RIP - Ted Kennedy

LOL, it's amazing how a simple little "rip Mr Kennedy" can turn into political mud-slinging.
Very entertaining! .

 

We agree on that principle


Here is the text of the proposed bill, Section 1233, which would direct the government to pay for voluntary consultations to discuss advance care planning every 5 years, during which individuals can receive information about living wills or specify what interventions they would like in the event they become incapacitated. At no point does the bill say the individual must attend these consultations, nor that the doctor will be making the decisions regarding end-of-life care.

15 SEC. 1233. ADVANCE CARE PLANNING CONSULTATION.
16 (a) MEDICARE.—
17 (1) IN GENERAL.—Section 1861 of the Social
18 Security Act (42 U.S.C. 1395x) is amended—
19 (A) in subsection (s)(2)—
20 (i) by striking ‘‘and’’ at the end of
21 subparagraph (DD);
22 (ii) by adding ‘‘and’’ at the end of
23 subparagraph (EE); and
24 (iii) by adding at the end the fol25
lowing new subparagraph:
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1 ‘‘(FF) advance care planning consultation (as
2 defined in subsection (hhh)(1));’’; and
3 (B) by adding at the end the following new
4 subsection:
5 ‘‘Advance Care Planning Consultation
6 ‘‘(hhh)(1) Subject to paragraphs (3) and (4), the
7 term ‘advance care planning consultation’ means a con8
sultation between the individual and a practitioner de9
scribed in paragraph (2) regarding advance care planning,
10 if, subject to paragraph (3), the individual involved has
11 not had such a consultation within the last 5 years. Such
12 consultation shall include the following:
13 ‘‘(A) An explanation by the practitioner of ad14
vance care planning, including key questions and
15 considerations, important steps, and suggested peo16
ple to talk to.
17 ‘‘(B) An explanation by the practitioner of ad18
vance directives, including living wills and durable
19 powers of attorney, and their uses.
20 ‘‘(C) An explanation by the practitioner of the
21 role and responsibilities of a health care proxy.
22 ‘‘(D) The provision by the practitioner of a list
23 of national and State-specific resources to assist con24
sumers and their families with advance care plan25
ning, including the national toll-free hotline, the ad-
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1 vance care planning clearinghouses, and State legal
2 service organizations (including those funded
3 through the Older Americans Act of 1965).
4 ‘‘(E) An explanation by the practitioner of the
5 continuum of end-of-life services and supports avail6
able, including palliative care and hospice, and bene7
fits for such services and supports that are available
8 under this title.
9 ‘‘(F)(i) Subject to clause (ii), an explanation of
10 orders regarding life sustaining treatment or similar
11 orders, which shall include—
12 ‘‘(I) the reasons why the development of
13 such an order is beneficial to the individual and
14 the individual’s family and the reasons why
15 such an order should be updated periodically as
16 the health of the individual changes;
17 ‘‘(II) the information needed for an indi18
vidual or legal surrogate to make informed deci19
sions regarding the completion of such an
20 order; and
21 ‘‘(III) the identification of resources that
22 an individual may use to determine the require23
ments of the State in which such individual re24
sides so that the treatment wishes of that indi25
vidual will be carried out if the individual is un-
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1 able to communicate those wishes, including re2
quirements regarding the designation of a sur3
rogate decisionmaker (also known as a health
4 care proxy).
5 ‘‘(ii) The Secretary shall limit the requirement
6 for explanations under clause (i) to consultations
7 furnished in a State—
8 ‘‘(I) in which all legal barriers have been
9 addressed for enabling orders for life sustaining
10 treatment to constitute a set of medical orders
11 respected across all care settings; and
12 ‘‘(II) that has in effect a program for or13
ders for life sustaining treatment described in
14 clause (iii).
15 ‘‘(iii) A program for orders for life sustaining
16 treatment for a States described in this clause is a
17 program that—
18 ‘‘(I) ensures such orders are standardized
19 and uniquely identifiable throughout the State;
20 ‘‘(II) distributes or makes accessible such
21 orders to physicians and other health profes22
sionals that (acting within the scope of the pro23
fessional’s authority under State law) may sign
24 orders for life sustaining treatment;
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1 ‘‘(III) provides training for health care
2 professionals across the continuum of care
3 about the goals and use of orders for life sus4
taining treatment; and
5 ‘‘(IV) is guided by a coalition of stake6
holders includes representatives from emergency
7 medical services, emergency department physi8
cians or nurses, state long-term care associa9
tion, state medical association, state surveyors,
10 agency responsible for senior services, state de11
partment of health, state hospital association,
12 home health association, state bar association,
13 and state hospice association.
14 ‘‘(2) A practitioner described in this paragraph is—
15 ‘‘(A) a physician (as defined in subsection
16 (r)(1)); and
17 ‘‘(B) a nurse practitioner or physician’s assist18
ant who has the authority under State law to sign
19 orders for life sustaining treatments.
20 ‘‘(3)(A) An initial preventive physical examination
21 under subsection (WW), including any related discussion
22 during such examination, shall not be considered an ad23
vance care planning consultation for purposes of applying
24 the 5-year limitation under paragraph (1).
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1 ‘‘(B) An advance care planning consultation with re2
spect to an individual may be conducted more frequently
3 than provided under paragraph (1) if there is a significant
4 change in the health condition of the individual, including
5 diagnosis of a chronic, progressive, life-limiting disease, a
6 life-threatening or terminal diagnosis or life-threatening
7 injury, or upon admission to a skilled nursing facility, a
8 long-term care facility (as defined by the Secretary), or
9 a hospice program.
10 ‘‘(4) A consultation under this subsection may in11
clude the formulation of an order regarding life sustaining
12 treatment or a similar order.
13 ‘‘(5)(A) For purposes of this section, the term ‘order
14 regarding life sustaining treatment’ means, with respect
15 to an individual, an actionable medical order relating to
16 the treatment of that individual that—
17 ‘‘(i) is signed and dated by a physician (as de18
fined in subsection (r)(1)) or another health care
19 professional (as specified by the Secretary and who
20 is acting within the scope of the professional’s au21
thority under State law in signing such an order, in22
cluding a nurse practitioner or physician assistant)
23 and is in a form that permits it to stay with the in24
dividual and be followed by health care professionals
25 and providers across the continuum of care;
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1 ‘‘(ii) effectively communicates the individual’s
2 preferences regarding life sustaining treatment, in3
cluding an indication of the treatment and care de4
sired by the individual;
5 ‘‘(iii) is uniquely identifiable and standardized
6 within a given locality, region, or State (as identified
7 by the Secretary); and
8 ‘‘(iv) may incorporate any advance directive (as
9 defined in section 1866(f)(3)) if executed by the in10
dividual.
11 ‘‘(B) The level of treatment indicated under subpara12
graph (A)(ii) may range from an indication for full treat13
ment to an indication to limit some or all or specified
14 interventions. Such indicated levels of treatment may in15
clude indications respecting, among other items—
16 ‘‘(i) the intensity of medical intervention if the
17 patient is pulse less, apneic, or has serious cardiac
18 or pulmonary problems;
19 ‘‘(ii) the individual’s desire regarding transfer
20 to a hospital or remaining at the current care set21
ting;
22 ‘‘(iii) the use of antibiotics; and
23 ‘‘(iv) the use of artificially administered nutri24
tion and hydration.’’.
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1 (2) PAYMENT.—Section 1848(j)(3) of such Act
2 (42 U.S.C. 1395w-4(j)(3)) is amended by inserting
3 ‘‘(2)(FF),’’ after ‘‘(2)(EE),’’.
4 (3) FREQUENCY LIMITATION.—Section 1862(a)
5 of such Act (42 U.S.C. 1395y(a)) is amended—
6 (A) in paragraph (1)—
7 (i) in subparagraph (N), by striking
8 ‘‘and’’ at the end;
9 (ii) in subparagraph (O) by striking
10 the semicolon at the end and inserting ‘‘,
11 and’’; and
12 (iii) by adding at the end the fol13
lowing new subparagraph:
14 ‘‘(P) in the case of advance care planning
15 consultations (as defined in section
16 1861(hhh)(1)), which are performed more fre17
quently than is covered under such section;’’;
18 and
19 (B) in paragraph (7), by striking ‘‘or (K)’’
20 and inserting ‘‘(K), or (P)’’.
21 (4) EFFECTIVE DATE.—The amendments made
22 by this subsection shall apply to consultations fur23
nished on or after January 1, 2011.
24 (b) EXPANSION OF PHYSICIAN QUALITY REPORTING
25 INITIATIVE FOR END OF LIFE CARE.—
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1 (1) PHYSICIAN’S QUALITY REPORTING INITIA2
TIVE.—Section 1848(k)(2) of the Social Security Act
3 (42 U.S.C. 1395w–4(k)(2)) is amended by adding at
4 the end the following new paragraphs:
5 ‘‘(3) PHYSICIAN’S QUALITY REPORTING INITIA6
TIVE.—
7 ‘‘(A) IN GENERAL.—For purposes of re8
porting data on quality measures for covered
9 professional services furnished during 2011 and
10 any subsequent year, to the extent that meas11
ures are available, the Secretary shall include
12 quality measures on end of life care and ad13
vanced care planning that have been adopted or
14 endorsed by a consensus-based organization, if
15 appropriate. Such measures shall measure both
16 the creation of and adherence to orders for life17
sustaining treatment.
18 ‘‘(B) PROPOSED SET OF MEASURES.— The
19 Secretary shall publish in the Federal Register
20 proposed quality measures on end of life care
21 and advanced care planning that the Secretary
22 determines are described in subparagraph (A)
23 and would be appropriate for eligible profes24
sionals to use to submit data to the Secretary.
25 The Secretary shall provide for a period of pub-
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1 lic comment on such set of measures before fi2
nalizing such proposed measures.’’.
3 (c) INCLUSION OF INFORMATION IN MEDICARE &
4 YOU HANDBOOK.—
5 (1) MEDICARE & YOU HANDBOOK.—
6 (A) IN GENERAL.—Not later than 1 year
7 after the date of the enactment of this Act, the
8 Secretary of Health and Human Services shall
9 update the online version of the Medicare &
10 You Handbook to include the following:
11 (i) An explanation of advance care
12 planning and advance directives, includ13
ing—
14 (I) living wills;
15 (II) durable power of attorney;
16 (III) orders of life-sustaining
17 treatment; and
18 (IV) health care proxies.
19 (ii) A description of Federal and State
20 resources available to assist individuals
21 and their families with advance care plan22
ning and advance directives, including—
23 (I) available State legal service
24 organizations to assist individuals
25 with advance care planning, including
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1 those organizations that receive fund2
ing pursuant to the Older Americans
3 Act of 1965 (42 U.S.C. 93001 et
4 seq.);
5 (II) website links or addresses for
6 State-specific advance directive forms;
7 and
8 (III) any additional information,
9 as determined by the Secretary.
10 (B) UPDATE OF PAPER AND SUBSEQUENT
11 VERSIONS.—The Secretary shall include the in12
formation described in subparagraph (A) in all
13 paper and electronic versions of the Medicare &
14 You Handbook that are published on or after
15 the date that is 1 year after the date of the en16
actment of this Act.

 

If you can make heads or tails out of that mumbo jumbo, you are a smarter person than I. Let me be clear though, many persons smarter than I have explained that the .gov "will not" pay a practitioner to do any procedure it deems unnecessary after a certain age. No reimbursement, no procedure.

That's not how we treat our older citizens. Unless you figure they're too old to matter. That death is acceptable over paying for treatment. That money matters more than dignity in old age.

 

Good read so far I tend to land in the conservative column with my views on social and political issues. I know many folks I heartily disagree with on political and social issues but fortunately I haven't come to the point where I view them as the "enemy" yet, just misguided

I will say this, however. I work for my local county government and have for the past five years. I have never in my life seen a more poorly run, inefficient, crony-laden, self-serving organization...ever! There are certainly good people trying to do the right thing everyday working in it but for the most part, the ones in charge (politicians mainly) are, as we fondly say where I live, "worthless as tits on a boar hog". After focusing on several obvious cost saving measures I saw in my department I was actually told by my boss early in my tenure "you need to get out of that for profit mindset you brought from the private sector and stop worrying about saving money. If we don't spend it this year, whether we need to or not, it will be taken out of our budget for next year". This blew me away...no wonder my freakin property taxes are so high!

I said all this to say, after seeing intimately firsthand how utterly worthless most of my simple county government is I can only imagine what it's like on the federal level. The really sad part is we all are under the illusion we somehow can change things by voting out the dead weight when in reality politicians on the national level have more power than we could even begin to imagine to retain their jobs. To even be a serious contender at that level, one has to already be a multi-millionaire with connections and power folks like us could never compete with. I think the same is true, to perhaps a lesser degree, on the state and local level too. I have experienced this firsthand from working on the campaign of a friend who ran for state office in 2006. Highly qualified and dedicated to positive results, he was completely shut down by the worthless incumbent's political and money machine. I seriously doubt the common man has any real voice in this country today regardless of what the powers that be (politicians, media, big business, etc.) would have us believe.

 

The founding fathers of this once great nation set an example for others to follow. George Washington served 2 terms as president, Benjamin Franklin refused to be paid when he held a public office, Thomas Jefferson served 2 terms as president,,,,.

But for some reason its ok for people like ted kennedy to live off of the tax payers and make a career out of being a senator? People like that are nothing but a parasite on the rear end of the tax payers. They contribute nothing to society.

Keep in mind that while teddie was in office, free trade with china has been upheld time and time again, the term "acid rain" was coined in the 1970s, mercury pollution from coal plants pollutes our water ways, illegal immigration was allowed to continue, taxes continued to go up, no public option for universal health care.

And most importantly - the income tax was not repealed and the federal reserve has been allowed to keep control of our money.

Banks get bailed out, while everyday people get kicked out of their houses when they get behind on their bills.

teddie did nothing outstanding to change our government or the way it works.

Its a sad day when people applaud parasites that suck the life out of this nation.

 

Sadly yes, I believe our country is headed for a Civil War.

A lady once asked Benjamin Franklin what have you done, he looked at her and said, "Ma'am, I have given you a Republic...if you can keep it." This is not a Democracy nor is it a Socialist country, instead it's a Republic. If you've watched the news you will see the people are fed up with your democracy and socialism. Just look at states like California who is over ran with big government programs. The people are being taxed to death. It's sad watching my brothers and sisters in Detroit living off Raccoons or people in New York eating Rats. You can't tell me big government is having a positive effect on our country but yet you want to grow it larger?


edited: Keep in mind both Obama and bidden stated during the election multiple times that the U.S. will be attacked between 2008-2013. So one has to wonder is Obama provoking a civil unrest?

 

Ray, I haven't equated conservatism with fascism, I haven't called anyone a kook,
nor do I go around using the word Republican as an epithet; please do me the courtesy of not equating "my democracy" (I like that term and will happily claim it) with socialism. My family has lived under real socialism, capital S Socialism, (and capital F Fascism, too) and don't wish a return to either. I'm just a Democrat who has seen too many American families bankrupted from medical issues, dropped from their insurance carriers, and has had friends die (and one currently dying) from lack of health insurance. I'm not some extremist.

I believe the country needs both conservatives and liberals (and even the extremists) to be America. The constant push-pull of opinions aimed at taking care of the populace and remaining fiscally strong. To call me a socialist is inaccurate and offensive.

I agree that too much government control would indeed be a bad thing, that's why I'm advocating for the inclusion of the Community Choice Act in this bill, so elderly people will have the option of receiving care in their homes instead of being forced into nursing homes. I simply disagree that this bill will turn us a socialist nation; people will still get to choose their doctors, no one is going up before death panels, there will still be private insurance for those of you lucky enough to qualify. (and before you jump all over my "lucky enough to qualify" statement, I merely meant healthy enough. You are very, very lucky if you are healthy.)

I find it very sad that you guys are talking about civil war. I certainly don't agree with everything Obama stands for (for one thing, I think he's too beholden to big corporations, and has let the industry influence this bill too much) but don't think violence is the answer. (Not to mention people like me generally don't fare too well in gunfights. Not easy to take cover in a bulky wheelchair. Got any tips for me, Ray?)

 

Anybody heard of the new plan for Obama to deliver a speech to school-children, in grades Pre-K through 6th grade next week?

Why am I not surprised that he wants time alone with our children when the parents aren't around (at school)? Perhaps it's to indoctrinate our children with his radical agenda? Indoctrinate the youth and you have them for life - Hitler knew that.

I'm continually amazed at how strikingly similar recent events are becoming to the historical Nazi Germany. How Did Hitler Control His Youth

 

How ironic, it was a Democrat that almost put me personally out on the street and I do mean Latterly with a capital "L". People think Obama is change but his policies are nothing short of failed democratic policies of the past. It took our our local economy 20+ years to recover from President Carter and now we're faced with President Obama preaching the EXACT same failed Carter policies.

It's interesting, you lived the socialist life, one you don't wish to see again but yet you vote socialism? President Obama him self is a member of the Democratic Socialist Association. His programs are socialist programs...just what do you think Obama meant by spreading the wealth :shrug: Just how in the world is attacking small business going to help our country? I'm talking about the increase on taxes and health care. As a small business owner we've already had to cut back but an increase on health cost will only make things worse and prevent us from expanding. Small business like my self is the back bone of the U.S. and President Obama is out to break it...why would even you support that?

When Obama mentioned Change, he failed to mention whether it was going to be good or bad.

 

Exactly. People loved the idea of change, and automatically assumed it was for the better because we were already in fairly bad shape. What people failed to realize is that it could have been far worse; and now Obama is about to prove it. (He already is)

 

I do not vote for socialism, I vote for civil rights. There is a vast difference between Democrat and Socialist, they are not interchangeable terms. I disagree with your assertion that this bill is Socialist in nature.

We agreed earlier in this thread that I should not be denied health care coverage because of my disabilities; this bill is about getting health care coverage for people with pre-existing conditions that prevent them from getting insurance, because insurance companies aren't exactly going out of their way to cover these people. Why should they? That's just capitalism, baby.

What other option do these people have? What would you suggest they do? If you have any ideas, I'm willing to listen.

...the hell? Do you have anything to back up that statement?

So he's Socialist and Fascist at the same time? That's a neat trick.

 

You're confusing, you don't like Socialism nor do you like Capitalism...you can't have it both ways. You must choose which is the lessor of the two evils. Is that really going to be Socialism?


So which socialist country do you originate from if you don't mind me asking?

Now we're calling people names?

This pretty much sums up Ted Kennedy...outside of being a Murder.

"How a politician stands on the Second Amendment
tells you how he or she views you as an individual;
as a trustworthy and productive citizen,
or as part of an unruly crowd that needs to be lorded over,
controlled, supervised, and taken care of."​

- Dr. Suzanna Gratia Hupp​

 

You indirectly stated people in this thread are stupid so don't play Coy...people who obviously don't share your same political thinking.

The difference here is I understand people may not share my same political views and I respect that. But modern Democrats on the other hand can not understand and nor respect people's Constitutional Rights. If a person doesn't share their same political thinking they automatically switch to name calling. This is an attempt to silence the people which isn't right.

As for the hate remark, I'm not the one calling people stupid all because of a difference in political thinking. That is just silly. In the end I still like Soliloquy despite her difference in opinions. The same thing with you. I understand Ted Kennedy did some good things but they don't out weigh the bad in my opinion. I'm Patriot, any attempt to restrict the people's Constitutional Rights is unforgivable.

 

I'm not against capitalism at all; I'm all for having a strong economy and social mobility. But a purely capitalist system sometimes leaves behind those who simply can't compete (people with disabilities, people with families to take care of, elderly people...). Surely a great country like the United States is capable of offering some protection to these people, so they do not end up dead, bankrupt, or unable to work because no one will hire them (for fear of raising their company insurance rates). If you're in a war, you wouldn't leave your fellow soldiers behind, would you? Why would you want to leave your fellow Americans behind?

I do not come from a socialist country; I said my family has lived under both Socialist and Fascist regimes (no, not by choice, there were wars going on). It's actually a fairly interesting, all-American story which I should really write a book about someday. Maybe I'll tell you some once you stop calling me Socialist. Deal?

I'm quite sure he was referring to Islamic extremists and trying to cover his butt in case there is another attack. Why do you think he's trying to promote civil unrest when Republicans have made the exact same assertions?

edit: +1 Ray's post for saying he still likes me even though I'm a Dem. Now we're getting this discussion back on track!

 

I realize no one is is perfect :p J/k I've actually got a good friend who is as democrat as it gets. We don't talk a lot about Obama but the Clinton years was interesting lol

Anyhow, I'm all for no one left behind but who is going to pay for it and how are you going to guarantee they don't bankrupt it like the rest of the government ran programs? Keep in mind Social Security, Medicaid, and Medicare are bankrupt and you got over 20 million baby boomers about to retire. We simply do not have the money to pay for these people let alone the rest of the country. And President Obama's bailouts which makes Bush's war look like chump change has the Chinese looking else where for investing their cash. I just read an article not sure how true it is but it stated the Chinese has ditched the USD. If that happens people it's Checkmate end of story. So ya this health care plan sounds great but show me the money :shrug:

 

Now don't you think that is a little immature?

We're talking about health care and you start calling people stupid. Now you're changing the subject to Class III weapons...a subject you obviously don't fully understand. If you must know I live in Texas which is a Class III friendly state. So devices like a Full Automatic firearm are completely legal. I know a several people with Class III devices and you can normally find me at the full auto gun range through out the week.

Anyhow, I grow tired of this subject. Ted Kennedy will not be missed by me and that is my Constitutional Right. Now his brother JFK on the other hand, there was a man worth remembering.

 

yeah, lol, I'm sure alot of women remember him.