From Volume 36, Issue 33 of EIR Online, Published Aug. 28, 2009

United States News Digest

Veterans Administration Promotes Idea of a Life Not Worth Living

Aug. 21 (EIRNS)—While the Obama Administration and the Democratic misleadership of House Speaker Nancy Pelosi are promoting the Independent Medicare Advisory Council (IMAC), a Hitler-style death panel, in their current health-care bill, the Obama Administration has already approved an end-of-life planning document, in the Department of Veterans Affairs (VA).

According to Jim Towey, in an op-ed in the Wall Street Journal on Aug. 19, entitled "The Death Book for Veterans," this document argues that depression, disability, and being a financial burden could constitute "Lebensunwertes Leben" (Life Unworthy of Life). According to Towey, last year, bureaucrats at the VA's National Center for Ethics in Health Care advocated a 52-page end-of-life planning document, "Your Life, Your Choices." It was first published in 1997, and later promoted as the VA's preferred living will throughout its vast network of hospitals and nursing homes. After the Bush White House took a look at how this document was treating complex health and moral issues, the VA suspended its use. Under President Obama, the VA has resuscitated "Your Life, Your Choices."

The primary author of the document is Dr. Robert Pearlman, chief of ethics evaluation for the Center, a man who, in 1996, advocated for physician-assisted suicide in Vacco v. Quill, before the U.S. Supreme Court, and is known for his support of health-care rationing.

The document suggests that both family finances and clinical depression could constitute a life unworthy of life. It invites veterans to define even non-terminal conditions (such as being in a wheelchair, or suffering from depression) as Lebensunwertes Leben. Veterans are asked if the following conditions would make life not worth living: "I can no longer walk but get around in a wheelchair; I can no longer contribute to my family's well-being; I am a severe financial burden on my family"; and "I cannot seem to shake the blues."

Only one organization is listed in the new version of this document as a resource on advance directives: the Hemlock Society (now known as "Compassion and Choices").

A July 2009 VA directive instructs its primary care physicians to discuss advance care ("end of life") planning with all VA patients, and to refer them to "Your Life, Your Choices."

Obama Science Advisor: Cut Health Care to the Elderly

Aug. 20 (EIRNS)—Dr. Christine Cassel, who was appointed on April 27 to be a member of President Obama's Council of Advisors on Science and Technology, spoke today in Washington, D.C., on the urgency of implementing the Obama health plan, which is focussed on saving money by denying medical care to people deemed to be in their last weeks of life. Cassel, who was an advisor to Congress on drafting the health legislation, argued that studies by the Robert Wood Johnson Foundation showed that half of the population suffers pain in the last three days of their lives, and that 38% are on ventilators for several days before they die, and that "this is clearly not what people want." Does that mean we should deny ventilators to the sick, or withdraw treatment in favor of pain-killers to anyone in pain?

Cassel answers that question with a chart, with a "quality of death score" on the vertical axis, and the amount of money spent in the last week of life on the horizontal axis; it is a descending graph, showing a score of 7 for no money spent on health at all during the last week of life, falling rapidly to only 5 with $6,000 spent, and falling slowly after that as more money is spent! Cassel concluded: "You can see that people who actually had less money spent on them actually had a higher quality of life over that last week. Spending money is just not the same as getting better care, or better quality of care."

This absurd methodology was dissected by Dr. Ned Rosinsky, M.D., in EIR, July 31, 2009.

Cassel was the founding director of the Robert Wood Johnson Foundation's Center for Clinical Research, among many leading positions at universities and hospitals. She appeared with Daniel Callahan, head of the Hastings Center (which promotes euthanasia), in 2003 for a discussion of "Should Age Count in Allocating Health Care Resources?"

Connecticut, Pennsylvania Still Have No Budget

Aug. 22 (EIRNS)—While most states are busy cutting their own throats with budget cuts and personnel furloughs, two remain with no budgets at all for the fiscal year that began July 1—Connecticut and Pennsylvania.

In Connecticut, Gov. M. Jodi Rell (D) is keeping the state going by executive orders, although this will become more and more difficult going into the Fall. She is insisting on more cuts than the legislature is prepared to give, and opposes tax hikes on the wealthy. The legislature and the governor agree, however, on a $290 million cut in Medicaid, the funds to assist the state's neediest citizens.

In Pennsylvania, there is a stalemate between Gov. Ed Rendell (D) and the Republican-controlled legislature. Besides putting localities, including Philadelphia, into desperate conditions, the lack of a budget means that the state cannot receive $3.8 billion in Federal stimulus money, which is earmarked for education, prisons, and housing programs.

Forthcoming Book: HMO Looting of Health Care

Aug. 23 (EIRNS)—"U.S. health insurance companies have the highest administrative costs in the world," writes T.R. Reid, a former Washington Post reporter, who will publish a book this week on health-care policies around the world. Reid calculates that insurance companies spend "roughly 20 cents of every dollar for non-medical costs, such as paperwork, reviewing claims and marketing." Although other studies show that this figure is 30-32 cents per dollar, Reid's estimate shows the staggering nature of the looting by the HMOs.

Reid writes: "France's health insurance industry covers everybody and spends about 4 percent on administration. Canada's universal insurance system, run by government bureaucrats, spends 6 percent on administration. In Taiwan, a leaner version of the Canadian model has administrative costs of 1.5 percent."

Reid considers Japan to be the "world champion at controlling medical costs. On average, the Japanese go to the doctor 15 times a year, three times the U.S. rate. They have twice as many MRI scans and X-rays. Quality is high; life expectancy and recovery rates for major diseases are better than in the U.S. And yet Japan spends about $3,400 per person annually on health care; the U.S. spends more than $7,000."

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