Just wanted to say.......
Comments
-
COSMO......I don't feel like writing a book, educate yourself. And GIMMESOMETRUTH....if it discredits myself to watch Beck..whatever, I watch alot of political news on both sides. I just try to educate myself as much as possible.0
-
gimmesometruth27 wrote:
what are you talking about?mb262200 wrote:To Gimmesometruth, read your last quote to me and then read your first quote to me. I simply did what you did.
tell us about the czars.
actually i will just look it up myself. probably get a better source then beck that way.
well, if you find a better source fill me in on it ok, i'm open to it.0 -
yeah, i am trying to educate myself about these "czars" since you will not post links for us.mb262200 wrote:COSMO......I don't feel like writing a book, educate yourself. And GIMMESOMETRUTH....if it discredits myself to watch Beck..whatever, I watch alot of political news on both sides. I just try to educate myself as much as possible."You can tell the greatness of a man by what makes him angry." - Lincoln
"Well, you tell him that I don't talk to suckas."0 -
gimmesometruth27 wrote:
what are you talking about?mb262200 wrote:To Gimmesometruth, read your last quote to me and then read your first quote to me. I simply did what you did.
tell us about the czars.
actually i will just look it up myself. probably get a better source then beck that way.
In your first Quote you simply thought I was wealthy from what I wrote.....so in return, I simply figured you were poor from what you wrote, kind of ironic isn't it......someone would think I was the wealthy one and you were the poor one.0 -
i was going by your rants in the other thread you created about coming from nothing and how the government was going to steal from you to give health care to the poor people who chose to get sick and do not deserve it. typical rich white man's rant from the right that i have been hearing for years. it doesnt matter, i disagree with you and believe you are wrong on this issue.mb262200 wrote:gimmesometruth27 wrote:
what are you talking about?mb262200 wrote:To Gimmesometruth, read your last quote to me and then read your first quote to me. I simply did what you did.
tell us about the czars.
actually i will just look it up myself. probably get a better source then beck that way.
In your first Quote you simply thought I was wealthy from what I wrote.....so in return, I simply figured you were poor from what you wrote, kind of ironic isn't it......someone would think I was the wealthy one and you were the poor one."You can tell the greatness of a man by what makes him angry." - Lincoln
"Well, you tell him that I don't talk to suckas."0 -
gimmesometruth27 wrote:
yeah, i am trying to educate myself about these "czars" since you will not post links for us.mb262200 wrote:COSMO......I don't feel like writing a book, educate yourself. And GIMMESOMETRUTH....if it discredits myself to watch Beck..whatever, I watch alot of political news on both sides. I just try to educate myself as much as possible.
I can't find links to post. As far as I know Beck is the only one reporting on it.0 -
so i googled health czar and got several biased blogs from both sides that i am not going to bother posting or reading on a friday night. the only real source was a time magazine article from march 2009 that does not really apply right now."You can tell the greatness of a man by what makes him angry." - Lincoln
"Well, you tell him that I don't talk to suckas."0 -
...mb262200 wrote:COSMO......I don't feel like writing a book, educate yourself. And GIMMESOMETRUTH....if it discredits myself to watch Beck..whatever, I watch alot of political news on both sides. I just try to educate myself as much as possible.
I recognize bullshit when I smell it... this translates into:
"COSMO... I really don't know shit about the czars... but, i heard Glen Beck talking about them on the T.V., so it must be important or something. I don't know why the Obama health care is bad... i just know that the people I watch on the T.V. say it's bad... so, it must be bad. So, educate yourself by watching the T.V. because that's there the educate comes from."
...
If you DID know something... a couple of paragraphs would do the trick. and last time i checked.. a book was longer than a couple of paragraphs.Allen Fieldhouse, home of the 2008 NCAA men's Basketball Champions! Go Jayhawks!
Hail, Hail!!!0 -
gimmesometruth27 wrote:so i googled health czar and got several biased blogs from both sides that i am not going to bother posting or reading on a friday night. the only real source was a time magazine article from march 2009 that does not really apply right now.
thats cool, but there is not only health czars, there are 32 czars surrounding Obama in the white house...maybe(who freakin knows who is telling the truth these days), all depends on who you want to listen to I guess but in all open minded honesty, I think everybody should pay attention to this issue, everything is worth looking into isn't it? I think everybody should stop labeling themselves democrat and republican and start labeling ourselves as simply an american citizen.0 -
Cosmo wrote:
...mb262200 wrote:COSMO......I don't feel like writing a book, educate yourself. And GIMMESOMETRUTH....if it discredits myself to watch Beck..whatever, I watch alot of political news on both sides. I just try to educate myself as much as possible.
I recognize bullshit when I smell it... this translates into:
"COSMO... I really don't know shit about the czars... but, i heard Glen Beck talking about them on the T.V., so it must be important or something. I don't know why the Obama health care is bad... i just know that the people I watch on the T.V. say it's bad... so, it must be bad. So, educate yourself by watching the T.V. because that's there the educate comes from."
...
If you DID know something... a couple of paragraphs would do the trick. and last time i checked.. a book was longer than a couple of paragraphs.
In all honesty....no, I wouldn't know how to write a couple of paragraphs on it...i'm not a writer and it's hard to explain. Does that mean it's not worth looking into for yourself?0 -
...mb262200 wrote:In all honesty....no, I wouldn't know how to write a couple of paragraphs on it...i'm not a writer and it's hard to explain. Does that mean it's not worth looking into for yourself?
Oh... I already know about the Health Czar Nancy DeParle who is working under Health and Human Services secretary Sebelius. I read HR 3200 (including Sec. 1233, the so-called 'Death Panel' section... which mentions nothing about Death Panels) because i wanted to read the actual text of the House Bill without the outside interpretations of a second party.
I just want your take on the subject. Your claim was that the Czars (in this case, DeParle) was going to do 'something' where I would not be receiving any assistance when I turn 65. I just want to hear... basically... WHAT is it that makes you feel this is going to happen. It was something Glen Beck said... well, what did he say that makes you agreee with him? Are they going to kill me and turn me into Soylent Green? Ship me off to some Island of Old People? What?
...
My guess is you watched Glen Beck... and you just agree with him... even though you aren't even sure what he is saying. He may have said things in the past that you agree with... but, on this... I'm guessing... you just are sure.
That is a total guess on my part... not claiming it's true... just trying to debunk yet another unsubstantiated claim in this whole Health Care debate.Allen Fieldhouse, home of the 2008 NCAA men's Basketball Champions! Go Jayhawks!
Hail, Hail!!!0 -
I'm not against health care reform, I know something needs to be done. But I don't think the government should run it. I feel that somebody should be able to walk into an insurance company and buy into a large group which would make it much more affordable for the average person. I think that's what the Public Options is.....isn't it? This post wasn't strictly based on health care. Look at people collecting unemployment, they could go look for work but even if they find a little bit of work it doesn;t extend there benifits if they start collecting partial unemployment......so where is the incentive for them to look? And how come people on well fare don't get drug screened? I don't need my taxes supporting someones bad habit.0
-
Feedback effects. Improve circumstances for some, improve circumstances for everyone. Basic economics: don't worry about the size of your piece of pie, make the pie bigger. If you sell bananas, you want as many people as possible to be able to buy bananas. Capitalism is not Malthusian.0
-
DeParle is recorded on video saying that it is in americas best interest to care for somebody ill thats 35 when somebody ill and elderly would be a waste of government money. I don't believe everything Beck says, but in the last week he has been on this issue and he has ALOT of video footage. Don't know where or how he got it but in any case, video tape does not lie.0
-
Lauri wrote:Feedback effects. Improve circumstances for some, improve circumstances for everyone. Basic economics: don't worry about the size of your piece of pie, make the pie bigger. If you sell bananas, you want as many people as possible to be able to buy bananas. Capitalism is not Malthusian.
What is Malthusian?0 -
Cosmo wrote:
...mb262200 wrote:In all honesty....no, I wouldn't know how to write a couple of paragraphs on it...i'm not a writer and it's hard to explain. Does that mean it's not worth looking into for yourself?
Oh... I already know about the Health Czar Nancy DeParle who is working under Health and Human Services secretary Sebelius. I read HR 3200 (including Sec. 1233, the so-called 'Death Panel' section... which mentions nothing about Death Panels) because i wanted to read the actual text of the House Bill without the outside interpretations of a second party.
I just want your take on the subject. Your claim was that the Czars (in this case, DeParle) was going to do 'something' where I would not be receiving any assistance when I turn 65. I just want to hear... basically... WHAT is it that makes you feel this is going to happen. It was something Glen Beck said... well, what did he say that makes you agreee with him? Are they going to kill me and turn me into Soylent Green? Ship me off to some Island of Old People? What?
...
My guess is you watched Glen Beck... and you just agree with him... even though you aren't even sure what he is saying. He may have said things in the past that you agree with... but, on this... I'm guessing... you just are sure.
That is a total guess on my part... not claiming it's true... just trying to debunk yet another unsubstantiated claim in this whole Health Care debate.
how do you read actual texts of the house bills? I am very interested in this. And if they are that easy to read, how come congress doesn't read them?
0 -
I don't care which party is in office! How long now has the government been playing bullshit games with everybody? In my opinion, since Kennedy assasination. It's time we stop labeling ourselves as democrat or republican and just start labeling ourselves as American Citizens.....WE THE PEOPLE!!!!We deserve to know what is going on in the White House, we deserve to know what decisions are being made, and we deserve to have a bill that costs billions of dollars read before they pass it. I'm tired of being treated like a bunch of herded cattle.0
-
mb262200 wrote:
how do you read actual texts of the house bills? I am very interested in this. And if they are that easy to read, how come congress doesn't read them?
http://www.govtrack.us/congress/billtex ... Aih%3A2824
SEC. 1233. ADVANCE CARE PLANNING CONSULTATION.
3
(a) Medicare-CommentsClose CommentsPermalink
(1) IN GENERAL- Section 1861 of the Social Security Act (42 U.S.C. 1395x) is amended--CommentsClose CommentsPermalink
(A) in subsection (s)(2)--CommentsClose CommentsPermalink
(i) by striking ‘and’ at the end of subparagraph (DD);CommentsClose CommentsPermalink
(ii) by adding ‘and’ at the end of subparagraph (EE); andCommentsClose CommentsPermalink
(iii) by adding at the end the following new subparagraph:CommentsClose CommentsPermalink
‘(FF) advance care planning consultation (as defined in subsection (hhh)(1));’; andCommentsClose CommentsPermalink
(B) by adding at the end the following new subsection:CommentsClose CommentsPermalink
‘Advance Care Planning Consultation
16
‘(hhh)(1) Subject to paragraphs (3) and (4), the term ‘advance care planning consultation’ means a consultation between the individual and a practitioner described in paragraph (2) regarding advance care planning, if, subject to paragraph (3), the individual involved has not had such a consultation within the last 5 years. Such consultation shall include the following:CommentsClose CommentsPermalink
‘(A) An explanation by the practitioner of advance care planning, including key questions and considerations, important steps, and suggested people to talk to.CommentsClose CommentsPermalink
‘(B) An explanation by the practitioner of advance directives, including living wills and durable powers of attorney, and their uses.CommentsClose CommentsPermalink
‘(C) An explanation by the practitioner of the role and responsibilities of a health care proxy.CommentsClose CommentsPermalink
‘(D) The provision by the practitioner of a list of national and State-specific resources to assist consumers and their families with advance care planning, including the national toll-free hotline, the advance care planning clearinghouses, and State legal service organizations (including those funded through the Older Americans Act of 1965).CommentsClose CommentsPermalink
15
‘(E) An explanation by the practitioner of the continuum of end-of-life services and supports available, including palliative care and hospice, and benefits for such services and supports that are available under this title.CommentsClose CommentsPermalink
‘(F)(i) Subject to clause (ii), an explanation of orders regarding life sustaining treatment or similar orders, which shall include--CommentsClose CommentsPermalink
‘(I) the reasons why the development of such an order is beneficial to the individual and the individual’s family and the reasons why such an order should be updated periodically as the health of the individual changes;CommentsClose CommentsPermalink
‘(II) the information needed for an individual or legal surrogate to make informed decisions regarding the completion of such an order; andCommentsClose CommentsPermalink
‘(III) the identification of resources that an individual may use to determine the requirements of the State in which such individual resides so that the treatment wishes of that individual will be carried out if the individual is unable to communicate those wishes, including requirements regarding the designation of a surrogate decisionmaker (also known as a health care proxy).CommentsClose CommentsPermalink
‘(ii) The Secretary shall limit the requirement for explanations under clause (i) to consultations furnished in a State--CommentsClose CommentsPermalink
‘(I) in which all legal barriers have been addressed for enabling orders for life sustaining treatment to constitute a set of medical orders respected across all care settings; andCommentsClose CommentsPermalink
‘(II) that has in effect a program for orders for life sustaining treatment described in clause (iii).CommentsClose CommentsPermalink
‘(iii) A program for orders for life sustaining treatment for a States described in this clause is a program that--CommentsClose CommentsPermalink
‘(I) ensures such orders are standardized and uniquely identifiable throughout the State;CommentsClose CommentsPermalink
‘(II) distributes or makes accessible such orders to physicians and other health professionals that (acting within the scope of the professional’s authority under State law) may sign orders for life sustaining treatment;CommentsClose CommentsPermalink
‘(III) provides training for health care professionals across the continuum of care about the goals and use of orders for life sustaining treatment; andCommentsClose CommentsPermalink
‘(IV) is guided by a coalition of stakeholders includes representatives from emergency medical services, emergency department physicians or nurses, state long-term care association, state medical association, state surveyors, agency responsible for senior services, state department of health, state hospital association, home health association, state bar association, and state hospice association.CommentsClose CommentsPermalink
‘(2) A practitioner described in this paragraph is--CommentsClose CommentsPermalink
‘(A) a physician (as defined in subsection (r)(1)); andCommentsClose CommentsPermalink
‘(B) a nurse practitioner or physician’s assistant who has the authority under State law to sign orders for life sustaining treatments.CommentsClose CommentsPermalink
‘(3)(A) An initial preventive physical examination under subsection (WW), including any related discussion during such examination, shall not be considered an advance care planning consultation for purposes of applying the 5-year limitation under paragraph (1).CommentsClose CommentsPermalink
‘(B) An advance care planning consultation with respect to an individual may be conducted more frequently than provided under paragraph (1) if there is a significant change in the health condition of the individual, including diagnosis of a chronic, progressive, life-limiting disease, a life-threatening or terminal diagnosis or life-threatening injury, or upon admission to a skilled nursing facility, a long-term care facility (as defined by the Secretary), or a hospice program.CommentsClose CommentsPermalink
3
‘(4) A consultation under this subsection may include the formulation of an order regarding life sustaining treatment or a similar order.CommentsClose CommentsPermalink
‘(5)(A) For purposes of this section, the term ‘order regarding life sustaining treatment’ means, with respect to an individual, an actionable medical order relating to the treatment of that individual that--CommentsClose CommentsPermalink
20
‘(i) is signed and dated by a physician (as defined in subsection (r)(1)) or another health care professional (as specified by the Secretary and who is acting within the scope of the professional’s authority under State law in signing such an order, including a nurse practitioner or physician assistant) and is in a form that permits it to stay with the individual and be followed by health care professionals and providers across the continuum of care;CommentsClose CommentsPermalink
6
‘(ii) effectively communicates the individual’s preferences regarding life sustaining treatment, including an indication of the treatment and care desired by the individual;CommentsClose CommentsPermalink
‘(iii) is uniquely identifiable and standardized within a given locality, region, or State (as identified by the Secretary); andCommentsClose CommentsPermalink
1
‘(iv) may incorporate any advance directive (as defined in section 1866(f)(3)) if executed by the individual.CommentsClose CommentsPermalink
‘(B) The level of treatment indicated under subparagraph (A)(ii) may range from an indication for full treatment to an indication to limit some or all or specified interventions. Such indicated levels of treatment may include indications respecting, among other items--CommentsClose CommentsPermalink
‘(i) the intensity of medical intervention if the patient is pulse less, apneic, or has serious cardiac or pulmonary problems;CommentsClose CommentsPermalink
‘(ii) the individual’s desire regarding transfer to a hospital or remaining at the current care setting;CommentsClose CommentsPermalink
‘(iii) the use of antibiotics; andCommentsClose CommentsPermalink
‘(iv) the use of artificially administered nutrition and hydration.’.CommentsClose CommentsPermalink
(2) PAYMENT- Section 1848(j)(3) of such Act (42 U.S.C. 1395w-4(j)(3)) is amended by inserting ‘(2)(FF),’ after ‘(2)(EE),’.CommentsClose CommentsPermalink
(3) FREQUENCY LIMITATION- Section 1862(a) of such Act (42 U.S.C. 1395y(a)) is amended--CommentsClose CommentsPermalink
(A) in paragraph (1)--CommentsClose CommentsPermalink
(i) in subparagraph (N), by striking ‘and’ at the end;CommentsClose CommentsPermalink
(ii) in subparagraph (O) by striking the semicolon at the end and inserting ‘, and’; andCommentsClose CommentsPermalink
(iii) by adding at the end the following new subparagraph:CommentsClose CommentsPermalink
‘(P) in the case of advance care planning consultations (as defined in section 1861(hhh)(1)), which are performed more frequently than is covered under such section;’; andCommentsClose CommentsPermalink
(B) in paragraph (7), by striking ‘or (K)’ and inserting ‘(K), or (P)’.CommentsClose CommentsPermalink
(4) EFFECTIVE DATE- The amendments made by this subsection shall apply to consultations furnished on or after January 1, 2011.CommentsClose CommentsPermalink
(b) Expansion of Physician Quality Reporting Initiative for End of Life Care-CommentsClose CommentsPermalink
(1) Physician’S QUALITY REPORTING INITIATIVE- Section 1848(k)(2) of the Social Security Act (42 U.S.C. 1395w-4(k)(2)) is amended by adding at the end the following new paragraphs:CommentsClose CommentsPermalink
‘(3) Physician’S QUALITY REPORTING INITIATIVE-CommentsClose CommentsPermalink
10
‘(A) IN GENERAL- For purposes of reporting data on quality measures for covered professional services furnished during 2011 and any subsequent year, to the extent that measures are available, the Secretary shall include quality measures on end of life care and advanced care planning that have been adopted or endorsed by a consensus-based organization, if appropriate. Such measures shall measure both the creation of and adherence to orders for life-sustaining treatment.CommentsClose CommentsPermalink
1
‘(B) PROPOSED SET OF MEASURES- The Secretary shall publish in the Federal Register proposed quality measures on end of life care and advanced care planning that the Secretary determines are described in subparagraph (A) and would be appropriate for eligible professionals to use to submit data to the Secretary. The Secretary shall provide for a period of public comment on such set of measures before finalizing such proposed measures.’.CommentsClose CommentsPermalink
(c) Inclusion of Information in Medicare & You Handbook-CommentsClose CommentsPermalink
(1) MEDICARE & YOU HANDBOOK-CommentsClose CommentsPermalink
(A) IN GENERAL- Not later than 1 year after the date of the enactment of this Act, the Secretary of Health and Human Services shall update the online version of the Medicare & You Handbook to include the following:CommentsClose CommentsPermalink
(i) An explanation of advance care planning and advance directives, including--CommentsClose CommentsPermalink
(I) living wills;CommentsClose CommentsPermalink
(II) durable power of attorney;CommentsClose CommentsPermalink
(III) orders of life-sustaining treatment; andCommentsClose CommentsPermalink
(IV) health care proxies.CommentsClose CommentsPermalink
(ii) A description of Federal and State resources available to assist individuals and their families with advance care planning and advance directives, including--CommentsClose CommentsPermalink
(I) available State legal service organizations to assist individuals with advance care planning, including those organizations that receive funding pursuant to the Older Americans Act of 1965 (42 U.S.C. 93001 et seq.);CommentsClose CommentsPermalink
(II) website links or addresses for State-specific advance directive forms; andCommentsClose CommentsPermalink
(III) any additional information, as determined by the Secretary.CommentsClose CommentsPermalink
(B) UPDATE OF PAPER AND SUBSEQUENT VERSIONS- The Secretary shall include the information described in subparagraph (A) in all paper and electronic versions of the Medicare & You Handbook that are published on or after the date that is 1 year after the date of the enactment of this Act.0 -
...mb262200 wrote:I'm not against health care reform, I know something needs to be done. But I don't think the government should run it. I feel that somebody should be able to walk into an insurance company and buy into a large group which would make it much more affordable for the average person. I think that's what the Public Options is.....isn't it? This post wasn't strictly based on health care. Look at people collecting unemployment, they could go look for work but even if they find a little bit of work it doesn;t extend there benifits if they start collecting partial unemployment......so where is the incentive for them to look? And how come people on well fare don't get drug screened? I don't need my taxes supporting someones bad habit.
Actually... think of the Public Option as the Post Office. It is a government run service that will take a birthday card that you grandmother in Boston wrote and fly it in an airplane to eventually drop it in your mailbox in Cypress, Califonia... for 48 cents.
Now, she can CHOOSE to have in in your mailbox the next day... by going to UPS or FedEx. The Choices are out there and it's up to you to decide.
Now.. if there was no post office.. and there was just UPS or FedEx... they will charge your grandmother more than 48 cents to delive that birthday card, right? The Public option of the Post Office makes it affordable for her to send that card and it does not drive UPS or FedEx into bankruptcy.
...
***Disclaimer: I am not saying the Post Office is a well tuned machine... it is JUST AN EXAMPLE.***
...
Now... as for Unemployment. You cannot collect unemployment if you haven't paid into it. What do you want to do to those auto workers who got laid off... not just the Union guys.. the Free Enterprise Personel, such as the secretarys, data services and low level supervisors? Tell them, 'Get a fucking job'... when they worked 30 years for the company? Only working people are worth caring for? What?
Finally... Welfare. The easiest people to pick on are the weakest in our society. Sure, there is fraud in Welfare. There is fraud in auto insurance... should we discard the auto insurance companies? I'm all for prosecuting the cheaters and thieves... but, there are families dependent on welfare. I don't mind helping my fellow Americans that are down on their luck... for whatever reasons they got their. All i see is they need a hand, so i offer mine. I can't predict the future... I may be in their shoes someday. I'm just hoping someone offers me a hand up instead of a spit in the face.
...
But, that's just me.Allen Fieldhouse, home of the 2008 NCAA men's Basketball Champions! Go Jayhawks!
Hail, Hail!!!0 -
norm wrote:mb262200 wrote:
how do you read actual texts of the house bills? I am very interested in this. And if they are that easy to read, how come congress doesn't read them?
http://www.govtrack.us/congress/billtex ... Aih%3A2824
SEC. 1233. ADVANCE CARE PLANNING CONSULTATION.
3
(a) Medicare-CommentsClose CommentsPermalink
(1) IN GENERAL- Section 1861 of the Social Security Act (42 U.S.C. 1395x) is amended--CommentsClose CommentsPermalink
(A) in subsection (s)(2)--CommentsClose CommentsPermalink
(i) by striking ‘and’ at the end of subparagraph (DD);CommentsClose CommentsPermalink
(ii) by adding ‘and’ at the end of subparagraph (EE); andCommentsClose CommentsPermalink
(iii) by adding at the end the following new subparagraph:CommentsClose CommentsPermalink
‘(FF) advance care planning consultation (as defined in subsection (hhh)(1));’; andCommentsClose CommentsPermalink
(B) by adding at the end the following new subsection:CommentsClose CommentsPermalink
‘Advance Care Planning Consultation
16
‘(hhh)(1) Subject to paragraphs (3) and (4), the term ‘advance care planning consultation’ means a consultation between the individual and a practitioner described in paragraph (2) regarding advance care planning, if, subject to paragraph (3), the individual involved has not had such a consultation within the last 5 years. Such consultation shall include the following:CommentsClose CommentsPermalink
‘(A) An explanation by the practitioner of advance care planning, including key questions and considerations, important steps, and suggested people to talk to.CommentsClose CommentsPermalink
‘(B) An explanation by the practitioner of advance directives, including living wills and durable powers of attorney, and their uses.CommentsClose CommentsPermalink
‘(C) An explanation by the practitioner of the role and responsibilities of a health care proxy.CommentsClose CommentsPermalink
‘(D) The provision by the practitioner of a list of national and State-specific resources to assist consumers and their families with advance care planning, including the national toll-free hotline, the advance care planning clearinghouses, and State legal service organizations (including those funded through the Older Americans Act of 1965).CommentsClose CommentsPermalink
15
‘(E) An explanation by the practitioner of the continuum of end-of-life services and supports available, including palliative care and hospice, and benefits for such services and supports that are available under this title.CommentsClose CommentsPermalink
‘(F)(i) Subject to clause (ii), an explanation of orders regarding life sustaining treatment or similar orders, which shall include--CommentsClose CommentsPermalink
‘(I) the reasons why the development of such an order is beneficial to the individual and the individual’s family and the reasons why such an order should be updated periodically as the health of the individual changes;CommentsClose CommentsPermalink
‘(II) the information needed for an individual or legal surrogate to make informed decisions regarding the completion of such an order; andCommentsClose CommentsPermalink
‘(III) the identification of resources that an individual may use to determine the requirements of the State in which such individual resides so that the treatment wishes of that individual will be carried out if the individual is unable to communicate those wishes, including requirements regarding the designation of a surrogate decisionmaker (also known as a health care proxy).CommentsClose CommentsPermalink
‘(ii) The Secretary shall limit the requirement for explanations under clause (i) to consultations furnished in a State--CommentsClose CommentsPermalink
‘(I) in which all legal barriers have been addressed for enabling orders for life sustaining treatment to constitute a set of medical orders respected across all care settings; andCommentsClose CommentsPermalink
‘(II) that has in effect a program for orders for life sustaining treatment described in clause (iii).CommentsClose CommentsPermalink
‘(iii) A program for orders for life sustaining treatment for a States described in this clause is a program that--CommentsClose CommentsPermalink
‘(I) ensures such orders are standardized and uniquely identifiable throughout the State;CommentsClose CommentsPermalink
‘(II) distributes or makes accessible such orders to physicians and other health professionals that (acting within the scope of the professional’s authority under State law) may sign orders for life sustaining treatment;CommentsClose CommentsPermalink
‘(III) provides training for health care professionals across the continuum of care about the goals and use of orders for life sustaining treatment; andCommentsClose CommentsPermalink
‘(IV) is guided by a coalition of stakeholders includes representatives from emergency medical services, emergency department physicians or nurses, state long-term care association, state medical association, state surveyors, agency responsible for senior services, state department of health, state hospital association, home health association, state bar association, and state hospice association.CommentsClose CommentsPermalink
‘(2) A practitioner described in this paragraph is--CommentsClose CommentsPermalink
‘(A) a physician (as defined in subsection (r)(1)); andCommentsClose CommentsPermalink
‘(B) a nurse practitioner or physician’s assistant who has the authority under State law to sign orders for life sustaining treatments.CommentsClose CommentsPermalink
‘(3)(A) An initial preventive physical examination under subsection (WW), including any related discussion during such examination, shall not be considered an advance care planning consultation for purposes of applying the 5-year limitation under paragraph (1).CommentsClose CommentsPermalink
‘(B) An advance care planning consultation with respect to an individual may be conducted more frequently than provided under paragraph (1) if there is a significant change in the health condition of the individual, including diagnosis of a chronic, progressive, life-limiting disease, a life-threatening or terminal diagnosis or life-threatening injury, or upon admission to a skilled nursing facility, a long-term care facility (as defined by the Secretary), or a hospice program.CommentsClose CommentsPermalink
3
‘(4) A consultation under this subsection may include the formulation of an order regarding life sustaining treatment or a similar order.CommentsClose CommentsPermalink
‘(5)(A) For purposes of this section, the term ‘order regarding life sustaining treatment’ means, with respect to an individual, an actionable medical order relating to the treatment of that individual that--CommentsClose CommentsPermalink
20
‘(i) is signed and dated by a physician (as defined in subsection (r)(1)) or another health care professional (as specified by the Secretary and who is acting within the scope of the professional’s authority under State law in signing such an order, including a nurse practitioner or physician assistant) and is in a form that permits it to stay with the individual and be followed by health care professionals and providers across the continuum of care;CommentsClose CommentsPermalink
6
‘(ii) effectively communicates the individual’s preferences regarding life sustaining treatment, including an indication of the treatment and care desired by the individual;CommentsClose CommentsPermalink
‘(iii) is uniquely identifiable and standardized within a given locality, region, or State (as identified by the Secretary); andCommentsClose CommentsPermalink
1
‘(iv) may incorporate any advance directive (as defined in section 1866(f)(3)) if executed by the individual.CommentsClose CommentsPermalink
‘(B) The level of treatment indicated under subparagraph (A)(ii) may range from an indication for full treatment to an indication to limit some or all or specified interventions. Such indicated levels of treatment may include indications respecting, among other items--CommentsClose CommentsPermalink
‘(i) the intensity of medical intervention if the patient is pulse less, apneic, or has serious cardiac or pulmonary problems;CommentsClose CommentsPermalink
‘(ii) the individual’s desire regarding transfer to a hospital or remaining at the current care setting;CommentsClose CommentsPermalink
‘(iii) the use of antibiotics; andCommentsClose CommentsPermalink
‘(iv) the use of artificially administered nutrition and hydration.’.CommentsClose CommentsPermalink
(2) PAYMENT- Section 1848(j)(3) of such Act (42 U.S.C. 1395w-4(j)(3)) is amended by inserting ‘(2)(FF),’ after ‘(2)(EE),’.CommentsClose CommentsPermalink
(3) FREQUENCY LIMITATION- Section 1862(a) of such Act (42 U.S.C. 1395y(a)) is amended--CommentsClose CommentsPermalink
(A) in paragraph (1)--CommentsClose CommentsPermalink
(i) in subparagraph (N), by striking ‘and’ at the end;CommentsClose CommentsPermalink
(ii) in subparagraph (O) by striking the semicolon at the end and inserting ‘, and’; andCommentsClose CommentsPermalink
(iii) by adding at the end the following new subparagraph:CommentsClose CommentsPermalink
‘(P) in the case of advance care planning consultations (as defined in section 1861(hhh)(1)), which are performed more frequently than is covered under such section;’; andCommentsClose CommentsPermalink
(B) in paragraph (7), by striking ‘or (K)’ and inserting ‘(K), or (P)’.CommentsClose CommentsPermalink
(4) EFFECTIVE DATE- The amendments made by this subsection shall apply to consultations furnished on or after January 1, 2011.CommentsClose CommentsPermalink
(b) Expansion of Physician Quality Reporting Initiative for End of Life Care-CommentsClose CommentsPermalink
(1) Physician’S QUALITY REPORTING INITIATIVE- Section 1848(k)(2) of the Social Security Act (42 U.S.C. 1395w-4(k)(2)) is amended by adding at the end the following new paragraphs:CommentsClose CommentsPermalink
‘(3) Physician’S QUALITY REPORTING INITIATIVE-CommentsClose CommentsPermalink
10
‘(A) IN GENERAL- For purposes of reporting data on quality measures for covered professional services furnished during 2011 and any subsequent year, to the extent that measures are available, the Secretary shall include quality measures on end of life care and advanced care planning that have been adopted or endorsed by a consensus-based organization, if appropriate. Such measures shall measure both the creation of and adherence to orders for life-sustaining treatment.CommentsClose CommentsPermalink
1
‘(B) PROPOSED SET OF MEASURES- The Secretary shall publish in the Federal Register proposed quality measures on end of life care and advanced care planning that the Secretary determines are described in subparagraph (A) and would be appropriate for eligible professionals to use to submit data to the Secretary. The Secretary shall provide for a period of public comment on such set of measures before finalizing such proposed measures.’.CommentsClose CommentsPermalink
(c) Inclusion of Information in Medicare & You Handbook-CommentsClose CommentsPermalink
(1) MEDICARE & YOU HANDBOOK-CommentsClose CommentsPermalink
(A) IN GENERAL- Not later than 1 year after the date of the enactment of this Act, the Secretary of Health and Human Services shall update the online version of the Medicare & You Handbook to include the following:CommentsClose CommentsPermalink
(i) An explanation of advance care planning and advance directives, including--CommentsClose CommentsPermalink
(I) living wills;CommentsClose CommentsPermalink
(II) durable power of attorney;CommentsClose CommentsPermalink
(III) orders of life-sustaining treatment; andCommentsClose CommentsPermalink
(IV) health care proxies.CommentsClose CommentsPermalink
(ii) A description of Federal and State resources available to assist individuals and their families with advance care planning and advance directives, including--CommentsClose CommentsPermalink
(I) available State legal service organizations to assist individuals with advance care planning, including those organizations that receive funding pursuant to the Older Americans Act of 1965 (42 U.S.C. 93001 et seq.);CommentsClose CommentsPermalink
(II) website links or addresses for State-specific advance directive forms; andCommentsClose CommentsPermalink
(III) any additional information, as determined by the Secretary.CommentsClose CommentsPermalink
(B) UPDATE OF PAPER AND SUBSEQUENT VERSIONS- The Secretary shall include the information described in subparagraph (A) in all paper and electronic versions of the Medicare & You Handbook that are published on or after the date that is 1 year after the date of the enactment of this Act.
Now I see why congress doesn't read them...alll a bunch of jibba jabba0
Categories
- All Categories
- 148.9K Pearl Jam's Music and Activism
- 110.1K The Porch
- 275 Vitalogy
- 35.1K Given To Fly (live)
- 3.5K Words and Music...Communication
- 39.2K Flea Market
- 39.2K Lost Dogs
- 58.7K Not Pearl Jam's Music
- 10.6K Musicians and Gearheads
- 29.1K Other Music
- 17.8K Poetry, Prose, Music & Art
- 1.1K The Art Wall
- 56.8K Non-Pearl Jam Discussion
- 22.2K A Moving Train
- 31.7K All Encompassing Trip
- 2.9K Technical Stuff and Help