Election Day!

Thank you for voting today. But, please keep in mind it does not end here. Beginning tomorrow I encourage you to remain as fired up about the process as you are today and stay in the face of your elected representatives.

Here's a cool Google Maps page that locates your polling place. Simply enter your registered address and your polling place appears on the map.  Try it out here.

Follow me on Twitter: www.twitter.com/philhulett Subscribe to this blog: click Here

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.



Follow me on Twitter: www.twitter.com/philhulett
Subscribe to this blog: click Here

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.

1
(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

6

‘(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



7
‘(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.

Follow me on Twitter: www.twitter.com/philhulett
Subscribe to this blog: click Here

Read the Health Care Reform Proposal

I'm reading my way through the health care reform proposal, hoping Congress is doing the same. You should read it, too.

Here are a couple links for you:

• "America's Affordable Health Choices Act of 2009" (HR 3200) Introduced July July 14
  
• House Ways and Means Committee Discussion Draft Bill from June 19

Follow me on Twitter: http://twitter.com/philhulett
Subscribe to this blog: click Here

Something Stinks Under The Hood

Cash For Clunkers good? In one way, "YES". It did boost sales, and probably had a lot to do with a big gain for Ford (The Ford Focus is the most popular car purchased through the Clunkers program). But the answer may be "NO" on other fronts.

Consider car dealers, though happy about the foot traffic on their lots, are not pleased with the process. Many have complained about confusing instructions, and difficulty getting through the online application for reimbursement. In fact, the Department of Transportation, who oversees the program, acknowledged big challenges in managing the flood of requests from dealerships, by announcing 300 new contract workers would be hired to help the flow-through. I guess the DOT didn't already have enough salaried workers who could pick up the slack.

Here are some unintended consequences of Cash for Clunkers: Read here how charities complain about cars that would have been donated to their groups are now, at the direction of the DOT, being junked by dealers. Charities also worry that working families are being impacted as affordable used cars are being taken out of the market. Also, as Edmunds.com points out in their analysis of the program, that even though $4500 and $3500 rebates are offered to consumers who trade in qualifying clunkers, it may actually cost the government as much as $45,000 for each transaction.

Is it just me, or does any of this hoist a red flag for you? This is the same government that wants to manage your health care.

Follow me on Twitter: http://twitter.com/philhulett
Subscribe to this blog: click Here

National Health Care Debate - What's the Hurry?

Regardless of how you think on letting government administer health care insurance to the nation, I wonder what the rush is in the nation's capitol over a reform bill. The President says he wants a bill on his desk before the break. Lawmakers say they won't recess until they get it done. Something this big (a Trillion dollars over ten years, to start), that can easily go very wrong, should be approached with all careful consideration, right?

I get irked when Congress essentially says, "Damn the people, we're going to get this done." What's coming from this is something we'll be stuck with for a long time, and if they get it wrong, it could break us to fix it...and fixing stuff is what Congress thrives on.

Sometimes I wish they would just stay home.

Follow me on Twitter: www.twitter.com/philhulett
Subscribe to this blog: click Here

American Capitalism Gone With a Whimper

Did you miss this editorial from the English version of Pravda? I've always said, "Pay attention" when it comes to freedom and the government. Though the below is opinion, it certainly causes (the thinking) to think. At the very least, By posting it here, I hope it encourages the reader to, "Pay Attention."

It must be said, that like the breaking of a great dam, the American decent into Marxism is happening with breath taking speed, against the back drop of a passive, hapless sheeple, excuse me dear reader, I meant people.
First, the population was dumbed down through a politicized and substandard education system based on pop culture, rather then the classics. Americans know more about their favorite TV dramas then the drama in DC that directly affects their lives.

Then their faith in God was destroyed, until their churches, all tens of thousands of different “branches and denominations” were for the most part little more then Sunday circuses and their televangelists and top protestant mega preachers were more then happy to sell out their souls and flocks to be on the “winning” side of one pseudo Marxist politician or another.

The final collapse has come with the election of Barack Obama. His speed in the past three months has been truly impressive. His spending and money printing has been a record setting, not just in America’s short history but in the world. If this keeps up for more then another year, and there is no sign that it will not, America at best will resemble the Wiemar Republic and at worst Zimbabwe.

Follow me on Twitter: www.twitter.com/philhulett
Subscribe to this blog: click Here