Doctor’s View

Michael Ramirez Cartoon

 

You shouldn’t judge the Affordable Care Act based on headlines or by listening to politicians or talking heads. I tried for a while, but only heard wildly conflicting stories that seemed to have little basis in reality.

Instead, you should ask someone who actually deals with the law on a daily basis — a doctor, for instance.

The Physicians Foundation did exactly that in its “2014 Survey of American Physicians,” which was released last month. The survey, which reached over 80% of doctors in the U.S. and elicited responses from some 20,000, is doctors’ collective report card on the Affordable Care Act’s first four years.

The grades aren’t good. Only 25% of doctors give it an “A” or a “B” grade. Nearly half ( 46%) give it a “D” or an “F”.

I can help explain why so many of us are fed up with the law: In many cases, it shifts our focus from patients to paperwork, from finding cures to filing documents.

The survey indicates that physicians now spend 20% of their time on non-clinical paperwork. I now spend many hours at a desk or a computer rather than at the bedside assisting patients. This isn’t why I became a doctor.

Unsurprisingly, this shift negatively influences patients’ access to health care — doctors simply don’t have the time to see the same number of patients.

The survey indicates that 44% of doctors “plan to take one or more steps that would reduce patient access to their services.” This includes “cutting back on patients seen, retiring, working part-time, closing their practice to new patients or seeking a non-clinical job.”

I would add another important effect based on my own observations: Spending less time with patients.

The ACA’s regulatory burden directly bears on these decisions. There are already at least 11,000 pages of government regulations related to the law. Some of it applies to insurers, some of it applies to doctors and some applies to the relationship between the two.

No matter who it applies to, it adds bureaucratic hassles to the health care process that may impact your doctors’ ability to attend to your medical needs.

It should come as no surprise, then, that 69% of physicians “believe their clinical autonomy is sometimes or often limited,” meaning they have a diminished ability to make medical decisions in consultation with patients.

And “limited” may be an understatement. The ACA’s implementation has also coincided with a dramatic decline in private practice — the small, personal doctors’ offices that have been in local communities for generations.

The number of private-practice doctors has dropped by nearly half in a mere six years, with the most dramatic drops occurring in the four years since the Affordable Care Act was signed into law.

According to the survey, 35% of physicians are now independent practice owners. In 2012, half were independent. In 2008 — two years before the ACA was passed — 62% were independent. In the last two years alone, the number of solo practitioners has dropped from 25% to 17%.

No wonder: Private and solo practitioners often lack the staff and the financial resources required to implement and keep up with the ACA’s dramatic changes to medicine.

The Physicians Foundation survey indicates that our country’s health care is still going in the wrong direction. Of course, it’s important to note that the Affordable Care Act is only one of many issues affecting doctors’ decisions and outlook.

But it is not a good sign that in the law’s first few years, physicians are seeing fewer patients, private practices are disappearing and nearly twice as many doctors believe the law is harming, not helping, American health care.

• Fodeman is an internal medicine doctor practicing in Tucson, Ariz. (IBD)

Bass Ackwards

For years, ObamaCare critics focused on its least popular feature — the mandate that everyone buy insurance — taking their fight all the way to the Supreme Court.

But as ObamaCare’s official launch date approaches, even its backers are beginning to admit that the law could actually create powerful incentives for millions of people and thousands of businesses to drop their coverage, despite the mandate.

Like: Universal Studios Orlando, the #2 attraction next to Disney:

Universal Orlando plans to stop offering medical insurance to part-time employees beginning next year, a move the resort says has been forced by the federal government’s health-care overhaul.

The giant theme-park resort, which generates more than $1 billion in annual revenue, began informing employees this month that it will offer health-insurance to part-timers “only until December 31, 2013.”

The reason: Universal currently offers part-time workers a limited insurance plan that has low premiums but also caps the payout of benefits. For instance, Universal’s plan costs about $18 a week for employee-only coverage but covers only a maximum of $5,000 a year toward hospital stays. There are similar caps for other services.

Those types of insurance plans — sometimes referred to as “mini-med” plans — will no longer be permitted under the federal Affordable Care Act. Beginning in 2014, the law will prohibit insurance plans that impose annual monetary limits on essential medical care such, as hospitalization, or on overall spending.

Universal is one of the largest employers in Central Florida, with approximately 17,000 employees. It has thousands of part-time workers, though Universal said only about 500 of them are enrolled in the current insurance plan, as many part-timers are covered by a parent’s or spouse’s insurance.

“We care about our team members and we want them to have best, most-affordable medical benefits we can provide,” Universal spokesman Tom Schroder said Tuesday. “This particular issue affects about 3 percent of our 17,000 team members, and we’re going to continue to work toward a solution.”

A spokesman for Orlando-based Darden Restaurants (Red Lobster, Olive Garden,etc..) said Tuesday its limited-coverage plans will “go away after this year,” as well.

“We’d like to have the option to continue offering them, since they are popular with our part-time employees, but the ACA doesn’t offer that type of flexibility,” spokesman Rich Jeffers said. “There is still a lot we don’t know about the new health-care regulations for 2014, but we are committed to helping all of our employees navigate through the new environment as we learn more.”

Walt Disney World has about 1,400 part-time employees enrolled in limited plans. A spokeswoman for the resort would say only that Disney is “still assessing the health-care reform act and how it impacts our business.”

“They have not talked to us about it yet,” added Eric Clinton, president of Unite Here! Local 362, which represents some of Disney’s part-time employees.

SeaWorld Orlando, too, offers some limited-benefit plans to part-time and seasonal workers. The company said it is “currently assessing options.”(Orlando Sentinel)

There is growing concern, for example, that the law’s market reforms will cause a huge “rate shock,” particularly for those young and healthy.

A February survey of major health insurance companies in five cities across the country found that they expect premiums for this group to climb an average 169%.

Aetna CEO Mark Bertolini said late last year that he expects premiums to double for some small businesses and some individuals as a result of the law.

And state insurance commissioners are worried as well.

“We are very concerned,” California Insurance Commissioner Dave Jones told federal health officials at a December meeting, “if there is so much rate shock for young people that they’re bound not to purchase (health insurance) at all.”

The cause of this rate shock is simple: ObamaCare imposes what is called “community rating” on insurance companies, effectively forcing them to charge the young and healthy more so they can charge older and sicker consumers less.

The five-city survey, for example, found that while the law will jack up rates for the young, it will lower them an average 22% for older and sicker customers.

Which means the lowest risk is paying much higher because the  higher risk are paying less. THE EXACT OPPOSITE of the way insurance is supposed to work.

That’s like lowering the premiums on the guy who’s had 2 DUIs and raising it on the driver who hasn’t had an accident in 20 years to pay for it.

At the same time, ObamaCare also forbids insurance companies from turning anyone down — a reform called “guaranteed issue” — which also will provide an incentive for some to drop coverage, knowing they can get it back any time.

“Even with the tax penalty … some healthy people would avoid purchasing coverage until they are sick,” Howard Shapiro, director of public policy at the Alliance of Community Health Plans, told regulators .

The problem is that if the young and healthy drop coverage, the result be what the industry calls a “death spiral.” Premiums will climb as the pool of insured gets sicker, causing still more to cancel their policies.

This is just what happened in states that imposed strict community rating and guaranteed issue reforms in the past. In fact, of the eight states that did so, most ended up either dropping the reforms or loosening the rules after they saw enrollment decline and premiums climb.

ObamaCare backers say the law’s subsidies will keep premium costs down, while the mandate to buy insurance will keep the young and healthy in the market.

But even they admit that the subsidies won’t protect everyone from ObamaCare-caused rate shocks, and the mandate is likely to prove too weak to be very effective.

In fact, the annual penalty for not buying insurance will be as low as $95 in 2014, and even when the mandate penalty is fully phased in by 2016 it will be modest relative to the cost of buying insurance.

In one illustrative example provided by the IRS , a family earning $120,000 in 2016 would owe just $2,400 in “shared responsibility payments” — the administration’s new euphemism for the penalty — while buying insurance would run them, in the IRS example, at least $20,000.

In addition, after 2016, the penalty amounts will be indexed to inflation, even though insurance premiums have consistently risen much faster than the CPI, which means “shared responsibility payment” will be less of a deterrent over time.

On top of all this, the IRS has virtually no ability to collect the penalties from those who don’t pay them. As the IRS itself explains, the law forbids the agency from imposing liens or criminal penalties, leaving it few options beyond deducting the penalty from tax refunds.

Aren’t you glad you bought the “Vote For Me, the Other guy’s an Asshole!” because you wanted everything to be the same as it has been. 🙂

 

Political Cartoons by Lisa Benson

Political Cartoons by Glenn McCoy

Political Cartoons by Steve Kelley

Political Cartoons by Chuck Asay

Hmmm…

In light of new information emerging about the Bureau of Alcohol Tobacco Firearms and Explosives’ (ATF) Operation Fast and Furious (read here about ATF targeting FBI informants), we thought revisiting this video ain’t a bad idea.

Back in April of 2009, President Obama alluded in a question and answer session to the notion of “gun tracing” in Mexico . . . leading many to conclude that he may have known more than he’s ever admitted about Operation Fast & Furious and long before he says he knew anything.  You be the judge . . .

Hmmmm….

The Wisdom of Samuel L Jackson (He ain’t no Jedi…)

Barack Obama‘s politics meant nothing to Samuel L. Jackson because the “Pulp Fiction” star only voted for the president for one reason and one reason only … because he’s black. 

In an interview with Ebony magazine, Jackson explained, “I voted for Barack because he was black. ‘Cuz that’s why other folks vote for other people — because they look like them … That’s American politics, pure and simple. [Obama’s] message didn’t mean [bleep] to me.”

Jackson then went on to drop the N-word several times when discussing Obama, telling the mag, “When it comes down to it, they wouldn’t have elected a [bleep]. Because, what’s a [bleep]? A [bleep] is scary. Obama ain’t scary at all. [Bleeps] don’t have beers at the White House. [Bleeps] don’t let some white dude, while you in the middle of a speech, call [him] a liar. A [bleep] would have stopped the meeting right there and said, ‘Who the [bleep] said that?’ I hope Obama gets scary in the next four years, ‘cuz he ain’t gotta worry about getting re-elected.” (TMZ)

But if you disagree with a Liberal you’re a racist. 🙂

Hmmm….

Political Cartoons by Steve Kelley

Late last week, the White House tried claimed to “compromise” on the new ObamaCare requirement that all employers provide insurance with free birth control coverage, including religious employers. The compromise actually wasn’t a compromise at all, yet the White House is shutting down debate on the issue and saying it’s a done deal.

President Barack Obama and his deputies are using the demeaning language of disease and green-eyeshade accounting to establish free birth control as a government-backed right, and also to downgrade the value of human lives, say social conservatives.

“They’re claiming that children are like a disease and increase health costs,” said former Concerned Women for America president Wendy Wright.

Unborn children, however, “are humans beings and that’s what Obama and the abortion crowd refuse to recognize,” she told The Daily Caller.

The Catholic Church’s opposition to the new Obama administration regulations is heavily influenced by its ideological and religious support for human life, and its twinned opposition to birth control, including contraception, and abortion.

That ideological point was prominently displayed in the Feb. 10 response to Obama’s announcement from the U.S. Conference of Catholic Bishops.

“First, we objected to the rule forcing private health plans — nationwide, by the stroke of a bureaucrat’s pen — to cover sterilization and contraception … [but] pregnancy is not a disease,” said the response.

Obama’s unsympathetic language was showcased in his Feb. 10 announcement that he would require health insurance companies to offer free birth-control services to the employees of religious groups, despite the congregations’ constitutional protection from state regulation.

“It’s a lot cheaper to prevent an illness than to treat one … [and] preventive care should include coverage of contraceptive services such as birth control,” the president said in brief remarks in the White House press room.

Even when Obama championed the claim that women have a moral right to use birth control, he talked about biological health, not of moral freedom. “Every woman should be in control of the decisions that affect her own health,” he said.

Except that he passed a law MANDATING their “pro-choice”  “pro-Control”–it was called ObamaCare.

MANDATING Freedom of Choice…Hmmm….

White House officials also justified the far-reaching policy by saying it would cost nothing, and therefore would impose no real burden on religious organizations.

Cost Nothing? Boy he really has no idea how capitalism works does he…Hmmm…

“Covering contraception saves money for insurance companies by keeping women healthy and preventing spending on other health services,” said a White House statement released Feb. 10.

But if you’re oppose to birth control to begin with, Like the Catholic Church…well, screw you… Hmmm…

Making Insurance Companies pay for something without any recourse is “free”.
Hmmm…

The Catholic Church’s advocates have reserved their strongest condemnation, however, for the White House’s description of pregnancy as a disease.

The administration believes “pregnancy is some sort of health care anomaly… [and] to be pregnant is some sort of illness,” said Cardinal Donald Wuerl, the Catholic archbishop of Washington, D.C. They believe, he said, that they “must prevent that illness. … A pregnancy becomes the problem.”

“Kids aren’t commodities — they’re humans beings and that’s what Obama and the abortion crowd refuse to recognize,” added Wright, who is now advocating for socially conservative policies at the United Nations.

But they are political footballs…Hmm…

Now, after the many genuine concerns that have been raised over the last few weeks, as well as, frankly, the more cynical desire on the part of some to make this into a political football, it became clear that spending months hammering out a solution was not going to be an option, that we needed to move this faster.  So last week, I directed the Department of Health and Human Services to speed up the process that had already been envisioned.  We weren’t going to spend a year doing this; we’re going to spend a week or two doing this.

Not to be too cynical about this, but Obama last spoke with those Catholic officials months ago regarding his mandate.  And no one at the White House bothered to contact them when it came time to offer this “accommodation,” as the bishops made clear on Friday after the Obama administration announced it.  That sounds a lot like a cynical desire to punt a political football rather than figuring out exactly why the church objected to it in the first place.  And that failure looks like the product of a cynical desire to impose the same mandate while making it look like a compromise.

Following the announced “accommodations” from the White House for religious organizations whose beliefs preclude them from offering birth control, Richard Land, president of the Southern Baptist Convention’s Ethics & Religious Liberty Commission, had some tough words for President Obama.

According to Land, the adjustment in the mandate requiring all employers — including religious organizations — to provide birth control is “a distinction without a difference.”

“My initial reaction is: How dumb does he think we are?” Land wondered in an interview with The Daily Caller. “Does he think when he puts lip stick on a pig, that we don’t understand that it is still a pig?”

Yes, he does. Because that’s they way the Liberal mind works. Someone objects to your idea so you just change the wording or the word and suddenly a totally new idea and if object to that it’s just because you’re “obstructionist”.

Perfect Example: Global Cooling/Warming/Climate Change etc.

Next up: Deficit Reduction (aka spending more than we have but spending less of the more than before) is good. And if you’re against it you’re just an “obstructionist”

The government safety net was created to keep Americans from abject poverty, but the poorest households no longer receive a majority of government benefits. A secondary mission has gradually become primary: maintaining the middle class from childhood through retirement. The share of benefits flowing to the least affluent households, the bottom fifth, has declined from 54 percent in 1979 to 36 percent in 2007, according to a Congressional Budget Office analysis published last year.

The problem by now is familiar to most. Politicians have expanded the safety net without a commensurate increase in revenues, a primary reason for the government’s annual deficits and mushrooming debt. In 2000, federal and state governments spent about 37 cents on the safety net from every dollar they collected in revenue, according to a New York Times analysis. A decade later, after one Medicare expansion, two recessions and three rounds of tax cuts, spending on the safety net consumed nearly 66 cents of every dollar of revenue.

The recent recession increased dependence on government, and stronger economic growth would reduce demand for programs like unemployment benefits. But the long-term trend is clear. Over the next 25 years, as the population ages and medical costs climb, the budget office projects that benefits programs will grow faster than any other part of government, driving the federal debt to dangerous heights.

Americans are divided about the way forward. Seventy percent of respondents to a recent New York Times poll said the government should raise taxes. Fifty-six percent supported cuts in Medicare and Social Security. Forty-four percent favored both.

But now Obama wants to cut the Deficit (not the debt) so that he’ll promise to have less and less deficits (money we don’t have) every year for the next 4 years.

He’ll have it down to 1/2 trillion in deficits by the time he leaves.

Making it 7 years in a row!

And this is an improvement, and if you don’t want to go for it you’re an “obstructionist” who just wants to protect the “rich” (the same people giving him $38,500 a person).

Hmmm…

Political Cartoons by Steve Kelley

 

The Future of ObamaCare?

The Nationalized Health Care of Canada has stuck again.

This is ongoing and started earlier this week but Wisconsin took up the time.

If this doesn’t outrage you, you must be dead, or a Liberal.

But it’s coming to an ObamaCare near you…

London, Ontario Free Press: Jane Sims The London Free Press Moe Maraachli keeps the snapshots of his dying baby boy in an envelope in his jacket pocket.

He pulls out the photos of the son he’s about to lose, trying to  understand how a hospital, an Ontario health-related board assigned to  judge consent issues, and a London court could say he and his wife can’t  take Baby Joseph home to Windsor to die.

“I do my best for my baby. I do my best,” he said Thursday outside the London courthouse, tears in his eyes.

“This is killing, this is criminal . . . I’m sure this is murder.”

This Monday, on Family Day in Ontario, Joseph Maraachli, who’s in a  vegetative state from a neurodegenerative disease, will die after his  breathing tube is removed from his tiny body at a London hospital,  ending an ethical and legal dilemma that tried to balance unwanted  suffering with the needs of a child and his family.

“I lose my baby,” his father, 37, who came to Canada from Lebanon 11 years ago, said. “They take him from me.”

“I don’t lose my baby like God take him. They take him. They want to take him.”

“It was basically our family’s word versus the medical system’s  world,” said his aunt, Samar Nader, who’s sure she saw Joseph respond to  her this week when she touched his head.

“I think in medicine, they’re just looking at the world from a black and white point of view.”

“The family understands the child and for us to witness his death on Monday . . . I don’t know,” she said.

An emotional Superior Court Justice Helen Rady, who called it  “heartbreaking” and “such a sad and difficult case”, decided Thursday  not to allow the family’s appeal of a decision last month by Ontario’s  Consent and Capacity Board to have the child’s breathing tube removed  and put in place a do-not-resuscitate order and palliative care.

The baby’s father and mother, Sana Nader, 35, wanted the same  treatment for Joseph as was given to their daughter before she died,  eight years ago at 18 months – give Joseph a tracheotomy and  ventilation, and allow them to take him home to die what they would be a  peaceful death.

But Joseph’s doctors say while a tracheotomy – an incision is made in  a patient’s airway, to help breathing – may prolong the baby’s life,  it’s futile in this case and would likely cause much discomfort. It  would certainly also increase the risk of infection and pneumonia, they  argue.

“The medical officials would not want this little boy to suffer,” Rady said.

When born in January 2010, Joseph, now 13 months, was a beautiful, normal baby.

But five months later he started having seizures like his sister. By June, he couldn’t swallow.

In October, he stopped breathing while travelling with his parents.  He was taken to an Ingersoll hospital, then rushed to the London Health  Sciences Centre’s pediatric critical care unit where he’s been ever  since.

His father has stayed in London to be with his son.

His mother is in London every weekend and returns to Windsor to look after the couple’s other son, Ali.

Joseph’s on a ventilator and fed through a tube. He’s in what the  doctors call “a persistent vegetative state.” The doctors say he’s blind  and deaf.

He’s missing all five brain stem reflexes considered necessary for  life – gag, cough, eye movement, pupil and cornea responses. His brain  deterioration is irreversible.

A team of doctors, including a world-renowned pediatric expert from  Toronto’s Hospital for Sick Children, has examined Joseph and agrees  he’s dying of the same progressive neurodegenerative disease that  claimed his sister.

Joseph’s doctor told the adjudication board that doctors  “reluctantly” gave the couple’s daughter a tracheotomy. Since then,  doctors have learned “substantially” more about the procedure and  determined it isn’t right for Joseph.

The board agreed with Joseph’s attending doctor that the baby has “no hope or chance of ever recovering.”

“While we feel a great deal of empathy for the parents, we held that  their view was not in any way realistic,” the board said, adding  Joseph’s parents “were blinded by their obvious love” for their child.

The State Board knows better!!!  Sound ObamaCare-ish? Yes!

Obamacare establishes the Independent Payment Advisory Board, whose stated responsibility is to develop proposals to reduce the growth of Medicare spending.
His parents fear Joseph will choke to death once the tube is removed.  They say he responds to their touch and wanted the board to see him in  hospital before deciding.

Rady said it’s unclear what the board would have seen had its members  agreed. And she noted that while Joseph’s head and body have grown, it  doesn’t mean the medical assessments are wrong.

The case digs deeply into the delicate balance of life versus. suffering.

Ethicist Margaret Somerville, of McGill University’s Centre for  Medicine, Ethics and Law, said the case is “a judgment where the parents  are giving priority to the prolongation of life and the doctor is  giving priority to the quality of that life.”

“I’m sure there’s no doubt in this case that this child has a very  poor quality of life, but we do know that health care professionals  judge quality of life much lower than people themselves do.”

Somerville said such quality-of-life decisions are delicate and often  at odds. What needs to be examined is why the family doesn’t agree with  the decision and if their reasons are acceptable, she said.

The board had ordered Joseph’s breathing tube be removed Friday, but Rady said that wasn’t sensitive to the family’s need.

Instead, she ordered they comply by Monday – a statutory holiday in  Ontario, to celebrate family – “to afford the whole family adequate time  to say their good-byes.”

Rady’s voice broke when she addressed the family. “I hope that in time you’ll find peace,” she said.

Joseph’s father wasn’t satisfied. “It’s not help,” he said later.

His lawyer, Geoff Snow, said he understands Rady’s decision but  added, “the loss of a child in any circumstances is tragic and it’s  unfortunate that there’s not more than could have been done.”

Lawyer Julie Zamprogna Balles, who acted for the doctor, said Rady’s decision was “well-reasoned and compassionate.”

While the case had “very sad and unfortunate circumstances,” everyone  involved, she said, have “focused on Little Joseph’s best interests.”

But a grieving Moe Maraachli said there’s “no humanity” in Canada. He expressed a desire to die himself.

“I stay with him until the last moments and hopefully I go with him,” he said.

THE ETHICAL ISSUE

Whether to provide medical intervention to prolong the life of a dying child who’s in a persistent vegetative state.

THE LEGAL ISSUE

Whether to allow an appeal of a decision by an Ontario health-based  board that adjudicates consent issues, to take the child off life  support.

****

LONDON, Ont. – A father who has been battling to stop a London, Ont.,  hospital from removing his terminally ill son from a ventilator stood  his ground Monday and defied a court order requiring him to give  consent.

Moe Maraachli says he and his wife Sana Nader are happy  the breathing tube keeping their 13-month old son Joseph alive has not  yet been removed.

But their fight to get the boy a tracheotomy so they can take him home to die isn’t over.

“I’m  very excited because my son doesn’t remove his tube today,” said  Maraachli, who has been sleeping at the hospital since Friday.

“All my family is happy. We are happy. We feel it’s really Family Day today.”

The Windsor, Ont., couple has been fighting for months against doctors at Victoria Hospital in London  who say their son should be removed from life support because he will  not recover from the rare neurological condition that has left him in a  vegetative state.

The family fears Joseph will suffer a painful  death if the ventilator is removed, and prefers that a tracheotomy be  performed so they can take him home to live his remaining days  surrounded by people who love him.

The couple’s 18-month-old  daughter died almost nine years ago from a similar medical condition.  She had a tracheotomy and lived at home for six months before she died,  said Maraachli.

But, last Thursday, Ontario Superior Court Justice Helen Rady ordered the couple to agree to take Joseph off the ventilator by 10 a.m. Monday.

The judge was upholding a decision already made by Ontario’s Consent and Capacity Board.

Because  the London hospital could not get consent to remove the breathing tube  from Joseph’s parents or other family members, it has the right to seek  consent from the Office of the Public Guardian and Trustee, said Mark  Handelman, Maraachli’s lawyer.

But Maraachli is hoping his son Joseph will be transferred to Michigan’s Children’s Hospital in Detroit.

Joseph  has been treated there before under the Ontario Provincial Health  Insurance Plan and the family feels they would have another chance at  persuading doctors to perform a tracheotomy if he returns there.

The couple’s friends recently contacted the U.S. hospital about a transfer and the London Health Sciences Centre, which Victoria Hospital falls under, was asked to send Joseph’s medical records there on Sunday.

The London hospital sent Joseph’s medical chart by courier to Detroit on Monday, said spokeswoman Laurie Gould.

“At this point in time we have not received any request for transfer,” said Gould.

If a transfer request is made, Gould said her hospital would contact the public guardian and “wait for their direction.”

The London hospital would not need permission from the public guardian to transfer Joseph to Michigan, said Handelman.

Alex Schadenberg, executive director of the Euthanasia Prevention Coalition, called the baby Joseph case sad and tragic.

Schadenberg questioned why doctors, not parents, should have the final say over their baby’s care.

“Is it right that the doctor has now so much power?” asked Schadenberg.

“I think the balance of power has shifted in Ontario too far, and I’m getting very concerned about who has the right to decide.”

Gould said the case is certainly “emotionally charged.”

The  hospital has received calls and emails from the public, some offering  prayers for the baby, who’s been at the hospital since October, she  said.

As cars honked their horns, a couple of dozen people holding  signs and photos of the baby held a vigil outside the hospital Monday  morning, an hour before the baby was to be removed from the ventilator.

Maraachli’s  sister-in-law Samar Nader said the family is “relieved and thankful”  for all the support they’ve received from the public.

“It’s true  that miracles do happen and I would never have expected for my nephew to  live past 10 o’clock without the people’s help,” she said.

****

(CNN) — A Canadian family fighting to keep their 13-month-old son on a breathing tube says they have been denied a request to have him transferred to a hospital in Michigan.

Moe and Sana Maraachli refused to sign consent when Canadian health officials determined their son Joseph, who suffers from a progressive degenerative neurological disease and was in a persistent vegetative state, should be removed from life support. Joseph is being treated at the London Health Sciences Centre in Ontario.

The Maraachlis reached out to the Children’s Hospital of Michigan in Detroit in hopes of having their son transferred there for continued care.

Family spokesperson Sam Sansalone said the hospital initially agreed to accept the transfer. He said he has since received an email indicating the request has been denied.

Sansalone forwarded an email from the Detroit hospital that he said explains that after a review of Joseph’s records by neurological and intensive care physicians, “we cannot offer Joseph anything that he has not been provided already during his current admission by his current clinical care team … transfer to our facility will not provide him or the family any benefit.”

Vickie Winn, a spokesperson from the Children’s Hospital, confirmed Joseph is not a patient at the hospital but could not offer further comment, citing patient privacy laws.

Sansalone said the family is pursuing at least three other hospitals in other states.

The family says the hospital has it wrong and that their son is not in a persistent vegetative state. Sansalone said they have noted experiences where the baby has responded to being tickled and has jolted when he felt discomfort with examinations or the feeding tubes. They say these are signs he might still have brain function.

However, Canadian health officials disagree. On February 17, they decided Joseph should be removed from life support. The family was given until February 21 to say their goodbyes and sign the consent, but they have yet to do so.

The Maraachlis are seeking a second opinion from what they consider to be an objective source that can review the more than 1,000 pages of Joseph’s medical records and provide a better assessment of their son’s treatment options.

If he is beyond hope, they want him to be able to receive a tracheotomy, where he can be transferred home and die in the care of family instead of in a hospital.

Experts say even if the family is granted this request, caring for a child in this condition is an arduous task.

Dr. David Casarett, director of research and evaluation at the University of Pennsylvania’s Wissahickon Hospice, says patients at home with tracheotomies need monitoring to make sure the airway is clear of secretions, the skin is clean and dry and someone can make sure the incision at the tracheotomy site does not get infected.

“A child’s care would be much more complex if a home ventilator is required, since the parents would need to manage the ventilator with the help of a nurse and respiratory therapist,” he said.

Suzanne Vitadamo, spokesperson for the Terri Schiavo Life & Hope Network and Terri’s sister, issued the following statement:

“It is unacceptable for Canadian Health Allocation Officials and/or the Canadian Government to make decisions for Joseph that will end his life and deny the wishes of his loving parents.

“Every patient, regardless of age, has a right to proper and dignified health care. It is frightening to once again see government usurp the God-given rights of parents to love and care for their child at home, especially when the child is dying.”

We are from the Government and we are here to help you, control you, and make decisions for you.

Rejoice!

Political Cartoons by Chuck Asay

Political Cartoons by Gary McCoy

Adverse Selection

The leftists are all in a tizzy. A tizzy of their own making mind you.

But they’ll never see it that way. Because it was done “for the children” and the Insufferably Morally Superior Left doesn’t care about reality in their fantasies and delusions of “fairness” and “equality” in their own minds.

It makes them “feel good”.

Here’s a little lesson the Left refuses to hear about reality:

People who buy insurance often have a better idea of the risks they face than do the sellers of insurance. People who know that they face large risks are more likely to buy insurance than people who face small risks. Insurance companies try to minimize the problem that only the people with big risks will buy their product, which is the problem of adverse selection, by trying to measure risk and to adjust prices they charge for this risk. Thus, life insurance companies require medical examinations and will refuse policies to people who have terminal illnesses, and automobile insurance companies charge much more to people with a conviction for drunk driving or if you get into an accident (or if your neighbors are idiots you’re going to pay more because of a more adverse selection–that’s why “my rates keep going up but I haven’t caused any accidents”).

It describes a situation where an individual’s demand for insurance (either the propensity to buy insurance, or the quantity purchased, or both) is positively correlated with the individual’s risk of loss (e.g. higher risks buy more insurance), and the insurer is unable to allow for this correlation in the price of insurance. This may be because of private information known only to the individual (information asymmetry), or because of regulations or social norms which prevent the insurer from using certain categories of known information to set prices (e.g. the insurer may be prohibited from using information such as gender or ethnic origin or genetic test results). The latter scenario is sometimes referred to as ‘regulatory adverse selection’.

And regulatory adverse selection is what we have in droves in the Insufferably Morally Superior Left Health Care Cramdown.

And the little superior moralists are shocked and applauded that the insurance industry would actually follow these principle laid out above and not just roll over and kiss their morally superior asses and do  “the right thing for the children” and as they are told like a good little doggie.

Health plans in at least four states have announced they’re dropping children’s coverage just days ahead of new rules created by the healthcare reform law, according to the liberal grassroots group Health Care for America Now (HCAN).

The new healthcare law forbids insurers from turning down children with pre-existing conditions starting Thursday, one of several reforms Democrats are eager to highlight this week as they try to build support for the law ahead of the mid-term elections. But news of insurers dropping their plans as a result of the new law has thrown a damper on that strategy and prompted fierce push-back from the administration’s allies at HCAN.

The announcement could lead to higher costs for some parents who are buying separate coverage for themselves and their children at lower cost than the family coverage that’s available to them.

“We’re just days away from a new era when insurance companies must stop denying coverage to kids just because they are sick, and now some of the biggest changed their minds and decided to refuse to sell child-only coverage,” HCAN Executive Director Ethan Rome said in a statement. “The latest announcement by the insurance companies that they won’t cover kids is immoral, and to blame their appalling behavior on the new law is patently dishonest.

“Instead, they should reverse their actions immediately and simply follow the law. If the insurance companies can casually turn their backs on sick children now, who will they abandon next? This offensive behavior by the insurance companies is yet another reminder of why the new law is so important and why the Republicans’ call for repeal is so misguided.”

Health plans and state insurance commissioners in July raised concerns that the new rules could lead some insurers to stop children-only coverage because families could wait until their children get sick to buy coverage.

Days later, the Obama administration issued regulations clarifying that insurers would still be able to establish enrollment periods in accordance with state law.

“To address concerns over adverse selection, issuers in the individual market may restrict enrollment of children under 19, whether in family or individual coverage, to specific open enrollment periods if allowed under state law,” the Department of Health and Human Services clarified.

The issue had largely dropped out of sight since then, but insurers including WellPoint and CoventryOne have announced in recent days that they’re dropping children’s coverage in California, Colorado, Ohio and Missouri, according to HCAN. (The Hill)

I guarantee this is only the beginning. Trust me.

But the Insufferably Morally Superior Left will just sit there and be “appalled” and kick and scream and whine and moan “they aren’t doing what we told them to do whaaaahh!!!”

Then go to their government buddies and pass more regulations to have their way.

I say a new term in a headline recently that fit, LAWFARE. Waging a war by lawsuits and REGFARE, waging war by regulation.

That’s the Insufferably Morally Superior Left in a nutshell.

As I said repeatedly and often during the Health Care debate, it’s about the government and leftists wanting total control of who lives and who dies and you dependent on them for everything. Period. End of Story.

They want private insurance gone. But private insurance is not going quietly.

That would be a moral hazard.

In insurance markets, moral hazard occurs when the behavior of the insured party changes in a way that raises costs for the insurer, since the insured party no longer bears the full costs of that behavior. Because individuals no longer bear the cost of medical services, they have an added incentive to ask for pricier and more elaborate medical service—which would otherwise not be necessary. In these instances, individuals have an incentive to over consume, simply because they no longer bear the full cost of medical services.

And does this not sound like ObamaCare to you?? 🙂

Political Cartoon by Chuck Asay