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The President, Medicare, and Planning for Dying

An unemotional evaluation of Medicare’s new “end-of-life” planning

Curtis Coleman, The New South Conservative: During the 2009-2010 national debate on Obamacare, one of the most controversial and emotionally debated components of the bill’s massive leap toward socialized medicine was the now infamous Section 1233, which included plans and compensation to physicians for “end-of-life” counseling. The proposal touched off a political firestorm over “death panels,” so Democrats dropped it from healthcare deformation legislation. But the Obama administration will achieve the same goal by regulation, starting Jan. 1.

According to Robert Pear of The New York Times, “Under the new policy, outlined in a Medicare regulation, the government will pay doctors who advise patients on options for end-of-life care, which may include advance directives to forgo aggressive life-sustaining treatment.”

What About “End of Life” Planning?

When conducted for the benefit of the patient first (and secondarily for the patient’s family), “end-of-life” counseling and planning is a valuable tool for patients, their families and their physicians.

According to the Family Caregiver Alliance, “The one area that most of us avoid planning is the end of our life. Yet, if we don’t plan, if we don’t at least think about it and share our ideas with those we love, others take over at the very time when we are most vulnerable, most in need of understanding and comfort, and most longing for dignity.

“Big issues confront us when we think about our own death or that of someone we love. Our attitudes and beliefs about religion, pain, suffering, loss of consciousness, and leaving behind those we love come into play. We can let things unfold as they may, and for some of us that’s exactly right. For others of us, it is good to plan.”

End of life planning can include such valuable documents as a living will, a legal document that a person can use to make known his or her wishes regarding life-prolonging medical treatments. It can also be referred to as an advance directive, health care directive, or a physician’s directive.

Although laws vary from state to state, generally a living will describes certain life-prolonging treatments. The document can be used to indicate which treatments you do or do not want applied to you in the event you either suffer from a terminal illness or are in a permanent vegetative state. A living will does not become effective unless you are incapacitated; until then you’ll be able to say what treatments you do or don’t want. They usually require a certification by your doctor and another doctor that you are either suffering from a terminal illness or permanently unconscious before they become effective as well. This means that if you suffer a heart attack, for example, but otherwise do not have any terminal illness and are not permanently unconscious, a living will does not have any effect. You would still be resuscitated, even if you had a living will indicating that you don’t want life prolonging procedures. A living will is only used when your ultimate recovery is hopeless.

End-of-life planning can also include a health care power of attorney or health care proxy. This document becomes valuable to your family and your health care providers when your health is not so dire that your living will becomes effective. A health care power of attorney is a legal document that gives someone else the authority to make health care decisions for you in the event you are incapacitated. The person you designate to make health care decisions on your behalf is supposed to consider what you would want, so be sure to talk with them about it. It may be a difficult conversation, but you’re asking someone to take on a great burden for you – letting him or her know what you want lessens that burden.

It is entirely appropriate and important for one’s physician to be involved in this planning process, and it is equally appropriate for Medicare to reimburse your physician for his or her participation in the planning process – if that is the limit of Medicare’s involvement.

So why the emotionally charged debate?

Are Conservatives Just Fear-mongering?

Are conservatives just fear-mongering (like the liberals and progressives in the recent mid-term elections when conservatives advocated eliminating the IRS and its tangled, mangled tax codes in favor of the Fair Tax, or when conservatives had the courage to talk about the obvious and unavoidable adjustments required for Social Security to continue to be viable)? Are conservatives doing “a despicable thing” by playing on the fragile emotions of seniors who are facing difficult discussions and decisions – and possibly fears – about the end of life?

Or is there a legitimate concern of which Americans must be aware? The answer is an unequivocal “yes!”

[Read full article]


Curtis Coleman is the President of The Curtis Coleman Institute for Constitutional Policy and former conservative Republican candidate for US Senate.

Tags: Curtis Coleman, Health Care, Affordable Care Act, Obamacare, Death Panels, End of Life Care

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December 30, 2010 Posted by | Health Care | Leave a comment

Foreclosures Up Again, Another Obama Failure

Home foreclosures jump…in spite of all of Barack Obama’s efforts to help homeowners stay in their homes.

Since he took office, Obama has been on something akin to a crusade to keep floundering homeowners in their houses and off the streets. Blaming banks and mortgage brokers for borrowers’ irresponsibility, the President and his big-government, anti-personal-responsibility pals in Congress implemented several programs to allow borrowers who couldn’t make their payments to keep the homes they couldn’t afford. But today we learn that foreclosures spiked yet again in the 3rd quarter of this year.

The Department of Housing and Urban Development‘s (HUD) website promises “Help for the Unemployed”, help for “Homeowners Like You”, and “Help for the Hardest Hit.” The site also offers visitors the opportunity to “Learn About Making Home Affordable.”

Learn About Making Home Affordable

The Obama Administration’s Making Home Affordable Program includes opportunities to modify or refinance your mortgage to make your monthly payments more affordable. It also includes the Home Affordable Foreclosure Alternatives Program for homeowners who are interested in a short sale or deed-in-lieu of foreclosure.

On his 2008 presidential campaign website,, Obama promised help for “millions of homeowners who played by the rules can’t meet their mortgage payments and face foreclosure…” The idea that everyone facing foreclosure is some sort of victim in a corrupt system relieves the irresponsible of any personal responsibility.

Though many did play by the rules, the rules involved risks that too many failed to account for. Obama played the victim card for homeowners in trouble and refuses to acknowledge that any investment involves risk that must be accounted for by any responsible investor. Borrowers who bought homes with payments they couldn’t afford were betting the soaring prices would continue and rapid appreciation would cover their deficits. If someone borrowed several hundred thousand dollars and bought shares of a skyrocketing stock, then the stock suddenly crashed, would that investor be labeled a “victim”? The parallels are obvious.

Obama and his henchmen perpetrated this fraud on the American people, promising to right these “wrongs” and claimed their plan “provides direct relief to help America’s homeowners pay their mortgages, stay in their homes, and avoid painful tax increases while protecting taxpayers and not rewarding the bad behavior and bad actors [mortgage brokers and banks] who got us into this mess.” But today’s news proves his naivete.

The simple fact is, while some may have been swindled and actually defrauded when they bought their homes, the vast majority of those who find themselves in trouble are in that position because they made irresponsible decisions. All the President’s programs to help these “victims” of the economic downturn only enabled them to continue to live in houses they couldn’t afford. Failing to address the borrowers’ irresponsibility did nothing to change the behavior that put them in danger of losing their home in the first place.

Last quarter’s foreclosure provide the proof that another of Obama’s victim-making programs has failed ro accomplish its stated goals.

Tags: Obama, Making Home Affordable, HUD, Foreclosure, Mortgage

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December 30, 2010 Posted by | Economy | Leave a comment

Did disgruntled workers cause chaos (and cost lives) in NYC?

Being from the South, where lots of things shut down whenever a little of the white stuff hits the ground, I’ve often listened to folks from the North complain about our inability to cope with a little winter weather. But this time the shoe’s on the other foot. The question is, why?

Stranded travelers and even New Yorkers on the street have been complaining non-stop since their “City-That-Never-Sleeps” was tucked snugly under an historic blanket of snow this week. Over 5,000 flights were canceled as all three New York City airports were socked in, turning thousands of people into temporary residents of the airports themselves. Trains in and out of the city, and even the always dependable subway system ground to a halt. Buses, taxis, and the city’s few POVs couldn’t move through the snow swamped streets. New Yorkers for the first time in their lives found themselves snowed in, and they didn’t like it.

Most of their anger has been directed at the city’s billionaire Mayor Bloomberg. One Brooklynite was quoted saying the mayor, “doesn’t care about the little people,” insinuating the wealthy Bloomberg channeled resources to take care of Manhattan while ignoring the outer boroughs. Bloomberg admitted Wednesday, “We did not do as good a job that we wanted to do or the city has a right to expect.”

Earlier though, the mayor was less contrite. Estimating 5,000 trucks with plows would have been necessary to keep pace with the falling snow, the mayor held press conferences and pretty much told the people his response was adequate because citizens would not want to pay for more than the 2,000 trucks his administration deployed. Though this initial response to critics sparked even more outrage, residents’ anger at the mayor might be somewhat misplaced.

In a New York Post exclusive, city Councilman Dan Halloran (R-Queens) claims three apologetic sanitation workers and two Department of Transportation supervisors visited him to confess the city’s inadequate response was more the result of a protest against the mayor by disgruntled city workers and supervisors. Apparently, workers were ordered by their supervisors to intentionally slow the cleanup in order to force the city to pay overtime wages.

New York’s Strongest used a variety of tactics to drag out the plowing process — and pad overtime checks — which included keeping plows slightly higher than the roadways and skipping over streets along their routes, the sources said.

The snow-removal snitches said they were told to keep their plows off most streets and to wait for orders before attacking the accumulating piles of snow.

Though the Sanitation Department and union representatives deny the allegations, Bloomberg spokesman Stu Loesser said, “We would hope this is not the case.” But if it is, heads should roll.

Everyone knows of New York City’s budget woes, but these workers suffer from the Great American Entitlement Syndrome. They apparently forget that employers can only pay for workers they can afford. Instead, America’s move away from Capitalism and toward Socialism has infected them. Our entitlement dependent society is training people to believe their standard of living is a birthright instead of something earned. Crews paid to clear the streets should give an honest day’s work for an honest day’s pay. If they believe their compensation is unfair, they should quit and live off Obama’s permanent unemployment benefits until someone agrees with them. Instead, they believe their job and their salary is more important than anything else in the world–even human lives.

At least two deaths have been attributed to the uncleared streets in the city. A baby born in an apartment building lobby died after 911 calls went unanswered for hours. Another woman called 911 when her mother began struggling to breathe. It took three hours for emergency crews to respond, and even then their ambulance was stranded a block and a half from the woman’s residence. Her mother was dead when they arrived. If these deaths could have been prevented, and if the plow operator confessors’ stories are true, these lives were sacrificed to pad workers’ paychecks and/or to protest city budget cuts.

If it turns out these allegations are true, workers and supervisors who participated in this job action should be fired and prosecuted. And if true, I hope they are haunted by nightmares of these deaths for the rest of their lives.

Tags: Blizzard, New York City, New York Post, Protest, Bloomberg, Entitlement

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December 30, 2010 Posted by | Labor | Leave a comment