @ Langley and builds a loyal readership of fat white middle-aged chickenhawks. His books are literary cotton candy, devoid of substance.

carnot| 12.28.10 @ 9:57PM

hmmmm...sauce for the goose......

mzk1`| 12.29.10 @ 1:39AM

Actually, this is exactly what Huxley described. A world in which everyone is happy (on drugs, actually) and healthy almost until they die - at age 60 or so. It's right there in "Brave New World".

Bill of Bama| 12.29.10 @ 3:59PM

The government has a vested interest in old people dying. Most of Americans by age 65-70 have already quit working, thereby not contributing to the tax base of working people. When an old person dies the social security payments stop, medicare expense cease and if military retired their pensions also stop. So I ask this question, what is the incentive for governent to keep us old people alive?

jdkchem| 12.30.10 @ 1:15PM

Had the government not stolen the social security and medicare payments made by working Americans age 65-70 to fund wasteful entitlements this would not be an issue. Typical of the democRATS to place the blame/burden on someone else. You old folks have become inconvenient. I am beginning to seriously despise and loathe these people.

Char| 12.30.10 @ 3:48PM

Nonewhatsoever. However, it should be a good incentive for people to rely on their own savings and insurance for their old age. I'm certainly sorry we didn't have more savings. We wouldn't be at the mercy of the government. We had some savings but mostly relied on a pension and insurance from my husband's work which insurance has now been combined with Medicare. Costs going up, up, up.

old white guy| 12.31.10 @ 6:24AM

the evil that is the obama administration shows no sign of being reversed.

John W.| 1.4.11 @ 4:13AM

I can't believe the silliness and vitriol I'm seeing here. Bottom line-if one believes in God, a higher power, the Creator, something greater than the sum of its parts (greater than us), one by definition believes in certain moral absolutes outside of which lies the concept of a panel of bureaucrats deciding who shall live and who shall die. On the other hand, if one has no such beliefs, government becomes "god;" if one thinks it's o-k for government to provide "free" health care, then one must accept the rules which inevitably come with this "gift." When we absolve ourselves of responsibility for ourselves and put that on government, then we must accept the rules and stipulations which always come with such a plan. This is true in all things, and might as well be considered as immutable as a law of physics.

PaulD| 12.28.10 @ 7:18AM

Obama really is an s o b.

Susan| 12.30.10 @ 1:10PM

You have said it so well.

Intelligent Design| 12.28.10 @ 7:24AM

The logical extension of this "regulatory" action is to condemn "defective" babies, AIDS patients, Medicaid recipients, cigarette cancer patients, obesity patients, drug abuse patients, and various other defective comrades to death. Hitler would like this. Muslims will probably like it too, if the death panel condemns Infidels, Jews, apostates, homosexuals, rape victims, loose women, and readers of The Satanic Verses or the Constitution.

Da Monk| 12.28.10 @ 7:59AM

I think some how, unintentionally, American Spectator left out the "UN" in front of your name

JFGalt| 12.28.10 @ 8:09AM

What makes you think he is wrong? The whole process has been incremental. It is the natural extension - if you don't believe it then just look at how the TSA has been changing the rules as they go since its inception. These agencies should not have the power to make all the rules that they do which circumvent laws that were denied their fruition. This is in effect legislation without representation.

Deborah D | 12.28.10 @ 8:50AM

Amen, JFGalt! Someone else has called the work by all the president's men -- all the president's czars -- "regulation without representation." I believe that will be the new cry out on the Tea Party circuit.

You always have to look farther down the road when any politician, but especially a leftist, is making rules and regulations for the rest of us. As Mr. Lord said -- it's all about pressure and control -- they will NOT stop. Look at how the bureaucracies have grown everywhere you look! They keep finding things they want to control -- and we're all suffering from it. Now they want to control us through medicine or lack thereof. The ultimate control.

Negro X| 12.28.10 @ 5:14PM

JF, Deb,
Your assumptions are indeed correct.

flyman| 12.30.10 @ 9:51PM

you are so correct in your statememt. and to spite it all we continue to pay for all this folly in taxes,taxes,taxes. And yes, I am one of the old ones awaiting the arrival of the death squad. It is a frightening time young folks. One day you will look on the blog, in the mirror or listen to the late news and find tomorrow or the next day or the day after that you will be expected to arrive for some kind of examination or other. Stalin, Hitler and on and on. Please, take action. Do not wait for the knock on the door or the phone call with government orders. ACT SOON..... NOW IS NOT TOO SOON....

jstwndring| 12.28.10 @ 6:13PM

How is arguing consistently and persitently in favor of limited government--the exact reason the Constitution was written--un-American? Have you even read a tiny-little-bit of the Constitution? Can you comprehend it's over-arching theme? Limited government? Hello? What the heck are you talking about? Do you know?

FLYMAN| 12.30.10 @ 9:54PM

If they cannot comprehend just tell them to read Thomas Jefferson. The man was sooooo ahead of the time and pertinent today as well.

LT| 12.28.10 @ 6:28PM

Intelligent almost got it right...but, expect AIDs patients and homosexuals will get a pass. Bet on it. "O" will find a work-around for AIDs patients.
Democrats without homosexuals just wouldn't be....Democrats? Homosexuals and abortion IS the Democratic Party. And onerous taxation.

Charie| 12.30.10 @ 3:53PM

Looks like DA doesn't believe in incrementalism. "Death panels" didn't just spring out of the air. It's been a long slow time coming, but many programs that have been put into effect have contributed to it. Think!

Penny| 12.28.10 @ 11:33PM

We don't have to look to Hitler to see where this is going - just look to the UK, where callousness is the by-word for its so-called National 'Health' Service. Obesity, smoking and genetic imperfections are already reasons not to provide life-saving care. And, really, God help you if you are over 50, because then a DNR notice is attached to your medical chart. DNR stands for 'Do Not Resuscitate'. And they won't if something goes wrong.
Any hospital in the UK is a death-trap - if the untrained overseas 'doctors' don't get you, the MRS epidemic will. Take a look at this Hot Air article from earlier this year, and links, to see what will happen if this monstrosity is not stopped: http://hotair.com/greenroom/ar.....-hospital/

Mark Anderson| 12.30.10 @ 2:54PM

Penny, the United States ranks 36th in life expectancy, the U.K. ranks 20th. How many death traps are in the United States?

Charie| 12.30.10 @ 3:58PM

The U.K. doesn't count their deaths the same way we do. Deaths of children from birth to under one year are not considered deaths. They are counted as though they never lived. There are a couple of other things they don't count as deaths, either but I can't remember them.

That tends to bring down your mean averages IYKWIM.
Do you think the U.S. bureaucracies are the only ones covering their butts?

Lunar| 12.30.10 @ 4:10PM

2 questions for you:

What is the difference in life expectancy between these 2 nations, even 16 ranks apart? If it's less than a year, I don't consider it significant.

Do you believe life expectancy is based primarily, mostly, or totally on health care? I imagine the murder rate is higher here, which really skews the statistics downward, against the US.

notconvinced| 12.30.10 @ 2:58PM

Penny, that is just horseshit.

Smokers, the obese, alcoholics and drug users do get all the care they need and more in the NHS. More's the pity, because they are a real drain on resources. Especially when many of them would be entirely fit if it were not for their hedonistic, chaotic lifestyles. And DNR is for only those so far gone only palliative care is given, and it's only for those terminally ill or much, much older than 50, whose quality of life consists of being bedridden, medicated, helpless and clueless as to whats going on. People who are artificially being kept alive.

UK Hospitals are not death traps. They are not perfect, but the medical care is first class and fully up to date with the latest techniques. There are issues in some hospitals with housekeeping and hygiene, but these are improving. Many of these problems are due to a culture of contractorisation of domestic services which has cost the NHS a fortune and delivered worse services.

Lunar| 12.30.10 @ 4:14PM

I don't know exactly what the conditions are in the UK, but there is one thing I do know (or think I know). I haven't seen anyone from the UK here in the states telling us what a great idea it is for us to adopt their model, but I have seen someone warning us how horrible things are and asking why we would be considering such a thing.

The question isn't which current system is better. The real question is, is there a significant enough difference that we should turn our system on its head.

JCfromDC| 12.30.10 @ 9:36PM

Anybody remember The Benny Hill Show? Look at the commentary satire HE was making in the British system back in the... SEVENTIES???? Look up the shows, those with the "privae plans" vs. those with the "public option". Granted, it was satire, but very illustrative

Charie| 12.30.10 @ 8:21PM

***There are issues in some hospitals with housekeeping and hygiene, ****

These are the first rules in hospital care. It's what prevents infections from roaring through hospitals! Silly remark!

****Many of these problems are due to a culture of contractorisation of domestic services which has cost the NHS a fortune and delivered worse services.****

Another reason to be against government healthcare. If they haven't realized by now that their contracting out healthcare is the wrong way to go bad cess to them. I'll take private healthcare anytime without government intercession. It's also why I don't believe what you said.

Penny| 1.3.11 @ 5:54PM

@not convinced/Mr.Horseshit. Your comments regarding the so-called hedonistic lifestyles of some people and the lamentable drain on resources that those people comprise, tells us what kind of libtard you are. I speak as a Brit from personal experience, and if you could come out of your bubble to do the most cursory research on the subject, you would find myriad public resources to confirm my remarks.
As for the comment about the US ranking 36th in life expectancy, by which UN crackpot measurement would that be?

Frank| 12.30.10 @ 3:49PM

Really...I experienced the UK's NHS first hand. Never had an issue with it. Now, dealing with Medical Insurance companies in the US....well, they have had death panels for years. Drop you if you use the policy too much. Find ways to deny care. Have a catastrophic illness and suddenly discover there are limits to your policy and suddenly your treatment is cut off....or not covered....or your copays go up to a level that you may as well crawl out into the desert to die as it will end up costing your family everything they worked for and then some. And so on. Death Panels did not come about due to Obama Care, etc...

Hell, the Republicans and Tea Party folks have been clamoring to cut benefits to military veterans (raising TriCare fees...yes, we military retirees get to pay for the "free" medical care we were promised if we did a full career, etc, cut VA benefits, and so on.). I guess actually serving your country and be willing to give your nation a blank check that goes up to and including your life is actually worthless to some politicians...even more so to those who like to send us into combat.

Lunar| 12.30.10 @ 4:42PM

Frank I'll be happy to be the first (today, at least) to thank you for serving (assuming I understood that correctly, that you are a veteran). My uncle (a veteran) had a hell of a time getting care for his back. He ultimately needed surgery, but it took over a year to get a proper diagnosis and treatment. That's what I know of government run health care. If the UK does it that well, maybe they set it up the right way. As it is, I don't trust our government to run the service properly. If they can't take care of just the veterans, how are they going to take care of millions more people?

We need a provision for people to be able to get some kind of coverage with pre-existing conditions. That part of the health care law is good. The other thing that would help is having more choice in the insurance market. If your company sucks, you can drop them and get insurance from someone else. Denials of coverage due to re-existing conditions destroy that logic, but if we get rid of that hurdle, the companies that offer good coverage will prosper and the companies that cause their customers grief and frustration will die.

One last thing to your final comment, Frank. It is only the threat of being sent into combat that makes military service so honorable. Without that possibility, it's just another job. If you are proud of your service, you should consider how a pacifist President would devalue the military. I don't think anything has done more to help America appreciate the military in the last 20 years than the sacrifices made in any one of the last 9. To earn the special treatment you deserve, you have to accept that combat is a part of your job. Your life isn't worthless; it simply has a price, like we fear the types of rules discussed in the article will put on the lives of all Americans.

Frank| 12.31.10 @ 12:43PM

Lunar...thank you...I am a Vet (22 years USAF). And the issue with the VA I personally found was not with the doctors. It was getting to the doctors and the bureaucracy that exists. Shinseki is working on that, but is working with the constant threat of cuts. I'm still waiting on the appeal of my disability rating from the VA (they denied several things that were clearly documented in my military medical records).

My combat service is NOT was I was talking about, I was referring to the usage of the military by militaristic leaders for little to no gain and for false purposes. I accepted combat as being part of the job when I joined back in the mid-1980s (when military service was still reeling from the Vietnam conflict). I served in lots of places, and shot at numerous times (and shot back when allowed). I just want the other side to keep their half of our contract.

I, and many of my brethren in arms, would be willing to sacrifice our lives for our nation....but we also expect the rest to understand and keep the bargain they made with each of us. We also would prefer to be the LAST resort not the first choice when it comes to international conflict. Politicians (of all stripes), tend to consider us pawns in the political game. But those who truly honor us, understand that misuse of the military and failure to keep promises made to us will result in a weaker military. This is already occurring. We kicked out decorated combat vets for being homosexual, and give waivers to convicted criminals, some drug users and high school drop outs because they can't meet the recruiting goals!!!

nvrat| 1.2.11 @ 11:31AM

Republicans and Tea Party folks wanting to cut military benefits? Where did you get that from? I have heard the lefties and progressives wanting to do that but, not Republicans and Tea party folks. In fact it was Odumbo that started that talk in 6/08/2009.

Damian| 12.29.10 @ 1:59PM

Intelligent Design? You are a pimple on America's butt.
No one can put their head up their butt far enough to understand your point of view. If you don't like this country or the Constitution, please leave, or put your name first on the death list.

Elaine Suhre| 12.30.10 @ 1:58PM

A pimple can be cured, many cancers cannot. Since when has the Constitution said it is okay for the government to mandate health care? Get yours out of you know where, clear your eyes and head and look around. "You are like totally lost."

notconvinced| 12.30.10 @ 3:03PM

60% of cancers CAN be cured if detected early enough. But will the private medical healthcare industry spend the money looking for those cancers through testing their policy holders, or wait until they are too far developed and cut them loose? Tricky one...

Lunar| 12.30.10 @ 4:51PM

Don't most insurance plans cover yearly physicals? If the person with the policy doesn't go get tested, how is the insurance company supposed to guarantee any problem is detected? There is no way an insurance company can afford paying for cancer screenings often enough for all of their customers to be covered. If they raise their rates, it could happen, but you don't want to pay any more, do you? No one does, so people pick and choose which corners to cut and doom themselves. In order to stay in business and provide insurance for thousands of other people, an insurance company may need to deny certain things. No one likes that. The question is whether the government can do better. I don't see many people making an argument for that. Most of the time, the argument is that it doesn't matter if the government does it, because the insurance companies are already doing it. Why, then, should we trade 6 of one for half a dozen of the other?

Charie| 12.30.10 @ 7:59PM

The answer is - THEY ALREADY DO! If you had been paying attention you'd know that U.S. private healthcare is already miles ahead of NHS in the U.K. as far as cancer is concerned.

The U.S. has a breast cancer survival rate twice as much as does the U.K. and every other cancer , too, although not by such a flamboyant rate.

Are any of you "romancing the NHS" aware that the U.S. is in the forefront of finding new cures and medicines for diseases? It's just like the U.S. being the caretaker of the world. We keep a large standing military so if the bad guys attack any of those "biting the hand that feeds them" we can beat up on the bad guys who are picking on the "little guys"?

You people make me sick!

Cris Worth| 12.28.10 @ 7:40AM

Roe v. Wade nearly four decades ago began the slippery slope to euthanasia and now it's here sanctioned by the federal government. Hitler refereed to defectives of all types as useless eaters and quickly dispatched them the same here including those who oppose these policies.

Deborah D | 12.28.10 @ 8:52AM

Hitler was a social democrat. Just sayin'.

loulou| 12.28.10 @ 10:14AM

A godless social DEMOCRAT.

oldfart| 12.28.10 @ 2:06PM

Dr. Joseph Mengele would be proud of the 'progress' being made by the Progressives in the USA to purify the country of those not able to support the 'greater good'.

rdman| 12.28.10 @ 3:58PM

oldfart, you stole some of my thunder to wit:

There was another evil S.O.B. who carried the title Doctor... his name was Joseph Mengele and he worked for Adolf Hitler.

Charie| 12.30.10 @ 8:01PM

Two thumbs up, O.F!!!

Mike the Middle Manager| 12.28.10 @ 2:47PM

Hitler was a fascist who named his political party National Socialists (aka "Nazi") to appeal to the mainstream of his time. By definition, nationalism and fascism are far right wing political beliefs. Let's please get our facts straight. Now, if you'd like to discuss how political beliefs on both the extreme right and left end up resembling each other, then that's a topic worth talking about. However, here and now in the USA we really don't have any group or politician aligned with Hitler's political beliefs. C'mon now. Let's get real. And let's be sure to elect representatives who truly represent our beliefs and real-world needs as a people, a nation and a Union. Are there no Washingtons, Jeffersons and Lincolns in America today?!

Ray| 12.28.10 @ 3:29PM

Perhaps you need to brush up on your "facts" as well?

The National Socialist German Workers Party (The true name of the Nazi's) use the term "national" to distinguish themselves from the international socialist like the Soviets. They did this not because of policy differences, but of political differences. They didn't want to be considered allies with the Soviet Union. They want to control the Soviet Union, as well as the rest of the world. They just didn't want to admit that to their own people.

Their ideology, a left-wing ideology, was the same as the Soviets; that of total government control of society, a centralized control of the economy, production, distribution ect.

As happens with all centralized control systems, they became a dictatorship. Stalin was just as much of a dictator as Hitler, as was Mao, Pol Pot, ect., so I'd hardly call that a right-wing trait. That is definitively a left-wing trait.

Mark Anderson| 12.30.10 @ 3:05PM

Your comments are so far from the truth it's pointless to argue with your confirmation bias. Just read more and look for facts that perhaps you won't like.

Danny Lemieux| 12.28.10 @ 3:35PM

So, let me get this right: Adolf Hitler and the Nazis favored: strong, centralized government; universal healthcare, state-controlled retirement security, state-control of industry; state control of the media; free, universal, government-controlled education; strict environmental regulation; and eugenics...but, they were not socialists. Instead, they small-government, right-wing conservatives. Uh-huh!

Martin Treptow| 12.28.10 @ 4:14PM

Mike, while I love the alliteration in your nom de plume, I beg to differ with your main point.
I don't have the time to go into it at length, so I will refer you to Jonah Goldberg's book "Liberal Fascism", which makes the argument that Fascists from Hitler on down through history to today have actually been a lot more left wing than right. It's fairly well-researched and pretty convincing.

And, by the way, it isn't about labels anyway. Whatever one chooses to call the people in charge in Washington, they suck a**.

Cheers!

jstwndring| 12.28.10 @ 5:41PM

Mike, this goes beyond mere marketing. The Democrat Party has for years endorsed and put into place policies that mirror those of Nazi Germany:

-Pro-centralized government
-Pro-high taxes
-Anti-free market
-Pro-socialized medicine
-Pro-euthanasia
-Pro-eugenics
-Pro-abortion
-Pro-envirionmentalism
-Militant-anti-smoking
-Pro-evolution
-Anti-Christian
-State-run school system-->to facilitate trust in the State

Look at that list. Which of those points are endorsed by the Republican Party? None. Does it all sound a familiar? It should. And it should concern you. A marxist is a marxist no matter geography. Communism and socialism are merely two extremes on the same marxist scale. They only differ by degree. So, don't console yourself with the lie that socialism isn't as bad as marxism. It's marxism-lite. And, it all leads to the same result--that being the total loss of individual liberty and freedom in the name of the collective, or, "greater good". There is no such thing as good government. We should all, as Americans, embrace limited government.

Deborah D | 12.29.10 @ 11:55AM

Amen, jstwndring! And, Hitler got his ideas about eugenics from American progressives! Margaret Sanger (Planned Parenthood goddess) and Woodrow Wilson (Teddy Roosevelt too). Funny what happens when you read a little history. Thanks for your excellent retort.

Mark Anderson| 12.30.10 @ 3:20PM

Hey, you left out the Nazi's were anti- homosexual, anti-semitic, anti-communist, anti-labor union, anti-diversity. They condemned liberalism, hated women's rights, withdrew women from the professions, and Hitler said of women: "her world is her husband, her family, her children, and her home." Which party does this sound like?

Former Eastern European| 12.30.10 @ 1:38PM

Yes, fascism is on the left, not quite as far left as you can go, but still left. Left = total government control of everything. Right = total anarchy.

Charie| 12.30.10 @ 8:23PM

You're entitled to your own opinions, but not to your own facts!!

mzk1| 12.29.10 @ 1:40AM

Actually, it was Griswold vs. Conneticut.

Chuck| 12.28.10 @ 7:47AM

Note this came about on Christmas Day; I wonder if there is not so subliminal message here or is just a coincidence? Also note the liberal New York Times was the willing Yuletide messenger...two coincidences, or just too coincidental?

Stephanie| 12.28.10 @ 7:57AM

There is no such thing as a coincidence. This adminstration is saturated with the evil of hell and Satan. We must stand up folks and stop this madness.

rose schiavone| 12.28.10 @ 2:34PM

Am not sure of what word to use to describe Obama and the democrats. They are evil totalitarians.

And, of course, Obama and his family and congress and their families will be excluded from this travesty and they are imposing on the rest of us.

We must purge these people out of our political system in 2012. Write to your representatives and demand the undoing of all this. Frankly, BO should be impeached. He must be thrown out of office asap.

Elaine Suhre| 12.30.10 @ 2:59PM

Coincidence? Remember the "Holiday gift" we got last year? There are no coincidences with this administration. Subtle, subliminal? I don't think so.

Bill Hussein O'Stalin| 12.28.10 @ 7:51AM

This is the predictable end of all collectivism.

It would make more sense to to counsel the losers on unwanted pregnancies and prevent them from popping out the kids who later become the collectivists.

MikeD| 12.28.10 @ 7:53AM

Are you listening, Mr. Boehner? Are you, RINOs? I recommend that that scum berwick be dragged to the House the very first day the new House convenes; followed by every other scum 'czar' that barry the muslim has snuck into office to bypass Constitutional separation of powers. Or, just for chuckles and grins, how about every member of the obama$$hole administration be designated as the very first canbdidates to be euthanized. Turnabout is fair play. Apparently, even the new york times gets it.

The republicans MUST defund EVERY illegal cost center that barry the evil muslim has set up. Make no mistake, this P.O.S. is a murderous thug who cares about nothing but his own aggrandizement and power to destroy our Country in concert with the old 'nazi-wannabe' george 'killer' soros. Even some of the mental defectives on the left just might be able to figure out the implications of obama's and berwick's death panels. Whenever the demoncraps and their 'willing lackies' in the media scream and protest, look under the rocks; they're up to something. This even surpasses the old dem cries about 'grandma eating dog food'. The dems just want to kill her; the sooner, the better. That way the dems can steal her assets to help fund their continuing efforts to destroy us all. That 'loony tunes alan grayson had it right, he just named the wrong party. On that topic, how's your retirement, Alan? Oh, and did you even tell all your constitutients about your personal fortune of $34,000,000? I wonder where you got that?

Since it is quite clear that there are some really smart people on this forum, I'd love to hear your thoughts. (Ken? Occam? Mike D.?)

Ken (Old Texican)| 12.28.10 @ 10:28AM

MikeD
MY THOUGHTS?

I won't stand for it!
further,
Texas will have to say NO! once again.
( www.texassaidno.com )

One of our familiar dumbsh-ts below takes a cheap shot at Sarah Palin, saying she had nothing to lose when she single handedly turned the whole debate around..."she had no skin in the game..."

Of course, BG is not a pimple on Sarah's hiney and he must be simply insane with jealousy that she has so much power of truth, and the courage to express it so succinctly.
Hey dumbs--t!
Her baby boy is on the 'murder list'.

In addition, I cannot recollect ANYbody enduring more snot from people of your ilk for two and a half years in trade for her success. I would say she has earned her money.

Mike,
I do admire the lady. She alone is going to decide who becomes president in 2012, whoever it may be.
UH...if we still have free elections.

Bob Grant| 12.28.10 @ 5:40PM

Ken we have more in common than not. I'd save my snide remarks for the real enemy.

You still haven't made a compelling argument for insulting fellow conservatives into supporting Sarah as you'll need every one of us...and then some.

Occam's Tool| 12.30.10 @ 4:29PM

Guys, stop talking about Sarah. The Big Guy is thinking of running---BOLTON. AuH2O Conservative on domestic policy, THE GREATEST UN AMBASSADOR on foreign policy. The only question is if we can afford the strengthening of the floor of the Oval Office to support the huge Brass Ones he carries everywhere. I like sarah, but BOLTON is non-pareill.

Mike, thanks for the kind comments. Pass a Bill in the House defunding Berwick's position unless he agrees to certain principles in writing. Then handcuff the vicious bastard.

Mary| 12.28.10 @ 8:03AM

Under this rule Steven Hawking wouldn't stand a chance. The very thought of the implications are chilling beyond belief.

No Fan of Barry| 12.28.10 @ 9:20AM

I disagree, Mary. The health care waivers for certain companies were allowed as would "special consideration" for the likes of Hawking especially if those persons were progressive advocates. Pressure and control... pressure and controll, pre............

beebop| 12.28.10 @ 12:12PM

Maybe this week. Next week? New people making different decisions. Whose standards? Whose beliefs? This has absolutely horrific implications.

idalily| 12.28.10 @ 2:59PM

What the government giveth, the government can taketh away. Which is why the Founding Fathers said, "...endowed by their Creator with certain inalienable rights..."

The shaking earth beneath our feet is our Founders turning in their graves. Meanwhile, Margaret Sanger and her ilk are jumping for joy. Selective breeding at the discretion of the State.

Do leftists really not see this for what it is? Or do they genuinely see it for what it is and welcome it?

Bob Grant| 12.28.10 @ 8:33PM

Hayek's Road to Serfdom covers all of this as well. This book is so prescient, you'd think it was written in 2009.

Josh| 12.30.10 @ 1:49PM

What?! Why would Hawking not stand a chance? Under this rule, when Hawking reached the right age, a Doctor could be reimbursed for having a discusion with Hawking on what he would want in the event he became seriously ill and went on life support. What do you mean he wouldn't stand a chance?!

Frank | 12.30.10 @ 3:58PM

As Stephen Hawking is English, and therefore was raised receiving healthcare under the British National Health Care system, I would say he exemplifies the ideals that national healthcare (when properly implemented) works well. Under the US system of insurance, he very well could have ended up dead long before he did any of his greatest work. Of course, as he is an Atheist and a Scientist, I can see several of the posters here would not be heartbroken if he did die.

Occam's Tool| 12.30.10 @ 4:31PM

Hawking, I am sure, gets his health care from Harley Street private practitioners. There is a private hospital system in England, reserved for the non-hoi polloi. Hawking is Rich and Famous. He's not NHS. Sorry, Frank. Again, unlike you, I have worked as a Consultant in an English style NHS in NZ, with British docs. I know it well, and it sucks.

Frank | 12.31.10 @ 12:51PM

Tool...Today, Hawking may receive his treatment from docs on Harley street. Back when he started treatment for ALS, he was NOT rich and famous.

As for my knowledge of the British NHS...I lived there for over a decade. My father worked as a defense contractor after he retired from the US military and we lived on the British economy. I never had to wait more than a day to see my NHS doc. Needed to see a specialist...faster than my insurance does here in the states. My father's quintuple bypass surgery was done in an NHS hospital...his only complaint was the food, but he is a very picky eater and complains about something even in high end restaurants!
My English grandfather is being well taken care of in his advance stage of Alzheimer's, with meds being given that have extended his time that would have been cost prohibitive here in the US. My grandmother is also being well taken care of.

I would say my ACTUAL experience with the British NHS appears to be less anecdotal than yours. Mine is first hand, in that country. Yours is in NZ, talking to other people.

JoeSwiss| 12.28.10 @ 8:07AM

Taking down rules, through the CRA? Far too small-minded! No, it's time to start taking down entire agencies. What's the FCC for, as well? Everything these bureaucrats do working in the dark is a fresh invitation to start asking ourselves that question. Who seeth us? and who knoweth us?

jstwndring| 12.28.10 @ 5:54PM

Absoultely! I don't know what will be possible with Republicans only dominating the House, but, yeah get rid of most of these regulatory monstrosities that were set up by DemocRats to try and get around Congress. The EPA is high on my sh-t-list and should be removed IMMEDIATELY. Then, drill like mad and watch oil-prices tank. Then, give Israel the green light to take out that runt in the middle-east, the new Hitler, Ahmadinejad. Oh, and tell Saudi Arabia to go to hell. That's just for starters. :)

richard ryan| 12.28.10 @ 8:16AM

Like it or not folks, there are limited resources in this country. End of life decisions are best made between Physicians and patients, government regulations should be left out of the hospital. However, we need a program in this country to encourage living wills for everyone. End of life care in this country is generally wasteful, and driven by the guilt of family members afraid to agree to comfort care for the terminally ill. Many people, when competant to make life decisions, would not want a tube in their stomach to feed them, a tube in their throat to breathe for them, and a team of nurses to clean them daily. It is an individual decision, and it must be made by the individual, not family members. Unfortunately, when folks are admitted to the ICU, they often have no living will and are unable to speak for themselves, so they are submitted to procedures, IV sticks, tubes, machines, etc in their final days instead of the humane comfort care they deserve.

Bob K.| 12.28.10 @ 8:59AM

Never heard of Medical Malpractice Suits did you, Mr.Ryan! Never heard of Defensive Medicine, did you? Why do you think these procedures are routine?

Tell you what: Start talking Tort Reform first. Get that and then start talking about Living Wills. Most people don't have regular Wills let alone Living Wills! Would you prefer these Living Wills become mandatory like Obama wants health insurance to be?

If these unfortunate people have to undergo these procedures it is because their representatives don't know what to do and Doctors have to protect themselves from a predatory Tort Industry!

richard ryan| 12.28.10 @ 9:21AM

Bob,
You are correct. Tort reform is DESPERATELY needed. Hidden costs of defensive medicine are astronomical. Problem is DemocRATS are in bed with the trial lawyers. ATLA is biggest donor to leftists. Yes, if a patient chooses Medicare, part of enrollment should be a living will. You and I are paying for this. Our medicare taxes are MANDATORY. It is not a bad thing to insist that patients tell their doctor what THEY want prior to accepting this insurance. If they choose private insurance, it's up to them.

Bob K.| 12.29.10 @ 12:43AM

Richard,
The problem is that "one size fits all" doesn't work here. Lots of retirement pensions require pensioners to take Medicare after they reach the age of 65 as a supplement to the medical portion of their retirement so there is really no choice in taking Medicare in many instances.

And, I think, that by still giving Tort Lawyers free reign in Obama Care, the Democrats are sneaking a "Trojan Horse" into the castle that will eventually lead to it's downfall. No Doctors in their right minds will continue working in a profession where their wages are controlled but their costs of doing business (Malpractice Insurance here) are not! And these costs continue to rise. Indeed, here in PA, there would be virtually no Obstetricians if the State did not pick up half the costs of their malpractice premiums which now are in the neighborhood of $100,000.00 a year!

Something is going to have to give in this government/tort lawyer axis.

Occam's Tool| 12.28.10 @ 11:14AM

Dear Bob and Richard,

Thank you for your understanding of the pressures of my job. Happy New Year to you both.

KyMouse| 12.28.10 @ 1:25PM

The "Will to Live," available from the National Right to Life Committee (www.nrlc.org), is a good alternative to the Living Will. The Living Will was developed with support from euthanasia groups (e.g. an 1968 Indiana Law Journal article entitled "Due Process of Euthanasia: The Living Will, a Proposal").

On any document, be very specific about listing what treatments you don't want. A vague description (such as "excessive," "benefit" and "burden") may make it too hard for physicians and/or courts to determine your wishes.

Keep in mind that your wishes may change over time. A treatment you don't think you would want now might seem very good to you in the distant future (one of my relatives didn't want "heroic" measures taken to prolong her life -- until she learned that she was going to become a grandmother for the first time).

In addition to a Will to Live, it's a good idea to have a Durable Power of Attorney for Health Care, so that someone you know and trust will be empowered to consult with your physician(s) and consider treatments that weren't available back when you signed the document.

PJ| 12.28.10 @ 1:41PM

"Keep in mind that your wishes may change over time. A treatment you don't think you would want now might seem very good to you in the distant future."

I've been reading more & more of dying patients changing their minds & going against their living will. The desire to live even when dying is very strong.

Recently I read a very sad story in the British papers about a dying woman wanting to prolong her life but was refused treatment because she stated in her living will that she did not want her life extended.

Bob K.| 12.29.10 @ 12:44AM

Same to you, Ockham!

Deborah D | 12.28.10 @ 9:01AM

It is difficult. I know from experience. You are right -- the government has no place in this at all. It is a serious question that deserves serious discussion. My mother told us while she was still able to make her own decisions -- "I don't want to starve to death." That was her only request -- so she got the feeding tube. It was still difficult for all involved, but she still had so much joy until the very end a year later. God bless and rest her soul.

Stormzeye| 12.28.10 @ 10:17AM

Richard, I agree with your assessment. People must take responsibility for their own health care and for their own ending. Those who leave decisions regarding care and the extent of extraordinary measures at the end of life to guilt-ridden survivors are a bit careless and a bit cowardly. Dignity at the end comes through personal choice not through the choice of others, including the government.

Mike from Middle Management| 12.28.10 @ 2:54PM

This thread is exactly the kind of helpful, insightful discussion I personally need on this volatile topic. My parents are elderly, and I personally have had to re-assess my own eventual needs for end-of-life care knowing my children will face difficult decisions someday. My understanding of what I'll call "common law" in the USA is that even without a living will, if you tell your next of kin what you want in terms of end-of-life care, then that carries the weight of law. Does anyone know if that's true?

Steve A| 12.28.10 @ 3:37PM

Mike, In theory, I believe you are correct, however, you will likely not be in a position to be fully aware of the decisions being made by those you instructed & are relying on those selected to follow through with your wishes.

Long Term Care Policy & a Living Will. Have them both & I am in my 40s.

My understanding is that you can simply hand write a living will & it is binding if presented.

Fionnagh| 12.29.10 @ 2:41PM

Mike, with respect - No, No, and NO!! Put those wishes in writing, signature witnessed preferably by two healthy strangers, not family members. Let your attorney have the originally-signed document, locked in a fireproof safe; give certified copies to your primary care physician and banker. Am giving this advice both as a longtime paralegal, and as one of four daughters who saw her parents' last wishes tossed in the gutter by the other three sisters, because those final wishes were not in writng.

Occam's Tool| 12.30.10 @ 4:37PM

Mike, put things in writing, or trust your next of kin a lot. My wife and I have set each other up as power of attorney for precisely this reason. We have discussed this in detail with each other. The next of kin thing comes in to play only when you are incompetent or comatose. In questionable cases, the docs will get legal advice and play it that way. Putting things in writing will spare your kin a lot of grief, and LETTING them know this, as well. G-d Bless. As Louie Mayer once said: "A verbal agreement isn't worth the paper it's [not] written on.

But, there is no substitute for a legal consultation if you have questions---and certainly if you have a sizable estate.

Ray| 12.28.10 @ 3:38PM

"However, we need a program in this country to encourage living wills for everyone."

No, we don't. Those kinds of decisions are PERSONAL (like if you wish to be an organ donor or not), so there shouldn't be a government program to "encourage" a personal choice. One such a government program is put into place, the "personal" part of choice is invariably removed an replaced with" collective" choice, as history has taught us time and time again.

richard ryan| 12.29.10 @ 9:09AM

We had better prepare for some difficult choices then. Medicare is unfunded to the tune of 50 TRILLION $ over the next generation. I don't care how you change tax or spending policy in this country, we will NEVER EVER make ends meet, especially with the Boomers reaching their final few decades. We can ignore this problem and let the tidal wave engulf us, or we can begin to make some difficult choices now. Paul Ryan is the only person in our government who is seriously facing the truth and his Roadmap is a good start, but the Boomers may bankrupt us regardless.

mzk1| 12.29.10 @ 1:43AM

I most certainly would! I have no intention of committing suicide. Please speak for yourself.

Fionnagh| 12.29.10 @ 2:44PM

Thank you. At 58, having worked for 41 years and paid into the system, I so resent the consistent inference that "boomers" are the cause of the problem. Why should I be put on the defensive because I was born in 1952?

richard ryan| 12.31.10 @ 8:22AM

50 trillion Fionnagh. It's not possible to meet this obligation. By the way, if you had "payed into" your own HSA and retirement funds, you would be in much better shape as would the fiscal situation in this country. I'm not putting you on the defensive, I'm simple outlining our miserable situation. We seem unable to make tough choices in this country, so we are quickly going the way of Greece. When things get really bad, keeping a 90 year old alive on machines will be off the table, and the least of our worries.

Occam's Tool| 12.30.10 @ 4:43PM

I, personally, encourage a discussion. I DO NOT ENCOURAGE A GOVERNMENT LAID OUT SCRIPT.

However, getting things documented regarding DNRs, etc. is a great idea. Many people, for example, do not realize that if a 70 year old has a code, even if he/she survives it, the odds are quite poor of him making it out of the hospital alive. What a code will entail is the possible breaking of bones, etc.

So a discussion, and written documentation of it, is a very useful thing to do with your doc. It's part of being a grownup. In the absence of this, the fall back position is full court press, remember that. Try getting a decision against a doc for saving a guy's life when it wasn't wanted in the ABSENCE of written documentation to the contrary. And heroic efforts can be quite....barbaric.

Elaine Suhre| 12.30.10 @ 3:04PM

Hmmm. Be sure to email us when your time comes. It will interesting to see if you have the same attitude when life, or death, becomes personal.

End of life measures aren't defined between one's physician and self, but between God and self.

Melvin| 12.28.10 @ 8:19AM

Calling this fascist pig an S.O.B. is actually a term that is too good for him. He is so much worse. Sometimes I wonder if there is a term that is vile enough to describe him.
There is but it is not fit for public consumption.
Some of you have posted have alluded to the fact that Mr. Berkwick should be dragged from whatever hole that he is hiding in. I would take it a step further, this monster of a human being should be crucified and nailed to the cross and hung on the Washington Mall.
But alas this will never happen. Americans have been domesticated by government. They no longer hunger for freedom, but rather hunger for the next line up of Dancing with the Stars.
Many of us would be surprised in how many Americans actually support this. Offspring no longer want to take care of mom and dad when they get old. Death panels just get mom and dad conveniently out of the picture so the kids can divide up the stuff and property without having to deal with the guilt of having mom and dad euthanized.
The kids get the stuff in the house and the government gets the house and property for taxes and paying for putting the old grunts to sleep.
Thats right mom, dad, grandma and grandpa you old bastards are taking up too much space, just get the hell out of the way, your no longer economically viable.
What about the woman who left her handicapped kid at Sea World here before Christmas. Under Berwick's plan, she wouldn't have to dump junior at Sea World she could just dump him at one of Obama's end of life centers. Get an on-line death certificate and for a nominal fee, the government would dispose of the carcass.
Because after all Obama and Berwick don't consider us human beings anymore, we're just useless carcasses in their eyes.
Nope Americans will no longer fight this, they'll stand in line just as the Jews did getting on the trains in an orderly fashion and taking to Auschwitz, but instead of Auschwitz we will be taken to Washington D.C..

George True| 12.28.10 @ 8:23AM

The federal government has absolutely no business whatsoever inserting itself into the process of end of life planning. There are ALREADY a phalanx of different professionals who perform this function, including doctors, nurses, chaplains, financial and estate planners, insurance agents, attorneys, as well as long-term care, home care, and hospice care practitioners.

But there are several greater issues here. The first issue is the abject lawlessness of the Obama administration. The end of life planning was taken out of the legislation by the Democrats. The bill that was (illegally) passed did not include it. Yet the administration now enacts it by fiat, that is to say by unconstitutional means, or in other words, illegally. This kind of naked disregard for the law of the land by those in power cannot be tolerated, ever.

The second issue is the breathtaking dishonesty and duplicity of the Obama administration. The breach of trust exhibited by this administration in their covertly sneaking the 'death panels' back in and then trying to keep it under wraps is both contemptible and unconscionable. They have demonstrated by their actions that they cannot be trusted to conduct themselves honestly and in good faith on anything.

Even more than the death panels themselves, the lawlessness and the duplicity on the part of this president and his minions needs to be continuously pointed out to the electorate by the new leaders of congress.

Deborah D | 12.28.10 @ 9:13AM

Brilliantly stated, Mr. True. "Lawlessness" is the word I yelled at the television last night when Charles Krauthammer was struggling to find the right word to describe the Obama administration's outrageous behavior in (everything in my opinion) this circumstance. This administration makes the Nixon administration look like juvenile delinquents compared to their organized crime. If someone doesn't go to jail in this administration, then our whole system is no longer functional.

saleboter| 12.28.10 @ 8:32AM

So a bureaucrat with access to my financial, voting and religious records decides whether I receive treatment. Welcome to a Brave new world

JP| 12.28.10 @ 8:33AM

Berwick sets up Death Panels by regulatory fiat and Congress will let him. This will be one of Boehner's first tests.

Mimi| 12.28.10 @ 8:39AM

So Berwick "loves" the BRITS health-care ideas?
Didn't we have a war over 200 years ago called "The American Revolution"?
The Congressional Review Law needs to set up SHOP and Quick!! We are returning to NIGHT-MARE city with these darn LEFTIES......To them elections be DAMNED.... the new name in TOWN is DECREE and FIAT.....The battle goes on FOLKS....Don't sit down!!!!

Brian Mc| 12.28.10 @ 8:42AM

Let's call it the Teddy Plan. How much money was doled out to ol' Senator Kennedy's care in his last year on the planet? Adjust that dollar figure continually, and the least of our brethren are allotted the same figure.

When my father-in-law is lying on his death bed in a few years and a government hack is preparing to pull the plug I will look deep into his countenance and think, "I tried to tell you so, but you stood beside your socialism thinking you were fighting the good fight"...but instead will only tell him I love him and will miss him as everything around we the survivors flatlines.

Anthony| 12.28.10 @ 8:46AM

Don't expect Gov. Palin to be vindicated by either those "corrupt bastards" in the MSM and those beltway insiders talking heads on the Right.
Her instincts are dead on and each time she fires at the left she hits the bullseye.
Someday the elites will actually catch up to her, but I'm not holding my breath.
Amazing how this woman runs circles around these clowns, and all they can do is sniff down their noses at her,oblivious to the ass kicking she's giving them.
She'll do the same to Obozo in 2012. Maybe she'll even kick Obozo's birth certificate and school transcripts out of him.

NavyBrat | 12.28.10 @ 8:50AM

This is chilling to the bone. Its eugenics in all of its new whitewashed glory. Somewhere, Dr. Mengele, Margaret Sanger, Hitler, & the Devil are all smiling. Not only to see their visions advanced. But to have them advanced by, of all people, JEWS. As a Jew myself, this is BEYOND nauseating. And its Jews like "Dr." Emmanuel who propose this who enrage me the most. DO YOU PEOPLE NOT REALIZE WHAT YOU ARE ALLOWING TO HAPPEN? DO YOU EVEN HAVE ANY IDEA WHERE POLICIES LIKE THIS LEAD?

Apparently not. These people aren't Americans. They aren't Jews. They are Marxist/Facist scum. And the day we rid ourselves of them from the levers of power in 2012 will be the happiest day of my life next to my wedding day.

Melvin| 12.28.10 @ 9:01AM

NavyBrat, the Republicans are only going to be able to do so much.
Obama is not stupid. He will leave ticking time bombs in every nook and rabbit warren in Washington D.C.
Unfortunately for the Republicans they are only going to be able to be reactionary as these time bombs keep going off and keeping off balance and off stride.
Pelosi, the Bitch of Buchenwald summed it up. We know we are going to lose big, but Obama care will be waiting of us when we return. So how does this bitch know this unless something already wasn't in the works?
The only way to kill this beast is to completely defund these bureaucracies and scatter the bureaucrats all over this Country.

NavyBrat | 12.28.10 @ 9:31AM

I agree. The framework is all in place. This was a political kamikaze mission from the word "go." And THIS political banzai charge has a good chance of success. Unless, like you said, we defund ALL this crap.

Occam's Tool| 12.28.10 @ 11:15AM

Too True, NavyBrat. Too true.

mzk1| 12.29.10 @ 1:50AM

Yes, this is the exact opposite of Judasim. Do you know that the Agudah in New York has an emergency legal corps, ready to fight DNRs? this is what we've come to.

Ned the Red| 12.28.10 @ 9:04AM

My mother lost most of her sight from the ravages of Macular Degeneration; she lost most of her hearing from the ravages of old age.
She never complained. She quit driving in the early stages of vision loss and learned to live in a smaller environment. She was an avid reader, so she switched to recorded books. She used hearing aids and learned to change the batteries without seeing them. She got a dog.
We were all very proud of her strength of character. Her acceptance of fate and her steadfast adaptation to its adversity inspired all who knew her.
At 74 it was discovered she had three brain tumors. We found a neurosurgeon to take them out and she had 9 more years of life.
She suffered more the last few months than before but fought to the end.
In the future, if we let it happen, these folks and many more will be eliminated by a government decree long before their time, and unlike some stupid undiscovered fantasy cure for cancer in a rain forest, we will all be losing a very tangible asset.

Charie| 12.30.10 @ 9:00PM

Ned, God bless your courageous mother. If this country allows the government to take us down a government healthcare path, you can be sure it will make no difference how courageous the old are because they will be gone without leaving their courage to set an example for those who follow.

I think this will break down into all phases of life and will turn us into a nation of people who no longer care for their history. They will eat, drink and be merry, live their hedonistic lives and then die at the whim of the government. Or perhaps they will not even eat and drink because of government directive.

Actually, I don't think their lives will be that merry, either, even though hedonistic.

"Socialism is a philosophy of failure, the creed of ignorance, and the gospel of envy, its inherent virtue is the equal sharing of misery." ~Winston Churchill

Ned the Red| 12.31.10 @ 9:16AM

Thanks for the Churchill quote. I will stick it at the top of my facebook page.

Louis Jenkins| 12.28.10 @ 9:05AM

Berwick has nailed the lid on Obama's coffin for 2012. If Boehner gets up infront of the nation and cries, and denounces this policy, the video will go viral. If half of the Republican Congress cries it will sweep the nation. This nation is headed down people (read NavyBrat) and if we don't get it back we're going with it.

MikeD| 12.28.10 @ 9:06AM

NavyBrat; Remember that Jews voted nearly 80% for barry the muslim. And here I thought that Jews were so smart! I've already posted many times about all the time I've spent in Israel; and how the Israelis are infuriated at American Jews who seem to have a death wish. After Auschweitz and Dachau, how could ANY JEW ever vote for a demoncrap? I just can't understand their self-destructive impulse. Their Patron Saint FDR denied the existence of the death camps up till the day he died, and his hero was "Uncle Joe" Stalin. Hmmm...

American Jews: Go visit Israel and get some "Gonadal Spheroid Seeds". Maybe you'll grow a pair and start thinking for yourselves instead of reflexively hitting the (D) lever. All you have to lose is your life.

NavyBrat | 12.28.10 @ 10:26AM

It just makes me furious, MikeD. My Aunt (Dad's little sis) & her husband & kids are liberal Jews. My Dad used to jerk my Aunt's chain relentlessly about her being a liberal. Now that he's gone, I'm left to sit there in my own befuddlement when they issue forth with their "enlightened" liberal versions of current events. My cousin works on the Hill for John Dingelberry of MI. And I just sit & scratch my head in wonder at how willfully ignorant these supposedly "smart" people just keep voting for & espousing policies that go against everything that ANY good G*d fearing person would stand for. And I'm proud to say that I stand apart from these lemmings. Just like my Dad did.

Occam's Tool| 12.28.10 @ 11:17AM

Dear MikeD and NavyBrat:

Even planes carrying bombs directed to synagogues in Chicago cannot make my parents and sister see the light. My wife thinks I was switched at birth.

NavyBrat---go to Debbie Schlussel's page. Do you some good to realize there are ultra conservative Jewish attorneys.

NavyBrat | 12.28.10 @ 12:23PM

Occam:

Thanks for the tip on the website. And don't worry. My lib relies in DC are every bit as deluded as your folks & sister. This isn't to say I love them any less, but LORD, its frustrating.

Curly Smith| 12.28.10 @ 9:25AM

We should applaud Berwick and the Republicans should embrace his vision of the future. Not as their desired end-state but as the unavoidable end-state if we don't fundamentally reform Social Security, Medicare, the welfare state, insurance, and all the rest of the entitlements. Medicare cannot continue as it is, it has over $100 trillion in unfunded liabilities. Berwick's Death Panels will be the only possible outcome unless Congress quits sniffing at the edges and gets serious about reform.

So celebrate Berwick, let the people know about his "rule". Then ask them to make a choice: reform entitlements now or let bureaucrats decide your fate in a few years. Let the people make the stark choice and quit the nonsense of splitting the country by "everybody over 55" and "everybody below 55". The government lied to everybody, it's not fair to say "we'll keep our promises to this group but not to that group". Reform will be painful but it's a pain that must be equally shared.

Stan Redmond| 12.28.10 @ 9:44AM

Democrats and Obama... The party of death and tyranny. Their most precious "rights" are centered on death. Death of the unborn for their relentless support of abortion. Death for the non-desireables by their promotion of assisted suicide. And now death by executive fiat. Obama is on the same level as Pol Pot and Stalin. I have ZERO doubt that Obama would persue the same thype of country if he weren't restrained by a well armed populace.

davelnaf| 12.28.10 @ 9:47AM

If Democrats could get away with it they would effectively shove our democracy aside and rule by regulation. After all, they know what’s best for us because they’re Democrats and dems always have the best solution to every problem. It’s almost inspiring watching these people standing up for truth, justice, and political oblivion.

Impeach Don't Wait| 12.28.10 @ 9:46PM

"If Democrats could get away with it they would effectively shove our democracy aside and rule by regulation."

Good point... um... WAIT! That's what they're doing!!!

A. C. Santore| 12.28.10 @ 9:48AM

George Washington's "Farewell Address" never ceases to amaze me. Read one of the things he warned us about:

"...cunning, ambitious and unprincipled men will be enabled to subvert the power of the people and to usurp for themselves the reins of government, destroying afterwards the very engines which have lifted them to unjust dominion."

And this:

"It is important, likewise, that the habits of thinking in a free country should inspire caution in those entrusted with its administration, to confine themselves within their respective constitutional spheres, avoiding in the exercise of the powers of one department to encroach upon another. The spirit of encroachment tends to consolidate the powers of all the departments in one, and thus to create, whatever the form of government, a real despotism."

There's much more to learn about the present administration from Washington's "Farewell Address." It's online. Read it.

Louis Jenkins| 12.28.10 @ 1:22PM

And add this:

"The budget should be balanced, the Treasury should be refilled, public debt should be reduced, the arrogance of officialdom should be tempered and controlled, and the assistance to foreign lands should be curtailed lest Rome become bankrupt. People must again learn to work, instead of living on public assistance."

- Cicero - 55 BC

Bob Grant| 12.28.10 @ 9:51AM

This is a truly frightening piece but let's not forget others were discussing "death panels" long before Sarah Palin facebooked/tweeted/twittered it.

John Boehner is the only true leader here as he had REAL SKIN in the game when he protested from Capitol Hill. He put his leadership and house seat on the line.

On the other hand, when Sarah twittered her remark, SHE RISKED NOTHING. The only result being more books sold and increased speaking fees.

Let's not crown Mrs. Palin Joan of Arc part Deaux just yet.

The Big E| 12.28.10 @ 10:13AM

Bob Grant,

While your assessment of Sarah Palin having nothing to lose with her remarks is accurate, your assessment of Boehner as the "only true leader here" is premature. Leadership requires more than words when careers are at risk - it requires action, and especially, decisive and thoughtful action when lives are at risk. Boehner's actions over the next few months, or his lack of action as the case may be, will be far more telling. As this new "Death Panel" decree takes effect 1/1/11, undoing it should be the first action of the new Congress. If it is not . . .

Bob Grant| 12.28.10 @ 10:32AM

I completely agree.

I should have qualified with: "...up to this point, John Boehner is the only one who has displayed true leadership..."

George True| 12.28.10 @ 10:10AM

Stoe exaggerating, Curly. The sum total of the unfunded mandate of Medicare, Medicaid, and Social Security is 'only' 75 trillion dollars. (That is actually the real number - it staggers the imagination.)

You are correct that Social Insecurity must be reformed. The longer we wait, the more painful it will be and the more personally financially devastating it will be to most Americans.

The problem with reform is that the government has long since embezzled (stolen) all the money and spent it. Even if there were the political will to fundamentally reform and restructure Social Insecurity, the problem is how do you fund a pension program that is not just under funded, but totally unfunded since its inception? Where do we come up with the tens of trillions of dollars to put back into the 'lockbox' that, with dividends, would total at least twenty or thirty trillion dollars?

There is no way to conjure up even a fraction of that money. So you are absolutely correct, there will be pain. Those already retired may have to accept no indexing for inflation. Those within a few years of retirement may be forced to accept a reduced payout and/or not receiving benefits for an extra few years. (The baby boomers will be hardest hit.) Those below a certain age will be converted to a defined contribution rather than a defined benefit plan, just like an IRA or 401K.

Nobody will be happy. But the alternative is to continue whistling past the graveyard until eventually the checks start bouncing and/or the currency is so debased from printing money to back the checks that it isn't enough to provide even a subsistence level of living for retirees.

As far as Medicare is concerned, we have to reform our current system of medicine. That means that first, Obamacare must be repealed in its entirety. Then we need to address the problems that O-care was allegedly intended to address, but in reality addressed NONE of.

We need to convert everybody, including retirees, into cash customers for their health care needs through high deductible health plans with Health Savings Accounts. It is not and has never been the insurance companies who are responsible for the run up in health care costs. It is the health care PROVIDERS. The insurance companies are just the ones stuck with the bill. For people paying cash, the price for any given procedure or treatment is about 20-25% of what is charged if there is a third party payer.

When people are spending their own money out of tax-sheltered accounts for their health care, they will shop for the best deal, and prices will come down dramatically. Look at things like Lasik eye surgery and various cosmetic surgeries. Since these are elective surgeries (no third party payer) for which cost conscious consumers are paying their own money, the costs are about one fifth what they were just ten or fifteen years ago.

By using consumer driven solutions to rein in health care costs, the government would in the long term cut its own financial liability for Medicare costs by 75-80%. And it does not require the government to take over anything.

George S| 12.28.10 @ 10:29AM

Reform will occur once we take away the right to vote from entitlement recipients -- which will never happen. Nothing else will even come close. Imagine if there was a pot of gold that turned up to cover the liabilities of Medicare and social security. Do you think the political class will cover debts that proffered political benefit to long dead congressmen or will they buy future votes with that money? The productive class will not be impressed with that money but the professional agitators, grant recipients, government bureaucracies and other wealth transfer beneficiaries will salivate at the prospect of spending that money. What we should do and what we are able to do are two different things when 67% of the federal budget is under the heading of Payment To Individuals.

John Navratil| 12.28.10 @ 10:58AM

One idea I presented to my Congressman John Culberson - for which I got, as is typical, no response - was to begin incrementally raising the eligibility age for Social Security immediately. Some number-crunching is in order to set the actual increment; perhaps it is to raise the age by two months each year.

According to current news reports, 10,000 boomers are to retire each day for the next 19 years. This would raise the retirement to 68 by the time the last boomer becomes eligible. Proposals to raise the age to 67 by 2050 will do absolutely nothing.

The follow on thought is to keep raising the age until no one lives long enough to become eligible and the program simply fades away.

Ken (Old Texican)| 12.28.10 @ 11:06AM

Navotril,
Trust me, Culberson heard you. Check his voting record, and his statements on his site.

Believe you me, he hs heard all of us....and will act.

John Navratil| 12.28.10 @ 6:23PM

Ken,

I hope so. His head seems to be in the right place. However, when I write suggesting members of Congress all submit to an IRS audit to avoid the Rangel imbroglio and get a response about Ramos and Compean, write back and get not response, then write on four other topics and only get a response from someone else's email when I suggest it is hard to feel represented by someone with I cannot communicate, I wonder. It's not comforting.

Redstateboy| 12.28.10 @ 10:17AM

This Congress just might be America's last chance to save itself from the unbelievable audacity of Liber-ulism.

cyberdog| 12.28.10 @ 10:19AM

When I look at Obama's eyes all I ever see is Satan

virginia| 12.28.10 @ 10:35AM

OK , by recess appointment of berwick and the subsequent promulgation of the the new berwick death panel rule obama has put himself on the record as the chief engineer of death panels and thus his name whenever it appears in writing should forever be immediately followed by the skull and crossbones trademark.

virginia| 12.28.10 @ 10:35AM

OK , by recess appointment of berwick and the subsequent promulgation of the the new berwick death panel rule obama has put himself on the record as the chief engineer of death panels and thus his name whenever it appears in writing should forever be immediately followed by the skull and crossbones trademark.

Petronius| 12.28.10 @ 11:05AM

The only people who can stop these despots are the physicians and nurses themselves. Someday Berwick is going to tell them not to care for those dearest to them. On That Day it's over.
The only answer is to get market forces back into medicine; and education, and other things now insulated from it.

Occam's Tool| 12.28.10 @ 11:20AM

Actually, Petronius, we MDs CAN'T. Our power to practice our professions is state derived. YOU have to hammer the legislators in combination WITH us. Alone, we are powerless.

Steve A| 12.28.10 @ 11:06AM

All you neo cons are just jealous. Obama is smarter then all ov you. This end of life counselling is just what the Dr. ordered & provides a valuable public service, as spelled out in the "providing for the generel welfare" clause of the constitution.

They had to do something as the private sector greed of the insurance companies & capitalism once again failed.....

OK, I gave it my best shot at a Progressive argumant. Even including grammer & spellin. I think I feel sick now.

Occam's Tool| 12.28.10 @ 11:19AM

Steve, you are right. Being Liberal HURTS. G-d Bless, my Conservative friend.

John Navratil| 12.28.10 @ 11:24AM

Read two Sowell or Williams columns quickly. You're playing with fire. You should feel better in the morning :)

George True| 12.28.10 @ 11:19AM

Steve, that was a perfect imitation of Purpleguy. It is probably almost word for word what he and others of his mindset would say.

The ill feeling you experienced was just the cognitive dissonance.

Steve A| 12.28.10 @ 11:31AM

Thanks for the support, guys. My experiment reminded me of playing with a ouija board once when I was 12 & getting a chill up my spine. It was like channeling the Dark Side of the force & should not be attempted without proper training & a Conservative foundation.

PattyMor| 12.28.10 @ 11:20AM

The yearly "end of life counseling" has all the fingerpints of Haldren, the proponent of "nudge".
We'll just bring you along one step at a time, until the day we encourage you to jump off the cliff. Saves two birds with one stone: you save on medicare and social security payments.
But, like all good communists, they exempt themselves from the system they foist on the rest of us.

Bob Miller| 12.28.10 @ 11:38AM

As with any radical concept, this one first needs validation bta controlled experiment on a limited scale. I recommend exposing only Obama appointees to the ministrations of these death panels. We'll see then how they like the idea.

David W| 12.28.10 @ 11:39AM

"Life as a whole has no meaning. Life began, as the best available theories tell us, in a chance combination of gasses; it then evolved through random mutation and natural selection. All this just happened; it did not happen to any overall purpose."

If someone were to shoot and kill Mr. Singer would that be considered a crime? Since life has no purpose, as far as Mr. Singer is concerned, how could his death be wrong? Just asking.

Bob Grant| 12.28.10 @ 11:39AM

Will Mother Robinson or Auntie Zeituni be coerced to take one for the team and just die already?

Bob Miller| 12.28.10 @ 11:40AM

I meant "...by a controlled experiment..."

Melvin| 12.28.10 @ 11:43AM

The solution to this whole death panel argument is...
Legalize murder.
People shouldn't be so shocked really. We need to be realistic. This whole death panel argument is nothing more than a nice politically correct cutesy phrase of legalized murder.
Strip the fluff away and that what this whole thing boils down to doesn't it?
The government is absolutely terrified of the Baby Boomers no longer being productive.
Just because the government is in charge of it, somehow makes it more palatable to the masses.
Being denied a certain treatment, and walking down the public sidewalk and getting whacked amounts to the same thing.
In one instance the government bureaucrat carries out the death sentence and the next some thug does it, so what is the problem people!
Politicians, Unions, political staffers, they don't have to worry about getting whacked! Because they're health plan is golden with security.
You know something people? Maybe just maybe we need to start making politicians, unions, and political staffers economically unviable, ya think.
Kind of evening up the odds so to speak.

MikeD| 12.28.10 @ 12:07PM

Legalized murder would actually have a few unintended positive consequences; like:

1. Most of the weapons in our (so far) free Country are owned by us 'raht wang fanatiks".

2. If murder were legalized, what would that mean for barry the muslim? Would there be a huntin' season on demoncraps and other sub-human species?

Just askin' is awl...

Stay safe, y'all...and hold your breath as you pull the trigger: it steadies your shot and increases accuracy.

Charie| 12.30.10 @ 8:41PM

ROTFLMAO, Mike! Sure your name's not Ted Nugent?

Richard Baker| 12.28.10 @ 11:45AM

With where this government is going, we may owe Dr. Mengele and his sponsors an apology.

Yosemeti Sam| 12.28.10 @ 12:00PM

Picture this Berwick fellow being run over by his own Fiat.

Fee Fie Foe Fum.

MikeD| 12.28.10 @ 12:12PM

Sam; That was two-thirds of a pun: P U! Don't get my feeble mind started with terrible puns. It could just be the 'death of me'! At least it will help recuscitate a dying business; which is about the only thing barry the muslim could possibly take credit for.

Yosemeti Sam| 12.28.10 @ 11:06PM

:)

Wayne | 12.28.10 @ 12:10PM

I go onto medicare in 3 years. To me just as onerous as the death counseling is the yearly physical, with required data about body fat, medical history etc. This is none of the governments business. I am not serving the government, they are serving me. I paid into medicare for 40 years, and just expect to receive the medical treatment I need when I need it.

Melvin| 12.28.10 @ 12:15PM

Wayne budddyyy. It doesn't matter that you did what was asked of you. Look at the promises the government made to the Indians. The only thing is you won't be able to open a casino in you house or sell tax exempt cigarettes.

Bye Bye Baby, That's All Folks| 12.28.10 @ 12:22PM

I seem to remember learning somewhere that cave men handled "end of life issues" the following way---

if mom or dad was a drag, sit them on a stone, and just crack them on the skull, REAL HARD, with a hard object.

Fallgold| 12.28.10 @ 1:57PM

The other name for death panels is abortion for seniors. The same evil that has destroyed millions of the unborn will now turn to the next most vulnerable, the elderly.

idalily| 12.28.10 @ 3:19PM

Well, of course. What did you expect? It's all about convenience. Babies arriving at the wrong time? Aw, just scrape 'em out and throw 'em away. Parents becoming sick and needing care? Stick 'em on an ice floe. This is the ME generation, you know, where it's all about my life and to heck with anyone else, the philosophy of, " I DESERVE happiness, freedom, self-fulfillment, your money..." and anyone who inconveniences must die. The scary part is the people who advocate this are perpetuating the Holocaust mentality of Mengele and Hitler and they don't even know it.

Mac| 12.31.10 @ 1:02AM

Fallgold: The other name for death panels is abortion for seniors. The same evil that has destroyed millions of the unborn will now turn to the next most vulnerable, the elderly.

What you just said is kinda funny in it's own way. Just think, many of us that are old now and would be some of the first to come into play with these "death panels" would be us, the baby boomers, the ones who have murdered so many innocent babies who didn't have anyone to speak up for them. Now it is us that are going to have our life ended by those who believe it should be ended without us having anyone to speak up for us. Funny how things come back around and bit you in the butt.

PJ| 12.28.10 @ 2:02PM

Mr Lord, As usual a very good article. Can't add anything but to say that everyone better have a close friend or relative to watch out for your well-being when you become incapacitated.

What is happening w/our medical care & everything else wrong w/this country is occurring much too fast. I feel all the crap is leaking out of the woodwork & it is up to us w/a lot of divine help to clean it up.

A day of reckoning will surely take place & I'm wondering if we will all be alive when it happens.

Danny| 12.28.10 @ 2:19PM

This debate always shocks me. conservatives are always so intent on denying progress, and turning things back to "the good old days" Well for 1000's of years people died when they were supposed to, but now with all these voodoo drugs and liberal doctors keeping people alive against the will of a God trying to take them.. They protest.

NavyBrat | 12.28.10 @ 2:29PM

What we're protesting is that these are decisions in which the gov't. has no say. Period. If people want to take "voodoo drugs" (like Avastin?), that's THEIR business. Not Berwick's, not "Dr." Emmanuel/Mengele's, & not Obama's. Its really quite simple.

Impeach Don't Wait| 12.28.10 @ 10:06PM

Thanks, NavyBrat! Drugs, treatments, doctors and nurses exist specifically to enhance health, ease suffering, and extend live, insofar as they are able to do so. Of course no drug or treatment will make a person live forever... BUT I DON'T WANT THE GOVERNMENT DETERMINING MY ACCESS TO THEM--ESPECIALLY WITH COST-SAVING AS THE MAIN CRITERION!

John Navratil| 12.28.10 @ 2:44PM

Danny,

Hobbes described the natural state of man before a central government as "solitary, poor, nasty, brutish, and short." Hobbes had never met Obama.

Would you really like to go back to a world before Penicillin? Well get ready, because this government is taking us there.

Steve A| 12.28.10 @ 3:25PM

Hey Danny, Just a wild shot in the dark here but I think God could trump the voodo drugs anytime he wants to call your #. Just a complete guess though.....

Ray| 12.28.10 @ 4:06PM

"these voodoo drugs and liberal doctors keeping people alive against the will of a God trying to take them"

Just how did you come up with that conclusion? Do you commune with God and he told you this?

If God want's you dead, no amount of "voodoo drugs," no amount of medical intervention is going to prevent it. God is Omnipotent, has unlimited power. That means that mankind, even with all our resources combined, can not stop him for carrying out his own will.

People aren't living longer today in spite of God's will. They're living longer today BECAUSE of God's will. It is God's will which gives us the intelligence that needed to develop techniques to treat medical maladies.

To not use that intelligence, to not offer people the treatments that extend their lives, to arbitrarily decide when people should live and die, THAT is what violates God's will.

Ray| 12.28.10 @ 3:49PM

What bothers me the most about this subject is the mandatory yearly requirement of the doctors to be included in end-of-live counseling. Doctors should stay out of these types of decisions as doctors are supposed to be unbiased in how or when someone should receive treatments.

I don't know about the rest of you, but I don't want to be treated by a doctor who feels that letting me die could be in the best interest for me, my family, and the rest of society.

What the Obama administration is doing is removing the unbiased, objective care that usually exists and replacing it biased, subjective opinions. THAT is a deadly scenario when it comes to health care. Instead of reforming health care in America, Obama is destroying it, along with the people that health care serves.

rdman| 12.28.10 @ 4:20PM

There was another evil S.O.B. who carried the title Doctor... his name was Joseph Mengele and he worked for Adolf Hitler.

jstwndring| 12.28.10 @ 4:40PM

So true, and an accurate comparison. These DemocRats are such Nazis. Well, they are our country's National Socialist Party afterall. The Nazis got rid of people that were of no use to the collective as well. Swear allegiance to the party--as opposed to the Constitution.

Democrats = Monstors.

jstwndring| 12.28.10 @ 4:43PM

Also notice that democrats are generally agnositc, atheistic, or, at best believe in only a generic sense of "god". Consistently, those who don't believe in the One True God, can justify killing anyone.

Thom| 12.28.10 @ 5:22PM

I’m having increasing trouble finding any substance differences between our current Marxist collectivists and the more recent kind found in the Nazis and Communists. All such forms of “collectivists” will ultimately slaughter all forms of resistance in order to save the “system of control” at the expense of the soft human tissue that supports it with the fruits of their labor. Pick any Marxist program, Social Security, Medicare, Medicaid, Public Education, etc and when their monsters spin out of control the problem is the “people” side of the equation, not the program itself. 70+ years of uninterrupted incremental “progress” that has made more and more citizens into slaves is now bearing fruit and will ultimately destroy this Republic from within if a dramatic change of course is not undertaken relatively soon.

With half the country voting for these enslavement programs and living off the labors of a shrinking population of producers, there isn’t much of a realistic chance that the sloths in our population can be reasoned to vote against their own self interest. The set piece nature of our political system doesn’t work well with such dramatic shocks as our collective maters are arranging. Politics as usual will just delay the ultimate downfall a few months, maybe years at best.

As demonstrated by the well known collectives of the last century this crew will sacrifice as many people as required to obtain their goals of a god like utopia on this earth. Those that don’t appreciate this reality had better start assessing the new reality of having half your neighbors being your worst enemy when all is said and done. The most deadly and effective conspiracies in history took place in plain sight and tens of millions bought into it and even more couldn’t see it right before their eyes. Congress has for decades delegated it authority under the Constitution to an unelected and accountable bureaucracy and the Courts. If that does not change, we are going to be down to one very ugly answer to all this. If the leadership of the new House does not get this, we are all going to need divine help.

Jack London| 12.28.10 @ 5:30PM

What hysterical nonsense. Next you'll be saying there's no waste in end of life care and no suffering caused by medical interventions that keep people living as vegetables. I can understand calling for Medicare to be canned and we all taking our chances on the individual market (but just see what you're premiums will be when you're 75 and in poor health). But arguing against a consistent and compassionate approach to end of life care within a government program is just stupid, as without this and other measures such as evidence based medicine Medicare will collapse anyway.

We're seeing research now for example that hospice based, palliative care can lead to longer life of higher quality than endless surgery that means people will never leave hospital except in a body bag.

jstwndring| 12.28.10 @ 6:05PM

Shouldn't people at least have options? Our concern under socialized medine is that the government will take away options even if you can afford it. The U.S. has long been a nation of individual liberty and freedom--choice. The government is now proposing to cut off certain types of care for all because the cost is considered too high for some. Isn't that contradicting the arguement that state-run medicine should be implemented for cost reasons? The government is now arguing against one of the prime stated reasons for implementing national health care in the first place--cost.

Jack London| 12.28.10 @ 6:23PM

From what I can see we'll actually have more options, as hospice or home based care is often not offered.

I don't see anyone cut out of effective options (and if you can afford it you'll always be able to pay for what you want). What I see is the necessity of scaling down wasteful 'care'. Don't forget that physicians are already incentivized to intervene with expensive and often hopeless treatments - I take your point about cost but we simply can't afford to throw away money say on huge amounts of chemotherapy in the final couple of weeks of life where there can be no advantage whatsoever to the person.

As usual, we don't hear any alternate policy from the knee-jerkers - how would they contain Medicare costs and provide a higher standard of care?

Occam's Tool| 12.30.10 @ 4:54PM

IMPEACH---well said!!! Everyone who is interested in this---NZ has an NHS similar to Britain's. The largest daily newspaper follows the stories on it, although the conclusions never make their way onto the uber-Liberal editorial pages. But all you have to do is search there for "District Health Boards." You'll find every argument you need.

I am going to be seeing patients over the weekend, watching silly movies, and playing with the cats (Rocky and Cassius, of course). I do want to say that with very few exceptions, I have had a blast on this site this year, and have met quite a few wonderful people. I am continuously amazed by the depth of reading and thought that go into the majority of opinions here. Ken, Mike, Margie, Victor, Navy, Booger, Eric (and others)---what a lovely group of people you are. Drive safe and be careful this Holiday and look forward to blogging more next year!

Occam's Tool| 12.30.10 @ 4:59PM

Dear Jack:

If a physician opts out of Medicare to treat a patient with treatments not covered by same, then he can treat no Medicare patients, for, I believe, two years. It's quite draconian. Medicare is a jealous mistress. It's not quite---"you can pay for it anyway." Medicare has VERY strict billing and services offered requirements. I have hypertension, and my shoulders are starting to hurt already (I don't do Medicare now for precisely this reason), so I don't care to go into it in more detail, but Google "Physician opt-outs of Medicare."

Actually, the main thing that activates heroic treatments by docs in the hopeless cases is not money, but fear of malpractice retaliation. That, believe it or not, is our main incentive for going overboard.

Occam's Tool| 12.30.10 @ 5:03PM

Below are the opt-out rules---again please note--MDs opt out of Medicare for one of their patients, they must opt out For Two Years for All Patients:

"Overview

A physician or practitioner may "opt out" of Medicare and enter into private contracts with Medicare beneficiaries if specific requirements are met. When a provider "opts out" of Medicare, no services provided by that individual are covered by Medicare and no payment can be made to the physician or to beneficiaries except for services provided in an emergency/urgent care situation (see guidelines below).

Private Contract Specifics

A private contract is a contract between a Medicare beneficiary and a provider who has opted out of Medicare for two years for all covered items and services furnished to Medicare beneficiaries. The beneficiary agrees to give up Medicare payment for services furnished by the provider and to pay the provider without regard to any limits that would otherwise apply to what the provider would charge.

The private contract must:

Be in writing and in print sufficiently large to ensure that the beneficiary is able to read the contract.
Be signed by the beneficiary or his/her legal representative and by the physician/practitioner prior to any services provided under the contract's terms.
Clearly state whether the physician/practitioner is excluded from Medicare under the Social Security Act.
State that the beneficiary or legal representative accepts full responsibility for payment of the physician's or practitioner's charge for all services furnished by the physician/practitioner.
State that the beneficiary or legal representative understands that Medicare limits do not apply to what the physician/practitioner may charge.
State that the beneficiary or his/her legal representative agrees not to submit a claim to Medicare or to ask the physician/practitioner to submit a claim to Medicare.
State that the beneficiary or legal representative understands that Medicare payment will not be made for any items or services furnished by the physician/practitioner that would have otherwise been covered by Medicare if there was no private contract and a proper Medicare claim had been submitted.
State that the beneficiary or legal representative enters into the contract with the knowledge of the right to obtain Medicare-covered items and services from physicians and practitioners who have not opted out of Medicare, and that the beneficiary is not compelled to enter into private contracts with other physicians or practitioners who have not opted out.
State the expected or known effective date and expected or known expiration date of the opt out period.
State that the beneficiary or legal representative understands that Medigap plans do not, and that other supplemental plans may elect not to, make payments for items and services not paid for by Medicare.
Not be entered into by the beneficiary or by the beneficiary's legal representative during a time when the beneficiary requires emergency care services or urgent care services.
Be provided (a photocopy is permissible) to the beneficiary or to his/her legal representative before items or services are furnished to the beneficiary under the terms of the contract.
Be retained (original signatures of both parties required) by the physician/practitioner for the duration of the opt out period.
Be made available to the Centers for Medicare & Medicaid Services (CMS) upon request.
Be entered into for each opt out period.

The provider should not submit a copy of the private contract to WPS; the provider is responsible for keeping this information on file.

Medicare will pay for covered, medically necessary services ordered by an "opt out" provider, but only if the provider has acquired a unique provider identification number (UPIN) from Medicare and if the services are furnished by a provider who has not opted out. For example, if an "opt out" provider admits a beneficiary to a hospital, Medicare will reimburse the hospital for medically necessary care.

Opt Out Affidavits

In order for a physician or practitioner to "opt out" of Medicare, the provider must file an affidavit with the WPS Provider Enrollment department no later than ten days after the first private contract is entered into. The affidavit indicates that the provider will not submit any claim to Medicare for any item or services provided to Medicare beneficiaries during the two-year period after its effective date. They also agree not to receive any Medicare payments during this time period. After two years, a provider can return to Medicare or "opt out" again.

A provider cannot choose to "opt out" of Medicare for some Medicare beneficiaries but not others, or for some services but not others. The "opt out" status applies to all items or services the provider furnishes to Medicare beneficiaries regardless of the location where they are furnished. Therefore, it applies to all of a provider's Medicare numbers.

A valid opt out affidavit must:

Be in writing and be signed by the physician/practitioner.
Contain the physician's or practitioner's full name, address, telephone number, provider billing number, uniform provider identification number (UPIN), or, if neither a provider number nor a UPIN has been assigned, the physician's or practitioner's tax identification number (TIN).
State that except for emergency or urgent care services the physician/practitioner will provide services to Medicare beneficiaries during the opt out period only through private contracts that meet the criteria for services that would have been Medicare-covered services.
State that the physician/practitioner will not submit a claim to Medicare for any service furnished to a Medicare beneficiary during the opt out period, nor will the physician/practitioner permit any entity acting on his/her behalf to submit a claim to Medicare for services furnished to a Medicare beneficiary.
State that, during the opt out period, the physician/practitioner understands that he/she may receive no direct or indirect Medicare payment for services that he/she furnishes to Medicare beneficiaries with whom he/she has privately contracted, whether as an individual, an employee of an organization, a partner in a partnership, under a reassignment of benefits, or as payment for a service furnished to a Medicare beneficiary under a Medicare+Choice plan.
State that a physician/practitioner who opts out of Medicare acknowledges that, during the opt out period, his/her services are not covered under Medicare and that no Medicare payment may be made to any entity for his/her services, directly or on a capitated basis.
State on acknowledgment by the physician/practitioner to the effect that, during the opt out period, the physician/practitioner agrees to be bound by the terms of both the affidavit and the private contracts that he/she has entered into.
Acknowledge that the physician/practitioner recognizes that the terms of the affidavit apply to all Medicare-covered items and services furnished to Medicare beneficiaries by the physician/practitioner during the opt out period (except for emergency or urgent care services furnished to the beneficiaries with whom he/she has not previously privately contracted) without regard to any payment arrangements the physician/practitioner may make.
With respect to a physician/practitioner who has signed a Part B participation agreement, acknowledge that such agreement terminates on the effective date of the affidavit.
Acknowledge that the physician/practitioner understands that a beneficiary who has not entered into a private contract and who requires emergency or urgent care services may not be asked to enter into a private contract with respect to receiving such services and that the rules for emergency and urgent care apply if the physician/practitioner furnishes such services.
Identify the physician/practitioner sufficiently so that the carrier can ensure that no payment is made to the physician/practitioner during the opt out period. If the physician has already enrolled in Medicare, this would include the physician/practitioner's Medicare uniform provider identification number (UPIN), if one has been assigned. If the physician/practitioner has not enrolled in Medicare, this would include the information necessary to be assigned a UPIN.
Be filed with all carriers who have jurisdiction over claims the physician/practitioner would otherwise file with Medicare and be filed no later than 10 days after the first private contract to which the affidavit applies is entered into.

Illinois/Michigan/Wisconsin Minnesota
Wisconsin Physicians Service
Medicare B Provider Enrollment Unit
P.O. Box 8248
Madison, WI 53708-8248 Wisconsin Physicians Service
Medicare B Provider Enrollment Unit
8120 Penn Avenue South #200
Bloomington, MN 55431-1394

Effective Dates and Non-Participating Providers

Non-participating providers can "opt out" at any time by filing an affidavit. The effective date of the "opt out" period will be the date the provider indicates; if there is no designated date, it will be the date the affidavit was signed.

Effective Dates and Participating Providers

Participating providers can "opt out" if they file an affidavit that is received by Provider Enrollment at least 30 days before the first day of the next calendar quarter. The effective date of the "opt out" period is the first day in that quarter (1/1, 4/1, 7/1, or 10/1). They may not provide services under private contracts with beneficiaries earlier than the effective date of the affidavit.

Participating providers who "opt out" of Medicare also terminate their participation agreement since they no longer agree to accept assignment on all services furnished to Medicare beneficiaries. They will be considered non-participating for any emergency/urgent care services that are paid after the "opt out" effective date.

Early Termination of Opt Out

A physician/practitioner may terminate the opt out agreement within 90 days of the affidavit's effective date. To properly terminate, an opt out physician or practitioner must:

Not have previously opted out of Medicare.
Notify all Medicare carriers, with which an affidavit was filed, of the termination no later than 90 days after the effective date of the opt out period.
Refund to each beneficiary, with whom there is a private contract, all payment collected in excess of the:
Medicare limiting charge (in the case of physicians/practitioners) or
deductible and coinsurance (in the case of practitioners).
Notify all beneficiaries with whom there is a private contract of:
the decision to terminate opt out, and
the beneficiaries' right to have claims filed with Medicare for services furnished between the effective dates of the opt out and the termination.

Provider Specialties

Specialties That May Opt Out Of Medicare

Doctors of medicine;
Doctors of osteopathy;
Doctors of dental surgery or dental medicine;
Doctors of podiatric medicine;
Doctors of optometry;
Physician assistants;
Nurse practitioners);
Clinical nurse specialists;
Certified registered nurse anesthetists (CRNAs);
Certified nurse midwives;
Clinical psychologists;
Clinical social workers; and,
Registered dieticians and nutrition professionals.

Specialties That May Not Opt Out of Medicare

Chiropractors;
Physical therapists in independent practice; and,
Occupational therapists in independent practice.

Effect of Reassignment When a Provider Opts Out of Medicare

When a physician or non-physician practitioner opts out of the Medicare program and is a member of a group practice or otherwise reassigns his or her right to bill and receive Medicare payment to an organization, the organization may no longer bill Medicare or receive Medicare payment for the services that the physician or nonphysician practitioner furnishes to Medicare beneficiaries. However, if the physician or nonphysician practitioner continues to grant the organization the right to bill and receive payment for the services he or she furnishes to patients, the organization may bill and be paid by the beneficiary for the services that are provided under the private contract. In addition, the decision of a physician or nonphysician practitioner to opt out of Medicare does not affect the ability of the group practice or organization to bill Medicare for the services of physicians and/or non-physician practitioners who have not opted out of Medicare.

Emergency/Urgent Care Situations

In an emergency or urgent care situation, a provider may treat a Medicare beneficiary with whom he or she does not have a private contract and bill for such treatment. The provider may not charge the beneficiary more than the limiting charge and must submit a claim to Medicare on the beneficiary's behalf. Medicare payment may be made to the beneficiary for covered services in this situation.

To bill emergency/urgent services, use the GJ modifier. This indicates that the services were emergency or urgent and that there is no private contract.

Mandatory Claims Submission

Provisions regarding mandatory claims submission do not apply once a provider signs and submits an "opt out" affidavit to the carrier for the duration of the opt out period, unless the provider knowingly and willfully violates a term of the affidavit. "

And Jack, before you say it makes no sense, remember it is the government. Yeesh!

Purpleguy| 12.28.10 @ 9:32PM

We have state run medical care, and Obamacare is not it. It has government oversight and regulation, but it is still the free market that runs the system... As for the "Death Panels", it is completely voluntary and as one who experienced the end of life care of a loved one - my mother - having this type of counseling is as much for the family and caregivers of the patient as it is for the patient themselves. Any decisions are completely in the hands of the patient, their family and their doctor, period. Any description to the contrary (i.e., Sarah "I can see Russia from my house" Palin) is misinformation at best and downright lies at the worst.

Bob Grant| 12.28.10 @ 10:00PM

You sir are a naif.

Bob Grant| 12.28.10 @ 10:07PM

"...Any description to the contrary (i.e., Sarah "I can see Russia from my house" Palin) is misinformation at best and downright lies at the worst..."

This is so rich it's priceless. Sarah never said she could see Russia from her house...So as you scold people about spreading misinformation about death panels, which do exist, you proceed to spread your own misinformation.

And this is from no fan of Sarah. Just ask Ole Texican :-)

carnot| 12.28.10 @ 10:16PM

the real irony is that Obama and the Left are creating long-term economic conditions (read scarcity) that will indirectly force the equivalent of death panels. this situation, of course, has always existed. the difference is they will end up exacerbating the problem by orders of magnitude. what a bunch of clowns - the "best and the brightest" my rear quarter.

Impeach Don't Wait| 12.28.10 @ 10:17PM

"Any decisions are completely in the hands of the patient, their family and their doctor, period."

It's so sad that you don't see the obvious. Just add the words: "For now."

The groundwork is being laid for later takeover... when what they have set in place will be the tool for government control. Then all these things will be decided outright by government--or by governmental pressure.

Charie| 12.30.10 @ 8:35PM

****Any decisions are completely in the hands of the patient, their family and their doctor, period.****

Bwahahahahahaha! You still believe in what government bureaucrats say? Bwahahahaha! Too much! Naive doesn't begin to cover it.

Mike in Kansas| 12.28.10 @ 5:48PM

The only death panel is the death panel of one, Governor Jan Brewer of Arizona. Republicans might as well quit while they are ahead, re-elect Chairman Steele and start saving their money for the 2016 presidential election, when they'll be defeated by Hillary Clinton.

Bob Grant| 12.28.10 @ 6:03PM

Wake up Mike, we're not in Kansas anymore.

The only way the republicans lose is if they do the unthinkable and select the Queen of All Media.

George True| 12.28.10 @ 6:56PM

Yet again you insert another disparaging comment about Sarah Palin, and again in an article that is not about her and has nothing to do with her. So far that's three times today in addition to the three or four times yesterday. You don't like Palin. WE GOT THAT. So give it a rest already, will ya?

Bob Grant| 12.28.10 @ 8:01PM

Do you study the articles in question as much as you study my comments?

Sarah Palin's name is riddled throughout this article praising her "courage" for speaking out (no, twittering out) against death panels.

This is my version of speaking truth to power.

Are dissenting views allowed on this site or would you prefer an echo chamber of Ode's to Palin?

George True| 12.28.10 @ 10:17PM

I think this is the first time I have responded to one of your comments. And yes, of course dissenting views are allowed, and no, nobody says you have to like Sarah Palin. Other than your Palin bashing you do make a lot of incisive and insightful comments.

It's too bad you don't appreciate the good she does. Almost every time she speaks or tweets, she causes liberals to have a collective hissy fit. She lives rent free in their heads. This is a good thing.

Occam's Tool| 12.30.10 @ 5:06PM

I love Sarah as much as the next red blooded male conservative. But guys! John Bolton is gonna run! John "Two Ton Brass Balls" Bolton! A Goldwater Conservative!

Charie| 12.30.10 @ 8:38PM

Oc, you do remember what happened to Goldwater, don't you? I do remember that the situation at the time was different from now. Just sayin'.

Bob Grant| 12.31.10 @ 8:51PM

Bolton is interesting but do you have any idea what his stance on domestic issues are?

Charie| 12.30.10 @ 8:39PM

Bob, dear, I think the only way we can avoid studying your comments is by you not posting them. Sorry.

Bob Grant| 12.31.10 @ 8:52PM

Not happenin' sweetheart.

rdman| 12.29.10 @ 12:21PM

IMO, that’s a pretty lame post, Bob…

Has Palin declared that she is running for the Presidency???

What rigged polls are you looking at???… most people including conservative and moderate women and young people like and admire Palin. She draws thousands at Tea Party rallies and other events. That pretty good “gravitas” to most…

Most real conservative people agree with Palin’s label of the media as “lamestream.” The state-run media, as you label them, are arrogant, corrupt, disingenuous and incompetent… these people don’t run the country. The lamestream media needs to be confronted, exposed and put in their place for what they really are… the American version of Pravda and Ivestia There’s nothing worth repairing!

Palin accomplished more for Alaska and its people then Hillary has accomplished in her entire career. Real conservative, rational and logical people understand and have accepted Palin’s reasons why she resigned. Alaska is doing just fine without the hundreds of frivolous lawsuits and Palin is doing even better sticking it to and driving the loony Left insane… and I love it!!!

Where’s your problem, Bob????

GO SARAH GO…

Wayne | 12.29.10 @ 1:24PM

Agree! The Left uses Palin to try to prop up Obama. They like to call her stupid, to make Obama sound smart. If she were so stupid, they would not hate her so much. She touches a nerve in them. She gets what they are all about.

They instinctively see the threat. They dance around their true Marxists inclinations and they don't need Palin pointing those inclinations out. We know so much more about the enemy today because of Palin.

I assure you and strong conservative woman or minority candidate will get the Palin treatment. They will only play nice with the stodgy, white neo-conservative males. That is because those guys fit their stereotype. But a Palin hits them where they live. She is independent and self-reliant. She sees right through the lies and the spin. Conservatives need to help her in that task, whether she runs or not. Nothing more the Left loves than conservatives eating their own (as a Rove or Krauthammer seems to love to do).

Sir Winston| 12.29.10 @ 7:30PM

Although I am not an american citizen, I would support Governor Palin running for the US Presidency. I think she is one of those very scarce politicians (persons) that put their money where their mouths are. She supports the troops, her son is in the military. She is against abortion, she gives birth to a baby with Down's Syndrome. She sees and denounces death panels in a legislation that almost no one read and then withstands the attack of the MSM, which will be reluctant to acknowledge she was right. Does she lack the smarts? Does Obama really have them?

Bob Grant| 12.31.10 @ 8:54PM

Come on. Let's not overplay the Sarah-has-tons-of-executive-experience card.

jstwndring| 12.28.10 @ 6:08PM

Gettin' scared?

The dream! So close, yet so far away.......... ;)

Damn Constitutional liberties keep gettin' in the way, don't they?

WhiteBikerTrash| 12.28.10 @ 6:16PM

Ummm, am I the only one that knows that the "Death Panels" were passed into law in The American Recovery and Reinvestment Act of 2009? This is Death Counseling! They will pay the Doctor to tell the patient "Just Die And Get It Over With!" I am not a liberal troll, we need the truth on our side!

echodeltasierra| 12.28.10 @ 6:50PM

Liberals are truly Orwellian in their schemes and language.

Sonny| 12.28.10 @ 7:53PM

Dr. Berwick is nothing more than an Obama's Joseph Mengele, aka, the Angel of Death, as well as Obama's slobbering sad and pathetic, Yes man, which goes to prove, that advanced education, and supposed intelligence, does not equate to Respect, Morality, and Ethical and Humane behavior, as a Civilized Human Being.

mzk1| 12.29.10 @ 2:01AM

One should note that in Jewish theology, the Angel of Death and the "Devil" are one and the same.

Steve in Pittsburgh| 12.28.10 @ 8:11PM

The only way to cut back on the deficit is to cut back on Medicare and Social Security. Which will do the same thing, or close to it, as death panels.

ExExZonie| 12.28.10 @ 8:20PM

Dr. Ezekiel Emanuel, Obama's top health care advisor, advocates denying care to elderly and disabled
http://tinyurl.com/zekesdeathpanels

ExExZonie| 12.28.10 @ 8:26PM

@WhiteBikerTrash honestly I posted the above before I read your comment!

Do a search for FCCCER Ezekiel Emanuel. That's the real death panel although this is a backdoor effort to push Terri-Shiavo type deaths on all of us.

Nite| 12.28.10 @ 10:06PM

Individual high deductible health insurance plans and HSA accounts only work for people who are still working and are young and healthy. They do not work for anyone with a chronic disease of any kind.
Dr. Berwick is a crack pot in love with the British healthcare system who does severe rationing and euthanizes people on a regular basis against their will or that of their family. He is a recess appointment because Obama could not even get him confirmed by a Democrat controlled Senate. Why is this unconfirmed Czar being allowed to run a large agency like Medicaid and Medicare in the first place? Obama and the Democrats are going to pay for this one. I approve having a living will developed between a patient and their physician. I do NOT approve of the government writing regulations that mandates this being done yearly and who develops materials the healthcare provider has to use in instructions. One half trillion dollars is being taken out of Medicare and spent elsewhere. Believe me, services will start being denied right and left after Berwick gets his little feudal system in place. This will NOT just be Seniors, but sick babies, chronic diseases, and a whole spectrum of illness. I hope the Republican House will start taking all of the regulations apart than Obama and his minions are doing to bypass Congress.

Occam's Tool| 12.30.10 @ 5:08PM

A slight disagreement, nite, one which, upon further reflection, I think you'll agree with. Dr. Berwick may be a Crackpot, but he behaves like a Crack Head!

Speedypete| 12.28.10 @ 10:46PM

This health care legislation did absolutely ZERO to CURB the RISING COST of HEALTH CARE. I bet you would have rather seen fewer government regulations, less paperwork for patient care, fewer ambulance chasers and lower malpractice insurance premiums INCREASING the COST of PATIENT CARE. Instead they slipped it in you when you weren't looking by deciding what treatments they want you to receive .

inge| 12.28.10 @ 11:51PM

I do NOT doubt that healthcare is also part of 'paying back' the opposition, and deny care, as it was when car dealerships were closed due to republican affiliation.

Another question, since women with breast cancer are denied drugs to help them, what about the homosexuals with AIDS in the Military? Are they being denied drugs to help them, or are they a special protected group since they are mostly supporters of democrats?

mzk1| 12.29.10 @ 1:59AM

This is what I don't understand. I saw one of those congressional meetings, and this lady got up to say her parent would (did?) die because of a denial of insurance. Assuming she wasn't making it up, I do not understand how a person could let their parent die because someone else would not pay.

What would we do if this happened? My sisters would mortgage their homes, we would beg, borrow, plead, look for doctors who would do it at a discount, plead with rich people, whatever it took. What kind of sheep are people turning into?

Go to any synagogue during the week; you will see people (often from countries with socialized medicine) collecting money for operations in the U.S. If the U.S. goes this way, where will we go?

Fred| 12.29.10 @ 12:16PM

Satan,er, Obama and Dr. Mengela,er, Berwick intend to kill off Americans so they can get more illegals into the U.S.

David in MA| 12.29.10 @ 1:51PM

But, only the illegals who have a good "level of productivity in society," grade.
The new world order/one world government needs healthy slaves......sorta like culling livestock, the healthy remain for market while the unhealthy are destroyed---while that is good farm practice to produce a good product which will give a good return on an investment, when it comes to people it's simply placing no value on human life, ya know, like china.
Beware the communist U.N., beware the New World Order/One World Government ----& I think it was Ben Franklin who said--A government big enough to give you everything is big enough to take away everything.....or words to that effect.
obama & his gangsta's has ta go!

Charie| 12.30.10 @ 8:28PM

Just plain silly, Fred.

Lee| 12.29.10 @ 12:47PM

God, please help use find a way to get rid of Berwick, Obama, Polosi, Reid and all the other evil people in power. ASAP!!!!

Wayne | 12.29.10 @ 1:16PM

How the left refuses to admit that they WANT the government rationing all health care. They continually dance around the issue, because they know what they actually want is also very unpopular.

My Mother is 92 and has had a very healthy life. When she heard Obama intimating that his 87 year old grandmother shouldn't have hip surgery, she went from being a life-long Democrat to a Tea Party member. What the Left will NEVER understand is the reason for her indignation. She has a President who thinks her LIFE has no value.

This is what the whole debate is about. The Value of a Human Life. It is the same as the debate about abortion. It is the debate we need to have and the Left tries to avoid (except among themselves). They do not believe a Human Life has an intrinsic value. They HATE Sarah Palin because she CHOOSE to bring a Downs child into the world. She validates his INTRINSIC value.

To the Left, only the State has value, and the individual derives his value from the state. So an individual who is non-compliant or functional needs to be eliminated.

Charie| 12.30.10 @ 8:30PM

Wonderful mini-essay, Wayne!

David in MA| 12.29.10 @ 1:41PM

Once a medication is removed from availibility to patients because it is to costlt, etc. then that medication should be ruled as illegal and further production should cease............unless, of course, it's reserved for the "worthy"------and who would the "worthy" be? The very people who deny it to the masses, dat who da "worthy" be!
It's way past time for obama and his cronies to be arrested, tried & hanged!

NJK| 12.29.10 @ 2:35PM

Drag every one of these people in front of the American people for hearings. These I will watch. They need to be under oath because they will lie.
THERE CAN BE NO FUNDING FOR THESE MAD MEN AND WOMEN. THEY ARE AS NUTS AS HITLER.

P.S. MAKE OBAMA PRODUCE HIS BIRTH CERTIFICATE

See if it matches the one with the footprint that every member of Congress received by certified mail at the end of August. The one from Mombasa, Kenya with the footprint, that they all ignored.

NJK| 12.29.10 @ 2:38PM

This is just like the START Treaty that the twisted sisters in Maine and Scott Brown signed on to. They agreed to one thing, and everything will be changed secretly. FOOLS!

Dr Joyce| 12.29.10 @ 4:46PM

Professor Singer's statements about life happening by chance and therefore life is meaningless are the logical, consistent outworking of his worldview which is naturalistic/materialistic at it's core. If you the reader truly believe that humanity evolved by random chance over billions of years the logical, consistent outcome of that belief is Dr Singer's statement. Therefore, since life has no purpose and serves no purpose and came about randomly the state can end life randomly. While I most definitely do not agree with Singer, I will give him credit for consistency between worldview and actions. Many who hold to a naturalistic based world view are not as consistent as Professor Singer. I am afraid I have heard similar coments made from other people with ethics certification. Imagine my surprise when I was told that ethics and morality were not the same thing. That one need not have a moral center to have ethics. Really? I have to wonder what their ethics are founded on-certainly nothing that is absolute.

As to one persons comment about they would sell all they had to get care for their mother-good luck on that one. Medicare already does not allow doctors to accept payment outside of medicare for treatments medicare deems uncovered or unneeded. Many third party payors also have the same stipulations in their contracts with doctors and other providers of health care.

Trenton| 12.29.10 @ 5:22PM

The end result of all socialist philosophies is the elimination of large portions of the population.

If we view an economy as a pie that must be divided among the people, we gain insight into how certain ideologies handle the pie. Socialists, for example, view the pie as fixed in size. It cannot be enlarged because resources are finite. Thus, ensuring that everyone gets an equal share leads to an inevitable choice; either you continue to cut the pie into progressively smaller pieces, or you reduce the demand.

At first, socialists will try to cut the pie into smaller pieces, but eventually it becomes impractical to cut the pieces any smaller because there is no benefit to such a small piece. They will then try to artificially enlarge the pieces of the pie by borrowing, but this solution only reallocates a portion of some (usually the wealthy and the unborn) and gives it to others with immediate need. But this is only a stop-gap measure designed to forestall the inevitable; you can only borrow so much.

Eventually, the only choice remaining is to reduce the demand, i.e. eliminate certain groups of people. And it makes the most sense, economically, to eliminate those taking the largest shares. If medical care is part of each person's share of the pie, then those needing more care are the first to be eliminated.

It was correctly said, earlier, that the programs must be preserved over the people. Likewise, it is not Socialist philosophy that is in error, it's the propensity of human beings to put too much of a burden on the available resources. Thus the government must control all resources and, ipso facto, all demand for those resources.

GavInTucson| 12.29.10 @ 7:48PM

Perhaps the elderly will get a chance to renew on Carousel?

Sounds creepy, yes, but I can envision a world where you could be sent to your death (ahem, I mean renewal) once you reach a certain age.

I'm sure the movie [i]Logan's Run[/i] makes some liberals all warm and fuzzy inside.

GavInTucson| 12.29.10 @ 7:49PM

Argh... sorry about the bbc code.

Occam's Tool| 12.30.10 @ 5:10PM

Gavin---useless Trivia---the final scene in that movie was shot at the Fort Worth Water Gardens, which are quite beautiful.

"Renew, Renew!" Thanks, Dr. Berwick, you sack of scum.

GavInTucson| 12.31.10 @ 11:15PM

Occam's Tool, useless trivia is usually the most interesting. :)

Dale Cord| 12.30.10 @ 10:10AM

2011 a year that will live in Infamy. Future school history books will read: The year the Muslims conquered the United States of America. With not so much as a whimper from its cowardly military leaders, and name calling armchair patriots. Disgraceful,Shameful there are no words to adequately describe her defeat. As the 300 Spartans strength and ingenuity conquered all of those who challenged them, so a small band of renegades conquered the greatest country the world has known. When Davids rock slued Goliath. It also foretold a warning. "The bigger they are,the harder they Fall." Our country lost its battle of survival when it became intoxicated with its deceptive mentality, that it did not need its Creator anymore, and wisdom no longer was apart of its citizens physiology to survive.

Heywood| 12.30.10 @ 1:32PM

They'll just have to de-fund Obamacare. *Good luck there!*

John Jarrell | 12.30.10 @ 1:39PM

So, an official whose back-door appointment to skirt Congress promulgates a regulation enacting the very law rejected by Congress and the American people. We're not moving toward a socialist dictatorship, we're already there.

Next will come putting uniforms on union thugs/enforcers to be a "Civil Defense Corps" (in German it is: Schutz Staffel) to be used for control of the civilian population as Obama manufactures one more crisis that will collapse what remains of the original America. Thus the last and greatest obstacle to Geo. Soros' one world order will be removed.

Joe P.| 12.30.10 @ 1:47PM

I don't think Obama has any value and he should be the first one to get end of life counseling.

If the goverment ever tries to deny my parents medicine, I will deny them life by any means necessary. NO ONE is going to stop my parents or any other family members from geting medical treatment. Those that try will be facing their own end of life decision. Only God has the power of life and death. This was one of the arguments against the legalization of abortion. Once you cheapen the value of life for one group of humans, its just a matter of time before all life is cheapened for all groups. Now the elderly are next. Then the deformed, then the unproductive. Where does it end?

Obama needs to be IMPEACHED and TRIED and REMOVED FROM OFFICE. End of discussion

MattZ| 12.30.10 @ 2:03PM

If end-of-life counselling can be accurately termed "death panels," then this sketchy publication can be rightly termed "bullshit."
MZ

Occam's Tool| 12.30.10 @ 5:24PM

Matt, let me fill in the blanks for you...Dr. Berwick is a huge fan of the British NHS, which does horrible work with severe diseases. He is a fan of rationing.

For example, in NZ, I was not rewarded for seeing more patients than other docs, and doing better workups. Instead, the docs who got the kudos were those that best limited access to their services and did the smallest amount of workup consistent with their (state mandated) guidelines, that did NOT reflect US Best Practices. Money saving was elevated above patient care in many more instances than would have been allowed in an US system, and the outcomes were very poor. For example, Maori have the highest lung cancer rate in the world, and a smoking rate that is almost 50%. The life expectancy of the richest Maori is shorter than that of the poorest White, and the richest Maori were richer than the poorest white. But smoking and alcohol cessation medication, in 2007, was in VERY short supply. Generic Wellbutrin (Zyban), for example, was not available. One could strongly argue racist overtones to this denial of care (I did, at a rather controversial Grand Rounds).

Now, the end of life discussion is going to be scripted. Follow the script or don't get paid (for example, Medicare also had gag rules in place on certain topics for awhile). As an MD, I can think of LOTS of ways to shade data to encourage a certain outcome, and if the script tells me I have to hit a certain point, I will, and will document same. Please go back to 1984 and read the theoretical foundations of Newspeak. If you limit topics of discussion and language that can be used in a discussion, then you limit what CAN be presented. Basic principle of totalitarian propaganda.

In short, we are discussing a complex topic in a complex fashion, and one in which I'm a board certified expert. Many of the other bloggers bring expertise in law and business, as well. I assume decent intelligence on your part, and you'll note that my counter to your comments was highly respectful. 'Nuff Said.

Garry Owen| 12.30.10 @ 2:07PM

We are no longer a nation "of the people, by the people, and for the people". we have become a nation run by non elected loons who think they know what is best for us even if it kills us. Do away with all departments in the government and make our elected representatives make the decisions. That is what we elect then for!

Elisabeth| 12.30.10 @ 2:13PM

You are reporting about the wrong issue. Anyone can simply refuse to discuss end-of-life. Obama sneaking in death counseling is only to distract people from the real death panels of Obamacare.

The real death panels are in the stimulus bill and in the Obamacare bill. The stimulus bill establishes a medical dossier on every American, and sets up a "comparative effectiveness" research panel. Obamacare uses that panel's recommendations to decide who gets treatment. That's where the pain pills for some come in. Other death panels include the FDA and various government/insurance dominated "professional" societies.

Those who are well don't bother understanding what is happening. If you are well, take the time to learn and object. Those too ill to object won't be saying much because they will be dead.

bnuckols| 12.31.10 @ 5:13AM

I, too, believe that the focus on the payment by Medicare for visits for end of life counseling is smoke and mirrors to distract from the true "death panels:" the comparative effectiveness" and Independent Medical Advisory Board. These two groups - and other new regulatory agents created by the Stimulus and health care bills - have real teeth to arbitrarily rip into our US medical care. The IMAB will make recommendations as to what Medicare costs (treatments) to be cut. Those recommendations go directly to the Senate Finance Committee, for rubber stamping. Thanks to Harry Reid, neither the Finance Committee, the Senate, nor the House can refuse to make the changes recommended without coming up with an equivalent "savings" some other way. The Senate and the House are not even allowed to debate this Board unless a 2/3 majority in that body votes to do so --- and the debate time is limited by the Bill!

David L. Smith | 12.30.10 @ 2:20PM

So what does conservative concept of "liberty and freedom" get us? 50 million uninsured of whom an estimated 20,000 die each year from lack of medical care, and millions of bankruptcies annually for the uninsured and underinsured. How is this not rationing?

And who suffers from such free-market rationing? The same "sick, elderly and disabled, of course" for whom Sarah Palin sheds crocodile tears.

How is it that conservatives can brand a system that merely attempts to educate patients about quality-of-life vs. length-of-life tradeoffs as "downright evil" and not acknowledge the evil of a free-market system that excludes a sixth of the population from health care insurance, kills 20,000 annually and bankrupts millions more?

Conservatives would do well to first get rid of the plank in their own eyes before looking for specs of sawdust in their brothers' eyes.

Occam's Tool| 12.30.10 @ 5:30PM

Of those "20,000" (I have yet to run into ONE in my 21 years of medical experience, but I have treated people for free to the tune of 40-50,000/year when I was in private practice), how many were illegal aliens?

David, I've WORKED in an NHS. I daresay you have not.

The "sick, elderly and disabled" get Medicare or Medicaid. It is the young relatively healthy individual who would rather spend on beer than insurance that gets nailed. However, once you eliminate gun shot wounds and car accidents that did not get to the hospital in time, both of which, due to our size and other societal factors we have more of than any other country, our survival rates are much better than Britain and the EU.

In short, once you get to the hospital, you will do better here than anywhere else.

Occam's Tool| 12.30.10 @ 5:31PM

That's 40-50,000 dollars of my services for free, when I was in private practice in 'Bama 1993-1997, doing inpatient work.

Elisabeth| 12.31.10 @ 12:01PM

David, you are buying into liberal propaganda. No one in America who chooses to get health care is denied. No one.

http://www.americanthinker.com.....e_ref.html

http://www.cato.org/pub_display.php?pub_id=10449

markinidaho| 12.30.10 @ 2:28PM

We the people can and must resist this government by fiat. Doctors need to ignore the requirements, and lie on the reports to the government if necessary. Patients that are approached with this kind of thing need to find new doctors. The requirement for medical records to be electronic and available to the government needs to be subverted - do not obey.

Obama needs to be resisted at all costs. EPA inspectors need to be ushered to the door. All fiat government officials need to be treated like trespassers - if it gets bad enough, resisted even with deadly force.

The House of Representatives can intervene, by cutting off all funding to agencies that rule by fiat with regulations that are instituted to bypass law. I would love to see the TSA, the FAA, the EPA, the IRS, and the HSA have funding cut by 90%. Then we would see how much "regulation" they could enforce.

Jon C. Randall | 12.30.10 @ 2:50PM

The strategy, I believe, goes even deeper. The far left want to change the landscape of America, and bring it into line to the inclusion of the New World Order, creating geo-political, religious, and economic entitites throughout the world. What is stopping them is the elderly generations who KNOW what America is about, while they re-invent what America they want via the school system, re-writing of history, and a subtle change to the way things are by slowly taking away the Constitution under which we live by the Grace of God. Sooooooooo, how do they do this, kill off the elderly at a faster pace, utilizing those the elderly trust, the Doctors and Medical System. In opposition to the Hipocratic Oath, they are now bought and paid for servants to the government, instead of the values they would normally subscribe to. They become mercernaries, agents of death, just like those who take the lives of the innocents in the womb. The sooner they eliminate "to save a LOT of money" the elderly, the easier it is for them to move this nation in the direction they want to take us, to SOCIALISM. That is how I see it, and I do believe that I am seeing it clearly.
Jon C. Randall

Chet Brewer| 12.30.10 @ 2:54PM

ok, so paying for end of life counseling, things like conditions that I want to receive palliative care rather then aggressive treatment and making sure that my doctor understands that rather then guessing. All the whining about death panels is just a little much for me. So stay in your fantasy world and keep whining about death panels and socialism and following your cult leaders like Sarah, Rush, and the rest, instead of addressing problems and continuing to speed the downward spiral of America that George W and the republican party accelerated with their borrow and spend policies

Elaine Suhre| 12.30.10 @ 3:11PM

Are you sure you know what palliative care is these days? Now it is slow starvation. Look it up under palliative, (slow death).

eric| 12.30.10 @ 5:06PM

Are you sure _you_ know? Because yes, "slow starving" is one option -- in reality, it's usually death by thirst, but let's not pick nits -- but more often, it's a matter of giving the patient good pain drugs in enough quantity to actually relieve their pain, but don't do anything else to stop the disease.

That is, in fact, what it actually is. Go ask a hospice nurse. Or are they in on the Marxist conpsiracy?

Occam's Tool| 12.30.10 @ 5:39PM

Yes, Eric, but it's worse than that under NHS. It's denial of life saving care such as Herceptin for Breast CA, denial of basic prophylactic care such as vaccines for cervical cancer, denial of non addictive pain meds such as neurontin for neuropathic pain, denial of Naltrexone for alcohol and opioid abuse, absence of appropriate specialists in large cities (the NZ Capital, for a time, had NO child cancer specialists present there---metro area 500K), waiting lists for simple back surgery of 2 years despite patient invalid status (my wife), etc.

I could go on, but it sickens me. You do noty want what Obama and Berwick want. Ignore me at your peril, for I know the painful truth.

And Chet, you should read about Berwick and Emannuel's position in some depth. You should also be able to correlate it with deep experience in an NHS as a senior medical consultant. I can, and have. I doubt you can say the same.

Mark| 12.30.10 @ 3:22PM

Chet: You are correct that George W didn't do enough to curtail the Dems spending, and indeed, participated in far too much of it. Welcome to the Tea Party. We look forward to your help in repealing the disasterous spending policies of B.O., including Obamacare. Welcome aboard.

Elisabeth| 1.1.11 @ 12:23PM

Chet, you have virtually no concept of what a death panel means. Go read the stimulus bill and the Obamacare bill. The death panel has nothing to do with end-of-life counseling. That's a smokescreen.

Henry| 12.30.10 @ 4:19PM

A lot of time, ink, and reading could be saved by simply stating....obama is a pure bred Marxist. Marxist do what Marxist do. His Marxist regime is working fast and furious to install Marxism in America. The average American is apparently too stupid and ignorant to see what is happening. By the time they wake up it will be too late. Again, obama is a Marxist. It doesn't get any easier than that.

eric| 12.30.10 @ 5:07PM

This word 'Marxist' -- I don't think it means what you think it means.

Occam's Tool| 12.30.10 @ 5:42PM

Dear Eric,

try devotee of Karl Marx and his views, as changed and adapted by Mao, Stalin, and Lenin.

Yup, Marxist. The guy got his political start in BILL AYER's HOME. His Mentors were COMMUNISTS and TERRORISTS, and their supporters. I think I've got it.

eric| 12.30.10 @ 5:03PM

Somehow I'm missing the "rationing" component, here.

Let me make sure I understand what the Spectator's position is on this: Is it that doctors should not be paid for time they spend providing counseling to patients regarding their end-of-life options? Or is it that doctors should be required to pretend everything is going to be fine?

Because it seems to me that the really libtertarian thing to do is to admit that there's a problem: E.g., Uncle Jim Is Going To Die. And Uncle Jim has options, and one of those options -- this being Uncle Jim's choice -- might be to go into hospice care or die at home rather than expend massive effort and resources to prolong his life a few more days. (Which may or may not work -- something that "end of life counseling" might uncover.)

Occam's Tool| 12.30.10 @ 5:44PM

I don't think there is a problem, Eric, with MDs being paid. I think there is a problem with a government mandated script for discussion, designed by a guy who loves "bottlenecks in the delivery of care," and the concept of "underproviding." Have you READ Berwick? Do you KNOW what an NHS is like?

kai| 12.30.10 @ 10:17PM

First of all, it's not the NHS so your comparison is faulty considering Berwick has acknowledged that something akin to the NHS being established in the US is not appropriate. Secondly, all the the theoretical hot air that you've been blowing about "scripts" and bureaucrats making life and death decisions is pure speculation based on a belief that a certain health care system and its characteristics - again, NHS - will be constructed and then implemented. Balderdash.

What is funny about the above article using quotations from the "liberal MSM" bogeyman, the NYT, is that all of those quotes specify or imply the role of decision making by patients and doctors, not bureaucrats, a fact blithely glossed over by the author. The NYT article, if read in its entirety, reports on the controversy surrounding the unfounded/speculative "death panel" claims, not on theory veracity. What a poor reading by Mr. Lord and how unfortunate to include information contradictory to the argument within one's own work.

Of course Lord neglects to mention the genuine death panels instated and imposed by AZ's conservative Republican, Gov. Brewer, whose transplant cutbacks are endangering actual lives and placing a low monetary value on human life. This, of course, is the great cry of (religious) conservatives that say govt. involvement in the current and continued US private health care system will demeaning human life. Already conservatives have proven that they gladly put a value on human life and are willing to terminate lives in an effort to cut costs.

Gov. Christie must be proud (and a sign of hypocrisy at its finest).

William W. Wexler | 12.30.10 @ 5:48PM

Which is another way of saying something else:

Governor Palin has been vindicated. Speaker Boehner has been vindicated.

===========================

BULL SHIT.

You're an out-and-out liar, Lord. Frankly, you're a GOP cunt as well, allowing yourself to be fucked into writing the most absurd pieces of trash I've read HERE, which is saying a lot.

You're a sick fuck, go get some help. You can't tell reality from fiction. I hope you live long enough to discover what's really up with the health care system PERSONALLY instead of making up shit for 5 cents a word.

-Wexler

PS For those of you who do not already know; since this website allows posers to post under real people's names, I only post once in any thread. This particular thread is obviously just GOP genitalia waving in the breeze, but it gets one post from me. Any further posts under my name are forgeries.

LGA| 12.30.10 @ 9:43PM

Filthy mouthed leftist/fascists like the BS idiot reply are the voter base for Obummer and his wacko Dems.

ironhorzmn| 12.30.10 @ 11:28PM

Stay classy, sleazeball.
Say hi to your brother Larry Flynt.

Bob| 12.30.10 @ 9:18PM

I sent the following to the FBI. https://tips.fbi.gov/

The American Spectator Website has retained on their website for two days a comment that appears to be someone considering or urging murder for political reasons. AKA domestic terrorism. (Dr. Peter Singer is hated by many rightwing activists.) Thank you for your attention.

Here is the link: http://spectator.org/archives/.....h-panels-b

Below is the text:


David W| 12.28.10 @ 11:39AM

"Life as a whole has no meaning. Life began, as the best available theories tell us, in a chance combination of gasses; it then evolved through random mutation and natural selection. All this just happened; it did not happen to any overall purpose."

If someone were to shoot and kill Mr. Singer would that be considered a crime? Since life has no purpose, as far as Mr. Singer is concerned, how could his death be wrong? Just asking."

Here is the link: http://spectator.org/archives/.....h-panels-b

Below is the text:


David W| 12.28.10 @ 11:39AM

"Life as a whole has no meaning. Life began, as the best available theories tell us, in a chance combination of gasses; it then evolved through random mutation and natural selection. All this just happened; it did not happen to any overall purpose."

If someone were to shoot and kill Mr. Singer would that be considered a crime? Since life has no purpose, as far as Mr. Singer is concerned, how could his death be wrong? Just asking."

LGA| 12.30.10 @ 9:47PM

Bob is another irrational idiot from the left...so many thanks to the dumbing down of our schools by the Dem wits over the last forty years.

Lulu| 12.31.10 @ 12:40AM

This creep, along with EVERY federal government should be MANDATED to got BY HIS own health plan. If we can bring that in that they should be mandated to do as everyone else. just how long do you think the bama bill would last? When they learn they too must abide by that plan, WOW, would there be a fight in the Congress. They are no better than just an ordinary citizen and should be treated the same.

A pen| 12.31.10 @ 9:01AM

To heck with the piecemeal criticizims of this move to use government power to manage society, communism, just identify it, stop it and remove it from political advancement. USC 50 S 842 , get your heads focused in the right direction. Fraud put Obama in office and law can take him out. Or otherwise there is no law but what nature provides and accepting a death panel sentence is not a natural law, fighting back is.

Lauri| 12.31.10 @ 10:28AM

Death Panels? What? I am not sure what all this is about but end of life event has gotten fair consideration with medicare's support of hospice programs.

Pete0097| 12.31.10 @ 11:18AM

This will lead to something more like "Logans Run" although "Soilent Green" will let people live longer.

D| 1.1.11 @ 8:51AM

The author has clearly never had a loved one have a terminal disease or worked in healthcare. There are thousands who are "living" the end of their lives unconscious, on ventilators, with bedsores (because Medicare does not pay enough money to have the required number of people caring for them to allow for proper care), getting pneumonia, urinary tract infections, etc. until they dies after monthe or years of being in a horrible limbo and enduring multiple useless procedures. Live in the real world; this is not about killign people. This is about being realistic about expectations at the end of life. No one is proposing the British system. This makes for great headlines, but in reality, the story is quite different.

DL| 1.1.11 @ 11:19AM

What a bunch of nonsense! All this does is pay doctors (that is Medicare pays doctors) to help patients with advanced directives if the patients want such advice. No one is pushing death on anyone. You extract all sorts of information, from sources I've not seen in any other article about the subject (even conservative articles), and that has nothing to do with the order, in a lame effort to support you contorted views. It's no surprise rational legislators want to keep it quiet. The nonsense propoganda the extremist right puts out sucks all sensible thought out of the room. If people want a DNR order, they should be able to get it and Medicare should pay doctors for the advice they give to their patients for that advice. You, clearly, do not want people to have this freedom.

Elisabeth| 1.1.11 @ 12:29PM

DL, you have virtually no concept of what "the" death panel means. Go read the stimulus bill and the Obamacare bill. The real "death panel" has nothing to do with end-of-life counseling. That's a smokescreen.

DL| 1.2.11 @ 11:35AM

I've taken a look at Public Law 111 - 152 - Health Care and Education Reconciliation Act of 2010 and see no such thing. Also took a look at Public Law 111 - 5 - American Recovery and Reinvestment Act of 2009; nothing there either. The early health care bill (the one that the House passed but was rejected by the Senate), H. R. 3962, contains quite a bit of language about advanced directives and end of life planning but none of it is forced upon anyone. It is completely optional. It also states that none of this planning shall promote suicide, assisted suicide, 16 euthanasia, or mercy killing.

carl rogers| 1.1.11 @ 11:24AM

Hi Everyone...So far, I think I saw 2 or 3 comments about the cost of health care and about 100 comments about keeping people alive no matter what the problem is. I guess, for most of the commenters, money is not an issue. If you think saving life comes first, please tell us how to pay for it. Cursing Obama won't solve the problem. I'm sure that if you have a really good solution for the money problem, Congress will jump on it and ignore Obama. Otherwise, we are stuck with death panels and we better get used to it. I also would like to keep people alive as long as possible. I just don't know how to do it. Please post more comments on how to pay for Health Care. Thanks. Carl Rogers

Val| 1.1.11 @ 12:41PM

@carl rogers, how about a free-market system?

Read this and tell me what you think. My system addresses preexisting and affordability - both issues the liberals tried to solve with 5,000 pages of garbage, 160 new bureaucracies, a national medical dossier on every American, $44,000 computer systems for doctors so they can rat you out to the government, and 16,500 new IRS (KGB) agents. Ya' know, none of that is free?

We know nothing like this will ever be implemented because competition would bring prices down and push quality up. Congress will never jump on it and ignore Obamacare. There are too many special interests and lobbyists who are getting fat off the current system.

http://valariemurphy.blogspot......on_26.html

Yvette | 1.2.11 @ 8:42PM

if my doc or hospital people come at me with end of life counseling, I promise to hurt them.

Jonathon| 1.3.11 @ 6:37PM

Sorry to come into this discussion so late. I have been busy working all through the holidays with the sick and vulnerable individuals you all are so concerned about here. And I believe very strongly, as a geriatric nurse, that more discussion of end of life issues with patients, doctors and family, will indeed improve end of life care for most of these individuals. Both of my grandparents chose at the end of their lives to go home and spend their last few months with their families, rather than spending all of their time going in and out of hospitals. Everyday I see people in their nineties, whose hearts are failing, kidneys are failing, overall body systems are starting to shut down, spending days, even weeks, in the hospital seeking treatment that simply does not exist for them. It is no longer realistic to treat them. Simply put, they are dying. It happens to the best of us. But millions of dollars are spent providing intrusive and invasive diagnostic tests and treatments that are no fun for the patient. All too often, the patients themselves simply want to go home and be with their families. Call them death panels if you wish, the fact is, death comes to us eventually and too many in society are not prepared to face this fact. The result is unnecessary cost, unnecessary suffering, unnecessary misery for the old, sick and disabled individuals you claim to care so much for.

I Grumble| 1.3.11 @ 7:31PM

Oh for goodness sake. Does not the Amarican Privatised Medical Insurance already do this? If your Medical Insurance runs out, then you are left without long term treatment? If you have long term health needs, the Insurance Companies find reasons in the small print for not continuing treatments.

I had an American cousin who had to remortgage his home to raise funds after his Medical Insurance refused to fund long term treatments. So what's different about between Private Medical Insurance or Socialised Medicine?

Dwight| 1.4.11 @ 2:26AM

The last two comments are the only intelligent and rational comments posted here.

G| 1.5.11 @ 3:04PM

Another Jew trying to get your bodily fluids. Jews did 9/11

Michael P Stein| 1.6.11 @ 2:14AM

I have tried to make sense of Mr. Lord's article , but find myself completely at a loss. As Frank, I Grumble, and others have pointed out both above and elsewhere, we've had "death panels" for years. Private insurers have refused to pay for certain treatments because they cost too much, or because the treatment is "experimental" and not scientifically demonstrated to provide significant benefit. As Norm Ornstein points out here:

http://www.washingtonpost.com/.....03678.html

state governments - states with Republican governors, mind you, not liberal Democratic ones - have similarly rationed care.

Mr. Lord seems shocked that the federal government might do the same thing for those people it insures. It sounds as if he finds this wholly unacceptable. But what, then, is Mr. Lord's alternative? Is Mr. Lord really calling for unlimited spending (not to mention the accompanying deficits and/or tax increases) so that anyone whose life has a 5% chance of being extended by three days by the expenditure of ten million dollars is entitled to that treatment? I'd expect that position from liberals, not conservatives. Did someone from The Progressive hack into AmSpec's website to post this article?

Regarding Avastin, perhaps Mr. Lord was fooled by the word "research" in the name "Pacific Research Institute." Its research is political, not scientific, as can be seen from its own website:

http://www.pacificresearch.org/about/default.asp

PRI claims that some "super-responders" benefit greatlly from Avastin. But even if that's true, they apparently forget that others are harmed by it - but there's no way of telling in advance who will be in which group.

Yet Mr. Lord seems to be concerned about politicians overruling science simply because of the high cost. So may we assume that he supports efforts to reduce carbon emissions and other measures to stop global warming? After all, scientists have said so - so no politician should ever overrule them, right?

Christian Louboutin | 6.23.11 @ 6:20AM

WASHINGTON -- When a proposal to encourage end-of-life planning touched off a political storm over "death panels," Democrats dropped it from legislation to overhaul the health care system. But the Obama administration will achieve the same goal by regulation, starting Jan. 1.

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