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Old 07-26-2009, 08:10 AM   #331
TheMercenary
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Why did you leave out the rest of it? Maybe you aren't familar with the term "actionable medical order".

Quote:
`(2) A practitioner described in this paragraph is--

`(A) a physician (as defined in subsection (r)(1)); and

`(B) a nurse practitioner or physician's assistant who has the authority under State law to sign orders for life sustaining treatments.

`(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).

`(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.

`(4) A consultation under this subsection may include the formulation of an order regarding life sustaining treatment or a similar order.

`(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--

`(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;

`(ii) effectively communicates the individual's preferences regarding life sustaining treatment, including an indication of the treatment and care desired by the individual;

`(iii) is uniquely identifiable and standardized within a given locality, region, or State (as identified by the Secretary); and

`(iv) may incorporate any advance directive (as defined in section 1866(f)(3)) if executed by the individual.

`(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--

`(i) the intensity of medical intervention if the patient is pulse less, apneic, or has serious cardiac or pulmonary problems;

`(ii) the individual's desire regarding transfer to a hospital or remaining at the current care setting;

`(iii) the use of antibiotics; and

`(iv) the use of artificially administered nutrition and hydration.'.

(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),'.

(3) FREQUENCY LIMITATION- Section 1862(a) of such Act (42 U.S.C. 1395y(a)) is amended--

(A) in paragraph (1)--

(i) in subparagraph (N), by striking `and' at the end;

(ii) in subparagraph (O) by striking the semicolon at the end and inserting `, and'; and

(iii) by adding at the end the following new subparagraph:

`(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;'; and

(B) in paragraph (7), by striking `or (K)' and inserting `(K), or (P)'.

(4) EFFECTIVE DATE- The amendments made by this subsection shall apply to consultations furnished on or after January 1, 2011.
I really doubt that the government would ever get any provision passed that would begin to have a documented trail of withholding care, it will be done more quitely through rationing.
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Old 07-26-2009, 08:14 AM   #332
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Originally Posted by Redux View Post
You're obsession with snipping and pasting everything you read (most of which are partisan editorials that have no regard for the facts, but whose intent is to scare)...
Ummm... that would be BS. Few links are partisan. Where is the transparency? Why the secret meetings with members of the industry? Why not just come out and tell everyone about them from the beginning? Why no normal trail of photo ops with the visits? Remember the Energy meetings with Cheney? What double standards... And you support this numbnut?
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Old 07-26-2009, 08:14 AM   #333
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Originally Posted by TheMercenary View Post
Why did you leave out the rest of it? Maybe you aren't familar with the term "actionable medical order".
What part of:
`(ii) effectively communicates the individual's preferences regarding life sustaining treatment, including an indication of the treatment and care desired by the individual;
dont you understand?
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Old 07-26-2009, 08:15 AM   #334
TheMercenary
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Like I said, really doubt that the government would ever get any provision passed that would begin to have a documented trail of withholding care, it will be done more quitely through rationing.
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Old 07-26-2009, 08:17 AM   #335
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Ummm... that would be BS. Few links are partisan. Where is the transparency? Why the secret meetings with members of the industry? Why not just come out and tell everyone about them from the beginning? Why no normal trail of photo ops with the visits? Remember the Energy meetings with Cheney? What double standards... And you support this numbnut?
Hey,...IMO, you are obsessed and I thinks it amusing if not a little frightening.

Obama identified participants...Bush/Cheney did not. An indisputable fact.

I dont particularly want the press at every meeting. I want participants to be able to have open and honest discussions w/o it being misrepresented by many of the wing nut editorials you post.
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Old 07-26-2009, 08:18 AM   #336
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Maybe you can defend the two consecutive CBO reports that state no money will be saved over the 10 year projection to make and save money.

How about the estimates that we still will not have covered the uninsured.
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Old 07-26-2009, 08:21 AM   #337
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Obama identified participants...Bush/Cheney did not. An indisputable fact.

I dont particularly want the press at every meeting. I want participants to be able to have open and honest discussions w/o it being misrepresented by many of the wing nut editorials you post.
Well your guy fails big on that one. They only released the names after being threatened by a FOIA request and it was delayed. It is about what Obama is doing. He promised a change. Secret meetings are not part of that promise. What secret business deals do they have to hide?
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Old 07-26-2009, 08:26 AM   #338
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In fact, the CBO staff also stated that their analysis excluded estimates of potential savings.

I have some problems with several of the proposals..but I dont judge a book after reading only one chapter and I dont make final judgments on draft legislation that is far from final.

And I certainly dont base my opinion on mischaracterizations by partisan editorials.
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Old 07-26-2009, 08:28 AM   #339
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Well your guy fails big on that one. They only released the names after being threatened by a FOIA request and it was delayed. It is about what Obama is doing. He promised a change. Secret meetings are not part of that promise. What secret business deals do they have to hide?
Again..what part dont you understand.

Obama released the names....Bush did not. I know you cant or wont accept the difference.

I am for transparency as much as anyone, but I understand that it does not mean every minute of every discussion should be subject to press scrutiny. I hope it never comes to that.
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Old 07-26-2009, 08:34 AM   #340
TheMercenary
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Again..what part dont you understand.

Obama released the names....Bush did not. I know you cant or wont accept the difference.

I am for transparency as much as anyone, but I understand that it does mean every minute of every discussion should be subject to press scrutiny. I hope it never comes to that.
Again..what part dont you understand. It is not about what they finally have done after being pressed. What deals were made with the industry? Release the notes. Tell us what was discussed, what was the agenda, what were the topics. Show us the notes of the meetings. What do they have to hide?
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Old 07-26-2009, 08:36 AM   #341
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In fact, the CBO staff also stated that their analysis excluded estimates of potential savings.

I have some problems with several of the proposals..but I dont judge a book after reading only one chapter and I dont make final judgments on draft legislation that is far from final.

And I certainly dont base my opinion on mischaracterizations by partisan editorials.
I never really considered the CBO to be a partisan editorial, but if that is how you see them, what ever.

The evidence is that there is as much of a possibility that we will go bankrupt under the proposal as there is that they don't know? What kind of forcast is that? So you are willing to take that chance with our economy in the shape it is in? You are willing to take a chance with our childrens future? I am not.

We are not reading one chapter, we are reading the elements that need effective change. Not a the typical Demoncratic Rahm Rod and Pelosi push without adequate public comment and opportunity to have input and effective change in the Bill.
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Old 07-26-2009, 08:37 AM   #342
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I'll just wait for your next string of "snips and posts" to find out about the deals.

You're guys in the media seem to have all the facts.
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Old 07-26-2009, 08:39 AM   #343
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I never really considered the CBO to be a partisan editorial, but if that is how you see them, what ever.
Neither do I, but I also consider what they said that they did not include in their analysis...the potential savings.

Ahh...the 'whatever" defense again.

I guess that means we're done with this go round.
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Old 07-26-2009, 08:40 AM   #344
TheMercenary
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I'll just wait for your next string of "snips and posts" to find out about the deals.

You're guys in the media seem to have all the facts.
"You're" Guys?

We will never know about any deals unless Obamy and his Demoncratic cronies tell us. Will we?
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Old 07-26-2009, 08:42 AM   #345
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Looking forward to the "snips of the day" that tell me the government is planning to take over my life.
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