Ducks start the Season a Little Slow...Here's a Pep Talk

Check out this kid channelling Kurt Russell's "Miracle" speech, then tell me, if the Ducks players see this, would there be any way possible another team could win The Cup?

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Set Your Calendar; Dream Theater Interview

Here's an upcoming interview you would expect me to do on KNAC.COM, but no, it's happening August 25 at 8:02 a.m. Pacific time on KFWB! Yup, progressive metal on KFWB when Penny Griego and I speak live to Dream Theater keyboardist extraordinaire, Jordan Rudess.

Rudess and his band bring their Progressive Nation Tour to a close at the Greek Theater in Los Angeles August 29.

Dream Theater is one of my favorite bands, and if you're not familiar with them, or you think you'll be scared off by metal, give the video below a watch, with the perspective that these guys are all about the music and doing things most musicians haven't dreamed of yet. The song is one of my faves from DT, "The Dark Eternal Night" and for bands coming up, this song has about a dozen hooks, each of which could be the basis for a single song, but DT weaves them nicely into this 9 minute ditty, with tinges of 1970's Gentle Giant. A little frustrating they shield our eyes from guitarist John Petrucci's fret board during the solos, but he has little left to prove, so be it. Enjoy.




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Be Very Afraid

In case you missed it, Congressman John Conyers, with just a few words, made it very clear why people should worry about what's in the Health Care Reform proposal.

In case you missed it, The Detroit Democrat said, "...What good is reading the bill if it's a thousand pages and you don't have two days and two lawyers to find out what it means after you read the bill?"

Watch the Congressman say it over and over again below.



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Health Care: Planning to Die?

I've read this section of the House Health Care Plan several times, and it looks a lot like Doctors will be asked to prepare elderly patients to consider the greater good of society versus prolonging life through medical care.

Maybe you have a different view? Read it and see.

This is taken word for word from the H.R. 3200, which you can read in it's entirety. Click here to read the entire bill.

I'll have more items of concern to post soon.

SEC. 1233. ADVANCE CARE PLANNING CONSULTATION.

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(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

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‘(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



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‘(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

‘(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

‘(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




‘(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




‘(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




‘(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




‘(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.

Politics in the Check Out Line

I went to the local grocery store to pick up a bag of sugar, and to fill another prescription of Tamiflu to add to my stockpile. Arriving at the check out counter, I made a quick glance at the tabloid rack and I couldn't help but notice the one pictured to the right.

Wow, The Globe. Is it fair to say some of The Globe's readers believe Obama was spawned by space aliens? Journalistic integrity aside, if questions about the President's nationality have reached this far, he's clearly lost control of the spin.

I'll give the President the benefit of the doubt and assume the certificate The Globe speaks of is just part of a creative writing assignment. But, it seems to me President Obama could make all of this go away simply by producing his documentation. The longer he postpones the reveal, the louder the questions become.

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