UK's Death Pathway (Infant Death ment.)

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UK's Death Pathway (Infant Death ment.)

Should disabled babies or terminally ill children be starved and denied fluid so they will die faster? Is this really what we want to model our healthcare after? Do you think this could happen here now that with Obamacare we have an unelected board making medical decisions?

Sick children are being discharged from NHS hospitals to die at home or in hospices on controversial ?death pathways?.

Until now, end of life regime the Liverpool Care Pathway was thought to have involved only elderly and terminally-ill adults.

But the Mail can reveal the practice of withdrawing food and fluid by tube is being used on young patients as well as severely disabled newborn babies.

One doctor has admitted starving and dehydrating ten babies to death in the neonatal unit of one hospital alone.
Writing in a leading medical journal, the physician revealed the process can take an average of ten days during which a baby becomes ?smaller and shrunken?.

The LCP ? on which 130,000 elderly and terminally-ill adult patients die each year ? is now the subject of an independent inquiry ordered by ministers.

The investigation, which will include child patients, will look at whether cash payments to hospitals to hit death pathway targets have influenced doctors? decisions.

Medical critics of the LCP insist it is impossible to say when a patient will die and as a result the LCP death becomes a self-fulfilling prophecy. They say it is a form of euthanasia, used to clear hospital beds and save the NHS money.

The practice of withdrawing food and fluid by tube is being used on young patients as well as severely disabled newborn babies

The use of end of life care methods on disabled newborn babies was revealed in the doctors? bible, the British Medical Journal.

Earlier this month, an un-named doctor wrote of the agony of watching the protracted deaths of babies. The doctor described one case of a baby born with ?a lengthy list of unexpected congenital anomalies?, whose parents agreed to put it on the pathway.

The doctor wrote: ?They wish for their child to die quickly once the feeding and fluids are stopped. They wish for pneumonia. They wish for no suffering. They wish for no visible changes to their precious baby.

According to a BMJ article, a doctor had presided over ten such deaths in just one hospital neonatal unit

?Their wishes, however, are not consistent with my experience. Survival is often much longer than most physicians think; reflecting on my previous patients, the median time from withdrawal of hydration to death was ten days.

?Parents and care teams are unprepared for the sometimes severe changes that they will witness in the child?s physical appearance as severe dehydration ensues.

The use of end of life care methods on disabled newborn babies was revealed in the doctors' bible, the British Medical Journal

?I know, as they cannot, the unique horror of witnessing a child become smaller and shrunken, as the only route out of a life that has become excruciating to the patient or to the parents who love their baby.?

According to the BMJ article, the doctor involved had presided over ten such deaths in just one hospital neonatal unit.

In a response to the article, Dr Laura de Rooy, a consultant neonatologist at St George?s Hospital NHS Trust in London writing on the BMJ website, said: ?It is a huge supposition to think they do not feel hunger or thirst.?

The LCP for children has been developed in the North West, where the LCP itself was pioneered in the 1990s. It involves the discharge to home or to a hospice of children who are given a document detailing their ?end of life? care.

One seen by the Mail, called ?Liverpool Pathway for the Dying Child? is issued by the Royal Liverpool Children?s NHS Trust in conjunction with the flagship children?s hospital Alder Hey. It includes tick boxes, filled out by hospital doctors, on medicines, nutrients and fluids to be stopped.

The LCP was devised by the Marie Curie Palliative Care Institute in Liverpool for care of dying adult patients more than a decade ago. It has since been developed, with paediatric staff at Alder Hey Hospital, to cover children. Parents have to agree to their child going on the death pathway, often being told by doctors it is in the child?s ?best interests? because their survival is ?futile?.

Bernadette Lloyd, a hospice paediatric nurse, has written to the Cabinet Office and the Department of Health to criticise the use of death pathways for children.

'?I have also seen children die in terrible thirst because fluids are withdrawn from them until they die'

She said: ?The parents feel coerced, at a very traumatic time, into agreeing that this is correct for their child whom they are told by doctors has only has a few days to live. It is very difficult to predict death. I have seen a ?reasonable? number of children recover after being taken off the pathway.

?I have also seen children die in terrible thirst because fluids are withdrawn from them until they die.

?I witnessed a 14 year-old boy with cancer die with his tongue stuck to the roof of his mouth when doctors refused to give him liquids by tube. His death was agonising for him, and for us nurses to watch. This is euthanasia by the backdoor.?

Alder Hey, pictured, confirmed that children and babies are discharged for LCP end of life care 'after all possible reversible causes for the patient's condition are considered'

Alder Hey confirmed that children and babies are discharged for LCP end of life care ?after all possible reversible causes for the patient?s condition are considered?.

?There is a care pathway to enable a dying child to be supported by the local medical and nursing teams in the community, in line with the wishes of the child patients, where appropriate, and always their parents or carers.? Alder Hey said children were not put on the LCP within the hospital itself.

Teresa Lynch, of protest group Medical Ethics Alliance, said: ?There are big questions to be answered about how our sick children are dying.?

A Department of Health spokesman said: ?End of life care for children must meet the highest professional and clinical standards, and the specific needs of children at the end of their life.

'Staff must always communicate with the patient and the patient?s family, and involve them in all aspects of decision making.?

Read more: Now sick babies go on death pathway: Doctor's haunting testimony reveals how children are put on end-of-life plan | Mail Online

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No one wants children to die. That's going to be my first point.

Second point, per this article it says it is done at the okay of parents and medical professionals when all else has been reviewed. I'm assuming, like many older patients here in the US, they are drugged at a high level. I would like to read some more on this though.

Third point, the unelected board you speak of cannot decide things like this. They can decide on how much to pay a doctor or hospital for treatment but they cannot suggest rationing care or cutting benefits. So no, I'm not worried that they would suggest ending anyone's life because they can't.

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"Jessica80" wrote:

No one wants children to die. That's going to be my first point.

Second point, per this article it says it is done at the okay of parents and medical professionals when all else has been reviewed. I'm assuming, like many older patients here in the US, they are drugged at a high level. I would like to read some more on this though.

Third point, the unelected board you speak of cannot decide things like this. They can decide on how much to pay a doctor or hospital for treatment but they cannot suggest rationing care or cutting benefits. So no, I'm not worried that they would suggest ending anyone's life because they can't.

The first half of your sentence is the exact same thing as the second half of your sentence. So you should be worried.

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No it is not.

It means that they can set a set rate for doctors for X procedure. Maybe 2000.00. It doesn't mean that they can say that a person or someone of a certain age cannot have services.

Insurances ALREADY do this. It is called the allowed/contracted rate for services.

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"Jessica80" wrote:

Second point, per this article it says it is done at the okay of parents and medical professionals when all else has been reviewed. I'm assuming, like many older patients here in the US, they are drugged at a high level. I would like to read some more on this though.

It sure doesn't sound like to me that drugs are enough. We would arrest someone for treating a dog this way, and they are doing this to children?

I witnessed a 14 year-old boy with cancer die with his tongue stuck to the roof of his mouth when doctors refused to give him liquids by tube. His death was agonising for him, and for us nurses to watch. This is euthanasia by the backdoor.

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"Jessica80" wrote:

No one wants children to die. That's going to be my first point.

Second point, per this article it says it is done at the okay of parents and medical professionals when all else has been reviewed. I'm assuming, like many older patients here in the US, they are drugged at a high level. I would like to read some more on this though.

Third point, the unelected board you speak of cannot decide things like this. They can decide on how much to pay a doctor or hospital for treatment but they cannot suggest rationing care or cutting benefits. So no, I'm not worried that they would suggest ending anyone's life because they can't.

This, exactly. When DH & I decided to become parents, one of the first decisions we made was that we would not want our child to suffer pain for no purpose. At my age we knew that chromosomal problems were much more likely and we would not have continued a pregnancy with a diagnosis of an untreatable problem that would cause severe pain. I have no problem with allowing a child who is going to die from their condition anyway to die sooner, and hopefully more quickly & painlessly. Keeping someone alive when all they're doing is suffering is selfish.

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"GloriaInTX" wrote:

It sure doesn't sound like to me that drugs are enough. We would arrest someone for treating a dog this way, and they are doing this to children?

This being the Daily Mail, I have little doubt that the referenced incident probably didn't even happen. Anyone who is in severe pain, and especially those who are dying, should be given pain meds, and if they aren't then the doctors & nurses aren't doing their jobs.

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Can I just say this is a very depressing thread? How awful.

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"Spacers" wrote:

This being the Daily Mail, I have little doubt that the referenced incident probably didn't even happen. Anyone who is in severe pain, and especially those who are dying, should be given pain meds, and if they aren't then the doctors & nurses aren't doing their jobs.

So it is your opinion that this nurse is lying, or that she didn't actually send this letter to the Department of Health? And this doctor that wrote about these babies in the British Medical Journal, he was lying too?

Bernadette Lloyd, a hospice paediatric nurse, has written to the Cabinet Office and the Department of Health to criticise the use of death pathways for children.

'‘I have also seen children die in terrible thirst because fluids are withdrawn from them until they die'

She said: ‘The parents feel coerced, at a very traumatic time, into agreeing that this is correct for their child whom they are told by doctors has only has a few days to live. It is very difficult to predict death. I have seen a “reasonable” number of children recover after being taken off the pathway.

‘I have also seen children die in terrible thirst because fluids are withdrawn from them until they die.

‘I witnessed a 14 year-old boy with cancer die with his tongue stuck to the roof of his mouth when doctors refused to give him liquids by tube. His death was agonising for him, and for us nurses to watch. This is euthanasia by the backdoor.’

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My opinion is that "Bernadette Lloyd" either doesn't exist or, as a hospice nurse whose job by definition is to manage the pain of the dying, is not doing her job properly and should be promptly fired for incompetence.

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This whole thread is a reminder about why I support euthanasia. If a terminal illness comes to the point where everyone (doctors, the patient, or the legal guardians of the patient) agree that the patient is so terminally ill that they should cut off all means of sustaining life, why on earth do we have to put people through the suffering of waiting for them to die of lack of food or water??? Why don't we give them a large dose of morphine and let them die comfortably and peacefully?

Maybe I'm missing something, but from reading the article it seems like they are not doing this to save money, but because these children are so terminally ill and suffering that it is deemed (by both their doctors and their parents) that the kindest to let them pass. Which, while very sad, is the right thing to do in some circumstances IMO. However, rather than removing food and water and waiting for them to pass, it seems to me that once that decision is made, it's madness to withhold food and water and wait for that to kill them. Again, a dose of morphine would be a heck of a lot more humane.

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"Spacers" wrote:

My opinion is that "Bernadette Lloyd" either doesn't exist or, as a hospice nurse whose job by definition is to manage the pain of the dying, is not doing her job properly and should be promptly fired for incompetence.

So I guess they have decided to do an independent review for no reason?

Many people have claimed loved-ones were put on the pathway - which can involve the removal of drugs, nutrition and hydration if deemed to be of no benefit to the patient - without their knowledge. Some doctors have claimed it can hasten death.

Now Mr Lamb has announced a wide-ranging review, to be overseen by an independent chairman, which will report back to him in the New Year.

It will look at a number of issues, including why doctors are sometimes not informing relatives of decisions to put patients on the LCP, and the question of payments to hospitals for meeting targets on their use of the pathway.

The Daily Telegraph revealed last month that six in 10 NHS hospital trusts had received payments totalling ?12 million or more for attaining these goals. In some hospitals more than half of all dying patients are put on the pathway

Liverpool Care Pathway: far-reaching independent review announced - Telegraph

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That article states they are reviewing claims that patients are put on it without notifying the families properly.

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"Spacers" wrote:

This, exactly. When DH & I decided to become parents, one of the first decisions we made was that we would not want our child to suffer pain for no purpose. At my age we knew that chromosomal problems were much more likely and we would not have continued a pregnancy with a diagnosis of an untreatable problem that would cause severe pain. I have no problem with allowing a child who is going to die from their condition anyway to die sooner, and hopefully more quickly & painlessly. Keeping someone alive when all they're doing is suffering is selfish.

Sorry totally disagree.. we are all "going to die from"our"condition anyway". I do agree with eleviate as much pain for these patients as possible, but I know many people living with Chronic pain and do not think we should just kill them by not giving them food, water, etc.

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"Rivergallery" wrote:

Sorry totally disagree.. we are all "going to die from"our"condition anyway". I do agree with eleviate as much pain for these patients as possible, but I know many people living with Chronic pain and do not think we should just kill them by not giving them food, water, etc.

No, we aren't. I have seen family and friends suffer from cancer that they have no hope of recovering from. Pain management was the only concern for all involved. They stopped eating and, well, they were ready to die. (My gma told my mom flat out she was ready to go.) At some point the question becomes: for whose benefit is their suffering while they are dying a slow death? Is it for the family's benefit because the family isn't ready yet? Or for the paitent's benefit because who are we to play God or judge the quality of their life? Or is it for society's benefit so we can uphold our morals?

People make these kinds of decisions when a person ends up on life support. Do you "pull the plug" or keep their bodies "alive" indefinitely?

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"ethanwinfield" wrote:

No, we aren't. I have seen family and friends suffer from cancer that they have no hope of recovering from. Pain management was the only concern for all involved. They stopped eating and, well, they were ready to die. (My gma my mom flat out she was ready to go.) At some point the question becomes: for whose benefit is their suffering while they are dying a slow death? Is it for the family's benefit because the family isn't ready yet? Or for the paitent's benefit because who are we to play God or judge the quality of their life? Or is it for society's benefit so we can uphold our morals?

People make these kinds of decisions when a person ends up on life support. Do you "pull the plug" or keep their bodies "alive" indefinitely?

Yes, this. "Chronic Pain" makes it sound like these kids just have a bad back or something. These kids are terminally ill with no hope of recovery and in pain. I think at some point there has to be a consideration where you ask why you are drawing out the suffering for an inevitable conclusion. I saw my grandma die slowly and in great pain from cancer. To use the example that someone else threw out earlier, we would not treat a dog that way. Literally, when our dog had cancer, we put her to sleep when her suffering got to be too great, not because we didn't love her or value her, but because we DID love her and knew it was selfish to keep her around when she was in pain and dying simply because we weren't ready to let go. That was a decision made out of 100% love, and it amazes me that we can't do the same for humans who we love that much more.

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We're not talking about arbitrarily killing off people with chronic pain. We're talking about people suffering from horrible diseases or medical conditions that are going to kill them slowly and painfully within a few months, helping them die a faster and easier death. Some of us wish that for our loved ones, when there's no hope of recovery and their spirit is gone or their pain outweighs any pleasure they are getting from their life. Here's the story of my Nana. I've often said that dying is hardest on the ones left behind, but it shouldn't be literal agony for the ones dying, either. Of course, no one should be forced to do this, and that is what seems to be the problem with the program in the OP. My stepdad fought cancer for many years, and he was actually winning the battle when he died. But if he'd ever gotten to the point where he said, "I don't want to live like this anymore," I'd have done whatever I legally could to help him die as quickly and peacefully and painlessly as possible. And if I'm ever put in the position, I will do that for my husband or child. I love them too much to let them suffer needlessly.

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"Jessica80" wrote:

No it is not.

It means that they can set a set rate for doctors for X procedure. Maybe 2000.00. It doesn't mean that they can say that a person or someone of a certain age cannot have services.

Insurances ALREADY do this. It is called the allowed/contracted rate for services.

Um. People come one. Use some freaking logic. When these little committee's decide to set the price so low on procedures they don't deem beneficial for society, Dr's are going to STOP PERFORMING THEM> so it is the EXACT same thing, but if you'd prefer to bury your head in the sand, more power to you. It's far less stressful than to read and realize where our country is headed with this bill, I promise.

"Alissa_Sal" wrote:

This whole thread is a reminder about why I support euthanasia. If a terminal illness comes to the point where everyone (doctors, the patient, or the legal guardians of the patient) agree that the patient is so terminally ill that they should cut off all means of sustaining life, why on earth do we have to put people through the suffering of waiting for them to die of lack of food or water??? Why don't we give them a large dose of morphine and let them die comfortably and peacefully?

Maybe I'm missing something, but from reading the article it seems like they are not doing this to save money, but because these children are so terminally ill and suffering that it is deemed (by both their doctors and their parents) that the kindest to let them pass. Which, while very sad, is the right thing to do in some circumstances IMO. However, rather than removing food and water and waiting for them to pass, it seems to me that once that decision is made, it's madness to withhold food and water and wait for that to kill them. Again, a dose of morphine would be a heck of a lot more humane.

Morphine costs money.

"Jessica80" wrote:

That article states they are reviewing claims that patients are put on it without notifying the families properly.

hmmm. Sounds like something I want in our country. Perfect.

I'm so mad. If they vote in another democrat in 2016 and we have 12 straight years of people who don't think of the future and take the "wait and see" attitude we're so ****ed.

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Sorry I disagree that dying of starvation and thirst is not suffering or inhumane.

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"Jessica80" wrote:

That article states they are reviewing claims that patients are put on it without notifying the families properly.

Thats not all it says.

It will look at a number of issues, including why doctors are sometimes not informing relatives of decisions to put patients on the LCP, and the question of payments to hospitals for meeting targets on their use of the pathway.

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Did you pick a country to move to on the other thread yet? Wink Oh yeah, Italy, which sounds like they have as much of a problem with healthcare as the U.S.

I simply don't buy your argument that doctors are going to stop performing things that aren't priced high enough. I believe most doctors have enough integrity to do what their patients need even if they don't get paid "enough" for it. It's not unheard of. Lawyers do pro bono work where they don't get paid at all, and dentists usually lose money on routine cleaning appointments. I just don't see all the doctors in the U.S. deciding together that they are going to boycott X procedure if they don't get more money for it.

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"GloriaInTX" wrote:

Sorry I disagree that dying of starvation and thirst is not suffering or inhumane.

Neither is dying of cancer. Some of us just don't want it to be a drawn-out affair.

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"wlillie" wrote:

Um. People come one. Use some freaking logic. When these little committee's decide to set the price so low on procedures they don't deem beneficial for society, Dr's are going to STOP PERFORMING THEM> so it is the EXACT same thing, but if you'd prefer to bury your head in the sand, more power to you. It's far less stressful than to read and realize where our country is headed with this bill, I promise.

What procedures are you referring to?

I watched a segment on 60 Minutes on Health Management Associates.

If you want to know why health care costs so much in this country, consider this, it's estimated that $210 billion a year -- about 10 percent of all health expenditures -- goes towards unnecessary tests and treatments and a big chunk of that comes right out of the pockets of American taxpayers in the form of Medicare and Medicaid payments.

The doctors interviewed said the computer program would have a pop-up screen advising them to admit a patient. They had to override it. Clearly hospitals are going to make more money if they admit people who don't need to be admitted. They "quota" was somewhere around 20% of the patients seen should be admitted.

Medical decisions need to be made my medical professionals and their patients.

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"ethanwinfield" wrote:

What procedures are you referring to?

I watched a segment on 60 Minutes on Health Management Associates.

The doctors interviewed said the computer program would have a pop-up screen advising them to admit a patient. They had to override it. Clearly hospitals are going to make more money if they admit people who don't need to be admitted. They "quota" was somewhere around 20% of the patients seen should be admitted.

Medical decisions need to be made my medical professionals and their patients.

It doesn't bother you that that isn't going to be the case. Ask yourself who's really going to benefit from a committee paid to make decisions about healthcare costs and who will probably get bonuses for "saving" money.

for all those that really think it's a great idea to let our federal government start being more in control of the costs and the decisions in healthcare: I have needed a 24 hour urine collection test that costs about $50 since September and called again today to see if there were any appts to get my doctor to put the lab request in. Got through to teh appointment line (yeah!) Spent well over 10 minutes with her telling me that she could only put in a phone consult unless something was actually wrong. Kept repeating I needed the appointment for preventative measures and when I finally got someone on the phone they had no appts for the month of December. (But the guy in my shop who just wanted a colonoscopy and I quote "just in case" got one a week after asking for it because his dumb *** thinks he has cancer because he's fat.)You may be thinking I was rude or ugly, but I called the first day and kissed all of those ladies' asses. Like hardcore sweetness because I know what happens if you don't play by the rules. Hubby waited a LONG time to get his diagnosis of cancer and then waited a long time after to get the treatment because he lost it on one of the Tricare people.

ASk yourseelf when this coutnry started turning into a give me country. It was when the federal government and liberals started telling people that others owed them anything they had. I'm starting to get really mad. If you want healthcare costs covered, budget and buy your own ****ing insurance. Don't whine to some idiot Democrat in Congress and get a ****ing bill passed that most people that voted on it didn't even ****ing read. Get a ****ing job. Nobody owes anyone else a damn education, the costs of raising their kids, a car, a cell phone, or even a ****ing bandaid just because they happen to ask for it.

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OH, and I've never lived in Italy. I've never made any sacrifices for it and I don't know how it should be. I don't know (or give a ****) what their constitution says. I haven't learned way more than I ever want to know about in the last 9 years. So I'd rather start over in a place with ****ty healthcare and not waste my time doing something I used to think was for the greater good instead of for a bunch of really really stupid, whiny, assholes who can't think far enough ahead to waht they are doing to their children's futures by sticking their lazy grubby fat hands out and taking from those who are Allowed to MOVE OUT OF THE COUNTRY> Who can AFFORD to leave when the democrats have ****ed it up to the point where NO ONE WHO CAN Choose Stays here. When we are a ****ing second damn Mexico.

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And I could probably give you at least a dozen stories where I've had great experiences with my healthcare providers. I emailed a photo of some welts on Tiven's back to her ped, who replied that they could very well be a reaction to mosquito bites, give her ibuprofen and benadryl and call back if they get worse. I've done a phone consult when all I needed was a prescription refill. I can get a same day appointment if my kids are sick. On Tiven's due date my OB, knowing that I was planning a home birth, called to see if she'd been born yet and reminded me to make a ped's appointment whenever she arrived. When I left the hospital early after Weston was born (at 40 hours rather than the standard 96 hours for a c-section) a nurse called me at home the next day to check on us. My father-in-law has the same healthcare system, and he had his hip replaced within days after his doctor decided he needed that surgery. And there's an ad on TV right now about a woman who went in for a bad cold, the receptionist noticed that she was due for a mammogram, she got one that day, and they discovered breast cancer early enough to save her life. www.kp.org/mary

Why are you so upset about being offered a phone consult when all you need is a referral to the lab? Won't you be wasting the doctor's time, your time, and your insurance money on an unnecessary office visit, which ends up costing everyone more money? I don't understand especially when you're so vocal about how our system is so screwed up. It's screwed up because people want to run to the doctor's office for every little thing and they want a prescription and lab test every time, too.

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I am really so saddened by this thread. My BFFs daughter was terminally ill, told by doctors so many times she was going to die. She would have been a perfect candidate for this "pathway" but she is now 11 and doing great medically. So many of the children that my friend has met in the hospital have been told by doctors they would die, not all of them have.
I do not believe that doctors always have all the answers, they cannot know if a child has a will to live that well supersede any "terminal illness"

I also do not understand why people are ok with the government making decisions like this, but not insurance? when the insurance companies deny claims people can go to the government to help either overturn that decision or get help paying. Where will people go when government is making these decisions?

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"Spacers" wrote:

And I could probably give you at least a dozen stories where I've had great experiences with my healthcare providers. I emailed a photo of some welts on Tiven's back to her ped, who replied that they could very well be a reaction to mosquito bites, give her ibuprofen and benadryl and call back if they get worse. I've done a phone consult when all I needed was a prescription refill. I can get a same day appointment if my kids are sick. On Tiven's due date my OB, knowing that I was planning a home birth, called to see if she'd been born yet and reminded me to make a ped's appointment whenever she arrived. When I left the hospital early after Weston was born (at 40 hours rather than the standard 96 hours for a c-section) a nurse called me at home the next day to check on us. My father-in-law has the same healthcare system, and he had his hip replaced within days after his doctor decided he needed that surgery. And there's an ad on TV right now about a woman who went in for a bad cold, the receptionist noticed that she was due for a mammogram, she got one that day, and they discovered breast cancer early enough to save her life. www.kp.org/mary

Why are you so upset about being offered a phone consult when all you need is a referral to the lab? Won't you be wasting the doctor's time, your time, and your insurance money on an unnecessary office visit, which ends up costing everyone more money? I don't understand especially when you're so vocal about how our system is so screwed up. It's screwed up because people want to run to the doctor's office for every little thing and they want a prescription and lab test every time, too.

You have just proved Lillie's point. Government run tricare is really inefficient compared to private insurance

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wlillie - are you ok? never heard you swearing on the debate board before.. have you been hijacked?

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"wlillie" wrote:

OH, and I've never lived in Italy. I've never made any sacrifices for it and I don't know how it should be. I don't know (or give a ****) what their constitution says. I haven't learned way more than I ever want to know about in the last 9 years. So I'd rather start over in a place with ****ty healthcare and not waste my time doing something I used to think was for the greater good instead of for a bunch of really really stupid, whiny, assholes who can't think far enough ahead to waht they are doing to their children's futures by sticking their lazy grubby fat hands out and taking from those who are Allowed to MOVE OUT OF THE COUNTRY> Who can AFFORD to leave when the democrats have ****ed it up to the point where NO ONE WHO CAN Choose Stays here. When we are a ****ing second damn Mexico.

:comfort:

And Lisa, if your BFF's daughter had "the will to live," then she would NOT be a candidate for this pathway. You don't mention what her "terminal" illness was, but I'm pretty sure that most people who are declared to be terminal really do die soon.

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I don't have traditional private insurance; I belong to an HMO.

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I live and breathe this every single day. How they determine what a provider gets paid is very in depth and is already done with Medicare and private insurance bases their payments on Medicare rates as well. Centers for Medicare and Medicaid are already doing this and this is just a centralized panel.

This panel also cannot do anything without running it through Congress. They are not playing God nor will they be able to do anything you think they will be able to do.

Lillie~I don't quite get your example. You are saying you are getting the runaround for a lab test but someone else you know got a colonoscopy right away? To me, that sounds like inefficiencies at the office not about what Tricare is paying for the services.

(As a side note...NHCR also is putting into place a program for increase quality so under this denying you a cheap service as preventive measure would be "against the rules" so to speak. They would get decrease in quality of care payments. We have this system at my company...works really well and is starting to decrease overall costs.

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"wlillie" wrote:

OH, and I've never lived in Italy. I've never made any sacrifices for it and I don't know how it should be. I don't know (or give a ****) what their constitution says. I haven't learned way more than I ever want to know about in the last 9 years. So I'd rather start over in a place with ****ty healthcare and not waste my time doing something I used to think was for the greater good instead of for a bunch of really really stupid, whiny, assholes who can't think far enough ahead to waht they are doing to their children's futures by sticking their lazy grubby fat hands out and taking from those who are Allowed to MOVE OUT OF THE COUNTRY> Who can AFFORD to leave when the democrats have ****ed it up to the point where NO ONE WHO CAN Choose Stays here. When we are a ****ing second damn Mexico.

:eek:

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"Spacers" wrote:

but I'm pretty sure that most people who are declared to be terminal really do die soon.

Just to speak to this - Earlier this year my uncle was told he had terminal cancer. That there was nothing they could do. All the family said their good byes. When I was in NY I went to see him and said my good byes. My family cleaned out his apartment and bought his funeral plot. A second opinion showed it was not cancer in his lungs but food that he had chocked on. He is fine and in a nursing home now with no plans to die any time soon.

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I would think that is a clear example as to why 2nd opinions are important before making life decisions.

I don't think anyone is suggesting here that if you are told your child has terminal cancer you go..okay pain meds/no food.

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"Spacers" wrote:

:comfort:

And Lisa, if your BFF's daughter had "the will to live," then she would NOT be a candidate for this pathway. You don't mention what her "terminal" illness was, but I'm pretty sure that most people who are declared to be terminal really do die soon.

Her last time that she was close to death (about a 18mths ago) she had MRSA in her back after an 18 hour back surgery to correct a 90% curve in her spine. (she was born with severe cancer on her spine, but that is the beginning of a VERY long medical history) During that time in the hospital she was left with a 12in wide by 2 foot wide hole in her back with wound vacs on in and going into to clean it out every other day. She coded a number of times and the doctors told her parents on 4 separate nights she would not wake up in the morning. After 6weeks in the ICU she woke up one day and was out of the hospital in 2 more weeks. Every doctor that has ever dealt with her has said they are shocked she has lived this long. They are all stumped by her ability to overcome illnesses. Because she had a very experimental spine surgery 9 years ago her parents have been in contact with severely ill kids, the ones that are doing this surgery are on their very last option.
My point is not so much that Madeline made it so other kids will, I know that is not the case. My point is more that sometimes the doctors are wrong, and withholding food and drinks is a long horrible way to die. I just cant support this. I support doctor assisted suicide, but that is over in a short time with the adult making that choice for them self. A long horrible death without permission is never going to be acceptable

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Wow, that must be just so hard an awful for her parents to watch and to deal with constantly. What a tough deck she was dealt.

Yes, sometimes doctors are wrong and everyone here so far I believe has said it should be up to parents and family members.

If there was "Euthanasia" as you describe it but I believe in the UK that is illegal. When someone is not going to make it...food and drink just prolongs the inevitable. I know that sounds awful and I don't know if I could pick that for my children. Ever. and hopefully I never have to.

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"mom3girls" wrote:

You have just proved Lillie's point. Government run tricare is really inefficient compared to private insurance

"Spacers" wrote:

I don't have traditional private insurance; I belong to an HMO.

I had tricare for about 5 years. Never had any problems at all with anything. The level of care and concern was top-notch. We were also on MediCal for about 2 years or so. Again, no problems. I have a PPO now and my problems have been specific to the doctors themselves.

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"ethanwinfield" wrote:

I had tricare for about 5 years. Never had any problems at all with anything. The level of care and concern was top-notch. We were also on MediCal for about 2 years or so. Again, no problems. I have a PPO now and my problems have been specific to the doctors themselves.

That is surprising and might be regional. Around here we have almost no docs that take tricare. The closest military facility is over an hour away. All of my friends who have been here while their DHs have been deployed have had a nightmare of a time getting anything done medically

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"Spacers" wrote:

This being the Daily Mail, I have little doubt that the referenced incident probably didn't even happen. Anyone who is in severe pain, and especially those who are dying, should be given pain meds, and if they aren't then the doctors & nurses aren't doing their jobs.

The resident or family can deny/refuse all pain med's. There isn't a damn thing the nurses can do if that happens. I've seen it happen. Also, even if they are getting pain med's, the nurses still have to follow whatever orders/restrictions (every some odd hrs) are in place, if they don't they risk their professional liscience and could do jail time.

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I just want to say it's incredibly ridiculous that anyone is even putting out there that this is what we are going to do with 'obamacare'. Talk about trying to pull a scare tactic. Jeez. :rolleyes:

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"Rivergallery" wrote:

wlillie - are you ok? never heard you swearing on the debate board before.. have you been hijacked?

Yeah, I'm getting frustrated with the way our system is going. I'm actually starting to get scared and I'm tired of stupid people who don't use logic or try to reason out what's going to happen in the future and just hope for rainbows and unicorns. I'm so scared I'm raising responsible wonderful little boys who are going to be paying for these mistakes for the rest of their lives. I'm worried that our constitution isn't seen as important by ANYONE we vote for anymore.

Stacey, the problem is that if I do a phone consult, they have me call and make an appt. It's happened the last 6 times because our doctor's don't really deal with people with only one kidney. *Just tried again for January. No go. So I lost a little integrity and lied and said my foot hurt and I needed to be seen immediately. Got an appt for January 8th. Anyone who says they didn't have problems with Tricare didn't have Tricare. I have to have the kidney function lab done once a year. I'm not allowed to call in the consult and just have the lab done because the system isn't set up that way. My son's 6 month appt will be less late than his four month appt and will be at 7 months. At least I got in.

Jessica-Congress? You mean the one that passed this bill with the majority admitting to not reading it? That Congress? The one who still can't pass a budget the President will approve? That Congress? Tricare has treatment facilities, so when you say the office, you are actually talking about Tricare in this instance.

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Okay...I'm not 100% familiar with Tricare and a person that I knew that had it went to a regular office that took other insurance. Not a Tricare specific facility.

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All I was saying is that changes cannot be made without running it through Congress. I'm not going to debate the merits of Congress or what they pass or don't pass because there's always going to be something I agree with or don't. I was merely stating that the "panel" does not have the only or final decision and they are not a death panel. They do not decide if you get or don't get a service. They decide what usual and customary charges are for a specific procedure which private insurance does already. With their "panels" so to speak.

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"Jessica80" wrote:

All I was saying is that changes cannot be made without running it through Congress. I'm not going to debate the merits of Congress or what they pass or don't pass because there's always going to be something I agree with or don't. I was merely stating that the "panel" does not have the only or final decision and they are not a death panel. They do not decide if you get or don't get a service. They decide what usual and customary charges are for a specific procedure which private insurance does already. With their "panels" so to speak.

I just don't understand how liberals can't see how this works. Seriously. Once these panels decide that a particular procedure is too expensive for what the value they get, the procedures won't be available anymore. If private insurance doesn't feel like paying for something you still have the option to have a fundraiser or pay for it yourself. It just boggles my mind how shortsighted people can be. How they just can't think for themselves and take whatever the media and the people who benefit from changes like this dish out to them without trying to figure out what those changes will do to them. It's so freaking scary.

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So what stops you from holding a fundraiser if a federal plan doesn't cover a procedure or paying for it yourself?

I guess since I'm living in Mass. and we have HCR I have not seen this path you speak of. We still have plenty of private plan coverage. Masshealth (Medicaid) provides coverage and has plenty of covered services. U&C review boards don't review the med. necessity. They review the customary pay rate. That's what private insurance does now. There are physicians who review to determine if a procedure meets criteria for coverage and then another review board reviews how much they will pay a doctor and/or hospital for the procedure. This is being done NOW so what is the issue?

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"Jessica80" wrote:

So what stops you from holding a fundraiser if a federal plan doesn't cover a procedure or paying for it yourself?

I guess since I'm living in Mass. and we have HCR I have not seen this path you speak of. We still have plenty of private plan coverage. Masshealth (Medicaid) provides coverage and has plenty of covered services. U&C review boards don't review the med. necessity. They review the customary pay rate. That's what private insurance does now. There are physicians who review to determine if a procedure meets criteria for coverage and then another review board reviews how much they will pay a doctor and/or hospital for the procedure. This is being done NOW so what is the issue?

NOW they know people can leave Mass. and go to any other state and get the care they need. WTF are you going to do when the federal government makes it impossible or actually outlaws other insurance and you are left with whatever the hell they decide is worthy? When they jack the healthcare we have now even more and we get what I like to think of as the "education" effect. Federally funded student loans and scholarships have consistently raised the cost of higher education and led to a HUGE number of people who paid for their college with the hopes that their completely useless degrees will pay off in some way. Instead of letting the market help people decide what is actually needed (with scholarships for the careers who need/want people granted by those that care and invest in it). Now we have a 10 year period with about half the graduates living at home with their mom's and dad's and unable to pay off their damn loans cause some idiot told them they could "do whatever they want to when they grow up" and our stupid government co-signed for them to be able to do exactly that. Now they aren't able to pay, education is wayyyy more expensive because it's been subsidized by nitwits for so long, and we have an entire generation of people coming through who really honestly believe that everyone else owes them college and they shouldn't have to pay back those loans because they were tricked into them and they are often too stupid to even think about reading what the hell they are signing. Lets do that to healthcare even MORE than we already have. Sounds f*ing brilliant.

This healthcare bill is such a huge mess and so unconstitutional I am still reeling from shock that people are drinking the damn koolaid.

eta-Please please don't forget these boards aren't really going to go to Congress. They aren't. They are going to be delegated the responsibility and given about a tenth of the information they need to make the decision, they are going to be the people who couldnt' make it in the real world so their friends gave them a job, and they are going to go home not caring one way or the other if they made the right decision as long as their check is direct deposited. Just like the un-elected governemnt employees we have now.

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OH!!! and the Tricare thing? CANNOT wait to have liberals blow up facebook in about 10 years when the government has "fixed" healthcare and you guys are getting the same "free" healthcare we get. CANNOT wait. I'm just going to lay back and laugh until I pee myself. Because treatment facilities are in your future if you guys don't start voting differently. It's going to be so funny. I'm not even going to say I told you so because I'm honestly going to feel bad for them. But it's going to be so funny at the same time. Wait til your husband has cancer or your kid has a heart problem, or you need your kidney function tested and it's the government paying your doctors.

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Hey, I never said I wanted Tricare for everyone. I want everyone to be with Kaiser. Blum 3 Doctors on salary working set schedules, no more tired-to-the-bone-while-performing-your-surgery accidents. Integrated medical model, everything you need in one place, no finding a lab that takes your insurance or being sent home with a prescription you have to fill tomorrow instead of with the medicine you need now. And if you need to see a specialist, you see a specialist, there's no arguing with your "gatekeeper" PCP whose primary job isn't so much to care for you as it is to control costs by keeping you away from specialists. Love love love Kaiser.

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Lillie~you act like we haven't thought this through as much as you have. Just because I don't see your conclusion doesn't mean I haven't thought this through. I don't "drink kool-aid" and I can think for myself thank you very much.

NHCR is about a LOT of different things and not just universal healthcare. There isn't a move to go to a "Tricare-like system". Honestly, I am not pro single payer system and I've been up front about that. I am pro everyone has access to coverage for their healthcare. There is a larger access to federally funded health plans but you can still purchase your own healthcare. Private insurance already base their U&C rates on CMS allowance schedule and we haven't lost access to life saving procedures. Again, I've been living this for 5 years and the results you are foreshadowing are just not here or in the imminent future.