You guys would really be pissed if you saw the crap done at the hospital I work at. A bulk of our patients are uninsured/medicaid/medicare and the amount of BS we do for them is ridiculous. It's no wonder why health care costs are so damn high. The amount of money spent on disease processes like cancer, COPD, liver/kidney/heart failure to those who are at the [u]end of life[/u] stage is beyond obscene.
We really need to embrace the idea of stopping such extensive measures that merely give patients additional days/weeks with a poor quality of life and turning more towards comfort measures/hospice care.
Obama care, sticking it to the insured!
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RNaka
- Posts: 127
- Joined: Sun Apr 10, 2011 11:50 pm
Re: Obama care, sticking it to the insured!
[quote author=forgop link=topic=31395.msg133715#msg133715 date=1420105819]
You guys would really be pissed if you saw the crap done at the hospital I work at. A bulk of our patients are uninsured/medicaid/medicare and the amount of BS we do for them is ridiculous. It's no wonder why health care costs are so damn high. The amount of money spent on disease processes like cancer, COPD, liver/kidney/heart failure to those who are at the [u]end of life[/u] stage is beyond obscene.
We really need to embrace the idea of stopping such extensive measures that merely give patients additional days/weeks with a poor quality of life and turning more towards comfort measures/hospice care.
[/quote]
I don't disagree. The problem is who makes the descision? The insurance company? Government death panels? The insured?
No easy answers.
I guess that's why they call economics "the dismal science"
Cheers
You guys would really be pissed if you saw the crap done at the hospital I work at. A bulk of our patients are uninsured/medicaid/medicare and the amount of BS we do for them is ridiculous. It's no wonder why health care costs are so damn high. The amount of money spent on disease processes like cancer, COPD, liver/kidney/heart failure to those who are at the [u]end of life[/u] stage is beyond obscene.
We really need to embrace the idea of stopping such extensive measures that merely give patients additional days/weeks with a poor quality of life and turning more towards comfort measures/hospice care.
[/quote]
I don't disagree. The problem is who makes the descision? The insurance company? Government death panels? The insured?
No easy answers.
I guess that's why they call economics "the dismal science"
Cheers
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forgop
- Posts: 453
- Joined: Tue Jul 14, 2009 3:34 pm
Re: Obama care, sticking it to the insured!
[quote author=RNaka link=topic=31395.msg133719#msg133719 date=1420123411]
I don't disagree. The problem is who makes the descision? The insurance company? Government death panels? The insured?
No easy answers.
I guess that's why they call economics "the dismal science"
Cheers
[/quote]
I just find it frustrating the amount we spend for those who have reached a point that no recovery is possible. Take for instance the COPD patient who has multiple exacerbations a week and goes to the ER. Patient is then typically going to be admitted to the ER for 2-3 days in critical care using BiPAP, and usually require treatments from RT every 4 hours just to treat the exacerbation, let alone all of the other underlying health issues.
Unfortunately, there's no easy answer to solve the above scenario as this type of patient will end up with numerous admissions prior to their death...and for what? Another few days or a couple of weeks until it happens again? What we need is a change in the culture that there's more to living than just breathing alone and that there's much to be said about hospice facilities that would allow titration of morphine and various other drugs to allow for a smooth passing.
My dad was end stage cancer 7 years ago and we changed his code status and had him placed on a morphine drip. When you compare the dying process between someone placed on comfort measures vs. what we traditionally do, there's much more peace to witnessing the hospice/comfort measures method.
I don't disagree. The problem is who makes the descision? The insurance company? Government death panels? The insured?
No easy answers.
I guess that's why they call economics "the dismal science"
Cheers
[/quote]
I just find it frustrating the amount we spend for those who have reached a point that no recovery is possible. Take for instance the COPD patient who has multiple exacerbations a week and goes to the ER. Patient is then typically going to be admitted to the ER for 2-3 days in critical care using BiPAP, and usually require treatments from RT every 4 hours just to treat the exacerbation, let alone all of the other underlying health issues.
Unfortunately, there's no easy answer to solve the above scenario as this type of patient will end up with numerous admissions prior to their death...and for what? Another few days or a couple of weeks until it happens again? What we need is a change in the culture that there's more to living than just breathing alone and that there's much to be said about hospice facilities that would allow titration of morphine and various other drugs to allow for a smooth passing.
My dad was end stage cancer 7 years ago and we changed his code status and had him placed on a morphine drip. When you compare the dying process between someone placed on comfort measures vs. what we traditionally do, there's much more peace to witnessing the hospice/comfort measures method.
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mrmagee
- Posts: 123
- Joined: Wed Apr 10, 2013 1:41 pm
Re: Obama care, sticking it to the insured!
[quote author=forgop link=topic=31395.msg133767#msg133767 date=1420190381]
I just find it frustrating the amount we spend for those who have reached a point that no recovery is possible. Take for instance the COPD patient who has multiple exacerbations a week and goes to the ER. Patient is then typically going to be admitted to the ER for 2-3 days in critical care using BiPAP, and usually require treatments from RT every 4 hours just to treat the exacerbation, let alone all of the other underlying health issues.
Unfortunately, there's no easy answer to solve the above scenario as this type of patient will end up with numerous admissions prior to their death...and for what? Another few days or a couple of weeks until it happens again? What we need is a change in the culture that there's more to living than just breathing alone and that there's much to be said about hospice facilities that would allow titration of morphine and various other drugs to allow for a smooth passing.
My dad was end stage cancer 7 years ago and we changed his code status and had him placed on a morphine drip. When you compare the dying process between someone placed on comfort measures vs. what we traditionally do, there's much more peace to witnessing the hospice/comfort measures method.
[/quote]
I agree with this. I just went through a similar process with my grandmother last week. 94 years old, she had fell and broken her pelvis and two vertebrae, and had fallen into a coma shortly thereafter. They put her on sublingual morphine once every 4 hours, and she eventually passed peacefully in her sleep. Why on earth we'd want to prolong the life of someone who has lived a very full one, who has a severely low quality of life as they trend towards the end, is beyond me.
I just find it frustrating the amount we spend for those who have reached a point that no recovery is possible. Take for instance the COPD patient who has multiple exacerbations a week and goes to the ER. Patient is then typically going to be admitted to the ER for 2-3 days in critical care using BiPAP, and usually require treatments from RT every 4 hours just to treat the exacerbation, let alone all of the other underlying health issues.
Unfortunately, there's no easy answer to solve the above scenario as this type of patient will end up with numerous admissions prior to their death...and for what? Another few days or a couple of weeks until it happens again? What we need is a change in the culture that there's more to living than just breathing alone and that there's much to be said about hospice facilities that would allow titration of morphine and various other drugs to allow for a smooth passing.
My dad was end stage cancer 7 years ago and we changed his code status and had him placed on a morphine drip. When you compare the dying process between someone placed on comfort measures vs. what we traditionally do, there's much more peace to witnessing the hospice/comfort measures method.
[/quote]
I agree with this. I just went through a similar process with my grandmother last week. 94 years old, she had fell and broken her pelvis and two vertebrae, and had fallen into a coma shortly thereafter. They put her on sublingual morphine once every 4 hours, and she eventually passed peacefully in her sleep. Why on earth we'd want to prolong the life of someone who has lived a very full one, who has a severely low quality of life as they trend towards the end, is beyond me.
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RNaka
- Posts: 127
- Joined: Sun Apr 10, 2011 11:50 pm
Re: Obama care, sticking it to the insured!
[quote author=mrmagee link=topic=31395.msg133825#msg133825 date=1420245837]
I agree with this. I just went through a similar process with my grandmother last week. 94 years old, she had fell and broken her pelvis and two vertebrae, and had fallen into a coma shortly thereafter. They put her on sublingual morphine once every 4 hours, and she eventually passed peacefully in her sleep. Why on earth we'd want to prolong the life of someone who has lived a very full one, who has a severely low quality of life as they trend towards the end, is beyond me.
[/quote]
Hi mrmagee,
Both yours and forgop's experience illustrate the difficulties of end of life decisions. They also point out that at the moment those decisions rest with the insured and their family.
The problem as I see it with Obamacare which relies so heavily on Medicare and Medicaid subsidies is that those decisions will be increasingly determine by the bureaucracy.
If I understand the Swiss system as you described, the government only subsidizes the premiums NOT the services and procedures, leaving those choices to the insurers and insured. If so, the ultimate decisions as to services are still determined by the involved parties. I could support a similar system.
However that is not, in my opinion, structure or goal of Obamacare. By subsidizing not only premiums but services and procedures (Medicare/Medicaid) those decisions are determined increasingly by third parties.
The progressives have for years been in favor of a single payer system. Obamacare is in their world a stepping stone to such a system.
As a partisan, as you rightly noted, I have an inherent disdain for "mandates" in general.
But, in absence of a true laissez-faire economy I concede that a legitimate exercise of government oversight may be healthcare.
Hell, they already mandate the size of our toilet bowls and what's in a kids school lunches.
I agree with this. I just went through a similar process with my grandmother last week. 94 years old, she had fell and broken her pelvis and two vertebrae, and had fallen into a coma shortly thereafter. They put her on sublingual morphine once every 4 hours, and she eventually passed peacefully in her sleep. Why on earth we'd want to prolong the life of someone who has lived a very full one, who has a severely low quality of life as they trend towards the end, is beyond me.
[/quote]
Hi mrmagee,
Both yours and forgop's experience illustrate the difficulties of end of life decisions. They also point out that at the moment those decisions rest with the insured and their family.
The problem as I see it with Obamacare which relies so heavily on Medicare and Medicaid subsidies is that those decisions will be increasingly determine by the bureaucracy.
If I understand the Swiss system as you described, the government only subsidizes the premiums NOT the services and procedures, leaving those choices to the insurers and insured. If so, the ultimate decisions as to services are still determined by the involved parties. I could support a similar system.
However that is not, in my opinion, structure or goal of Obamacare. By subsidizing not only premiums but services and procedures (Medicare/Medicaid) those decisions are determined increasingly by third parties.
The progressives have for years been in favor of a single payer system. Obamacare is in their world a stepping stone to such a system.
As a partisan, as you rightly noted, I have an inherent disdain for "mandates" in general.
But, in absence of a true laissez-faire economy I concede that a legitimate exercise of government oversight may be healthcare.
Hell, they already mandate the size of our toilet bowls and what's in a kids school lunches.
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forgop
- Posts: 453
- Joined: Tue Jul 14, 2009 3:34 pm
Re: Obama care, sticking it to the insured!
Death panels in itself has a horrible sound to it, but honestly, I think there should be some sort of criteria that goes into effect that automatically places you on hospice status. It doesn't mean you're put down as we do with our pets (which is actually more humane than what we watch most of our family members go through), it just means you will receive no more life extensive measures, whether it be surgery, chemo, etc.
I wish there was a way to come up with a dollar amount to the burden placed on the health care system for those during the last 6 months of their lives that have chronic/life-ending disease processes. I heard from an educator in the oncology unit of the last hospital I worked at that something like 5% of their patients are DNR's. I can totally understand the life saving measures given to a trauma victim with virtually no other health conditions. What I find maddening is the amount of resources we spend on patients who have multiple comorbidities like COPD, diabetes, CHF, cirrhosis, kidney failure, obesity, heart disease, etc to just buy them another week until the next exacerbation.
I wish there was a way to come up with a dollar amount to the burden placed on the health care system for those during the last 6 months of their lives that have chronic/life-ending disease processes. I heard from an educator in the oncology unit of the last hospital I worked at that something like 5% of their patients are DNR's. I can totally understand the life saving measures given to a trauma victim with virtually no other health conditions. What I find maddening is the amount of resources we spend on patients who have multiple comorbidities like COPD, diabetes, CHF, cirrhosis, kidney failure, obesity, heart disease, etc to just buy them another week until the next exacerbation.