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Comment of the Day Nominee: Nurse Takes on Olbermann’s Billing for End of Life Counseling Rant

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Posted on March 1 2010 3:14 pm
David Forsmark is the owner and president of Winning Strategies, a full service political consulting firm in Michigan. David has been a regular columnist for Frontpage Magazine since 2006. For 20 years before that, he wrote book, movie and concert reviews as a stringer for the Flint Journal, a midsize daily newspaper.
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Frequently excellent NewsReal commenter “Peachy” today took on Keith Olbermann’s latest meltdown, this time over the issue of end of life counseling in the Democrat health bill.

Doctors have that conversation on a regular basis NOW, and as one doctor scornfully told me, “There is no billing code for that, and there never should be.”

This, of course, became an issue because Democrats wanted to budget for it in their health bill, meaning that social workers or government workers would become involved in the process.  This led to the famous “Death Panel” Facebook entry from Sarah Palin– and Democrat retreat on the issue.

“Peachy,” a veteran nurse weighed in on my post on the issue:

PEACHY: As a nurse for the past 36 years I listened to the content of Olbermann’s rant and still could not reconcile his frank disconnect between the legal responsibilities between patient, family and physician. The fact that he states that his father is in the ICU and receiving multiple therapies to combat post-operative infections along with the attending organ failure seen in many elderly patients is inconsequential to his Medicare and any supplement insurance that he may have. Decisions regarding care, the choices to advance or reduce levels of care, move from agressive to palliative (comfort measures) care are decisions made both in the past and now by patients, families and physicians everyday in every hospital here.

Peachy continued:

Olbermann’s open display using his father’s long drawn out demise (probable in view of the age and organ failure statisically) is both shameful and demonstrates the continued level of irresponsible and illogical thought placed on the end of life counseling being entertained in the Progressive mind. Placing end of life counseling within the realm of legislation ignores the concept of patient and family decision-based medical care. Physicians only present the accurate picture/status, the alternatives and therapies available, the potential outcomes and possible complications. These are decisions that do not require legislation because it is the responsibility of all citizens to seek legal documentation of their decisions and assign heathcare advocates, and to discuss their decisions with family. The documents for the Advanced Healthcare Directives are available at no cost at physician offices, hospitals and online. What Olbermann describes as death panels is what healthcare professionals refer to as “case management” and “utilization review”.

While this mechanism of patient management is used throughtout the US, it is also a tool for financial management of the patient’s care. Olbermann fails to understand the coming cost/benefit analysis that will accompany the Obama healthcare control and denial bill. You see, Olbermann’s father has multi-faceted illness, complicated by age, previous diagnosis of colon cancer with a high mortality even in the face of agressive treatment, organ failure and refractory episodes of infection(probably due to poor status, decreased immune system and age). In the real sense, the pending legislation would view his ability to return to a healthful and productive state negatively and a negative cost/benefit status would be assigned. When healthcare resources with the attendant costs become scrutinized, the patient’s ability be cured and once again be a productive “tax payor”will be a paramount decision in the authorization process.

It will all come down to a distant voice deciding the management of a patient’s care without the input of the patient, family or physician. This is the foundation of all socialized medicine. Decisions of the medical care process will be removed from the patient and physician and controlled by using statisical data, cost/benefit analysis of age, illness, cost, cure/remission/death rates,habits(tobacco,alcohol,illegal drugs), current illness (M.S.,cystic fibrosis,lupus,previous cancer diagnosis),projected remaining years of work and tax-paying status, productivity and long-term benefit to society, current statistical cure rates,rehabilitation potential with and without occurence of complications and the need for further intervention, need for additional and follow-up surgeries/therapies (staged therapy) and life span statistics of each gender.

When medical care and resources are governed by legislation and the funding provisions for the nation-wide governance of that care is directed and managed by governement, the focus of all decisions will be made with little or no respect to the value of human life. It will be based on the only foundation that government is proficient at, the complete and utter inability to function to the benefit of the people that it is charged to protect. Such is the tragedy of the current perception of the healthcare and cost control needs of the American public. The bottom line and expediency will trump human life. When the funds available for medical care and the management of that care diminish, the categories of those to receive those medical care assets will also narrow. Olbermann is somewhat correct. It will not be “death panels” in the conventional sense, it will be “those who are chosen to receive life” panels that will ultimately decide who lives and dies.

Logic and experience are the cure for ignorance and fear!

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