Thread: Sarah Palin - Obamacare Rationing = "Death Panels"

Sarah Palin

Obamacare Rationing = "Death Panels"

Take a look at this op-ed by a registered nurse discussing the strain Obamacare is putting on medical professionals as they scramble to accommodate an influx of new patients. This is one ingredient in the recipe for disaster that will lead to rationing. As I warned people from the very beginning, the danger of any government controlled or enforced health care law is rationing. Rationing happens when you increase the demand for a limited good or service (in this case health care, which is limited because we have a limited supply of health care professionals) while at the same time artificially capping the price of that good or service for people who would normally have to pay more because of pre-existing conditions. The end result is worse care, rationed care, and ironically more expensive care for everyone as all our premiums go up. Obamacare is unworkable. As we’ve said all along, health care reform needs to be grounded in patient-centered and free market-oriented common sense that allows people to find the care they desire by giving them more options, not fewer.

Here’s the article: http://time.com/88535/obamacares-killer-burden-on-nurses/

Obamacare’s Killer Burden on Nurses

Amy Dertz

12:01 AM ET

Nurse checking patient's pulse in office. Blend Images - Peathegee Inc—Getty Images/Brand X

The Affordable Care Act means more and sicker patients are entering hospitals, and less comprehensive and timely health care.

As the first enrollees in the Affordable Care Act begin seeking care at my hospital, I wonder how my practice as a Registered Nurse will change. We’re told the goal of the new law is to remodel healthcare in the United States into a system that promotes wellness and prevention, rather than just providing care to sick people. This seems like a great objective, but I worry that the switch may compromise the quality of the care our patients receive.
As a bedside RN working at an acute care hospital in Oakland, California, I care for an incredibly diverse patient population. Most of my patients have had health insurance through employer-based programs, private purchase, or Medi-Cal. Most have interacted with the health care system prior to being admitted to my hospital.
Now, I will take care of patients who are new to health care. Some haven’t had care in a long time (or ever). Some may have pre-existing conditions that enabled insurance companies to refuse them coverage. As they enter my care, their needs may be more complicated.
Last year, I cared for a patient who—like many patients covered through the ACA—hadn’t been to the doctor in years. She didn’t seek care until she was quite debilitated by Type 2 Diabetes.
My experience caring for this woman exemplifies the stress that patients who have never had health care may put on my hospital and nurse colleagues. This woman never had an IV in her arm nor had she ever stayed overnight in a hospital. Now, she was told that when she went home, she’d need to check her blood sugar with a glucometer four times a day and inject herself with insulin. I spent a lot of time with her, explaining things to ease her anxiety.
During that shift, one of my other patients said, “You must be busy. I haven’t seen you all night.” My heart sank. He was fine physically, but I could tell he needed someone to talk to for a few minutes. Unfortunately, I had to get back to my diabetic patient. Preventing her blood sugar from dropping took priority over spending time with my lonely patient. Unfortunately, there were no extra nurses to care for my other patients.
In fact, executives at my hospital recently proposed reducing our inpatient nursing staff. They note that the number of patients admitted for overnight stays has decreased in the last few years. They say medical and surgical care has improved, and better primary care has kept patients healthy enough to avoid hospital admissions. The ACA permits hospitals to continue shifting patient care from the expensive inpatient setting to the cheaper—and more profitable—outpatient setting.
The problem with that diagnosis? My patients are not healthier. With the ACA, there are more patients entering hospital infrastructures that have been diminished. Patients visit the emergency room and wait longer before being admitted. When they do get admitted, rather than being sent home and told to follow up with their primary care physician, they are often much sicker and require more care.
This new burden is falling heavy on the hospitals and staff. Nurses are working harder than ever with fewer resources.
It’s a killer combination: hospitals delaying and denying care to patients as the ACA enables more Americans to buy into this deeply flawed system. If the ACA is successful in contributing to keeping patients out of the hospital, inpatient care will be reserved for patients with acute, severe illnesses and the number of hospital nurses will drop dramatically. Meanwhile, other patients will be managed in the outpatient setting and more nurses will move into home health and advice nursing.
But it’s unrealistic to assume all the care I give my patients in the hospital can be done at home by family members, friends and the occasional visit by a home health nurse. In a hospital, patients benefit from a huge team of health care practitioners.
Consider my new diabetic patient. She benefitted from the ongoing support of nurses to teach her about diabetes, visits from the dietitian to help with her menu planning, and the assistance of a social worker who helped her identify additional resources. Her doctor monitored her blood sugar to see how she responded to the treatment. When, after a few days in the hospital, she checked her sugar, determined her insulin dose, drew it up and administered it to herself, I had tears in my eyes. She deserved that care and I was proud she got it. While I hope the ACA will get care to millions of other Americans, I worry that it may make it harder for people to get comprehensive, timely care from trained and compassionate health care practitioners, including nurses like me.

Amy Dertz is a Registered Nurse and has worked at Kaiser Permanente Hospital in Oakland on the Adult Medical/Surgical/Oncology Unit since graduating from California State University, East Bay in 2007. She lives in Richmond, California. This piece originally appeared at Zocalo Public Square.

http://time.com/88535/obamacares-kil...den-on-nurses/

bttt

The lying and dying at the VA



By: Betsy McCaughey
5/7/2014 08:39 AM

The nation was shocked by charges that more than 1,400 vets lingered and 40 died on a secret waiting list at the Phoenix VA medical center. The list was concocted to conceal long waits for care. But what you haven’t heard is even worse. VA hospitals all over the country are manipulating the official electronic waiting list, and the deadly cover-ups have been going on for years.
The dirty tricks at the Phoenix VA came to light on April 24, when retired VA physician Samuel Foote exposed how the hospital evaded legal requirements that patients be seen promptly. But since the 1990s, Congress has known about vets at many VA facilities waiting hundreds of days for care and sometimes dying in line.
In 1996, Congress passed a law requiring that any vet needing care be seen within 30 days. The General Accountability Office, a research service for Congress, reported in 2000 and again in 2001 that excessive waiting was still a problem. In 2007 and again in 2012, the VA’s own inspector general reported that VA schedulers routinely cheated to hide long waits.
The abuse was vividly documented in a hearing before the House Committee on Veterans’ Affairs on March 14, 2013, more than a year before the Phoenix scandal broke. Debra A. Draper, director of health care for the GAO, told Congress that her agency had visited four VA medical sites and found that more than half the schedulers were manipulating the system to conceal how long vets have to wait to see a doctor. Roscoe Butler, an American Legion investigator, described seeing similar tricks. When asked whether the VA can correct the problem, Draper was skeptical.
More investigations and congressional hearings will not fix the problem. The top three administrators at the Phoenix VA have been put on administrative leave. But only punishing them is like putting a Band-Aid on a gaping wound. Veterans’ demand for medical care exceeds the VA’s capacity. Again and again, VA bureaucrats have responded to this problem by lying, gaming the electronic monitoring system and making false promises to congressional committees.
All the while vets are suffering needlessly. On Jan. 30, it was disclosed that at least 19 veterans at VA facilities in Columbia, South Carolina, and Augusta, Georgia, died in 2010 and 2011 because they were forced to wait too long for colonoscopies and endoscopies that could have diagnosed their cancers while still treatable
The practical answer is to provide vouchers or health plans for vets who need colonoscopies, heart care, diabetes management and treatment for other non-combat-related conditions so they can escape the watlists and use civilian doctors and hospitals. A bipartisan proposal offered by Congressman Peter King, R-New York, and Steve Israel, D-New York, urges that vets needing mental health care be referred to civilian caregivers. Every day, 22 veterans kill themselves, many before they manage to get any help from the VA.
VA Secretary Eric Shinseki offers assurance that his department will solve these problems. Don’t believe him. Look at the VA’s recent announcement about another long watlist, this one for disability claims. Following President Barack Obama’s 2014 State of the Union pledge that “slashing the backlog” was a top priority, the VA announced on March 31 that it had cut the disability claims backlog by 44 percent, from 600,000 to 400,000. What the VA didn’t admit is that many of those applications were simply denied and moved into the appeals pile, according to outraged vets. Don’t count on more truthfulness when it comes to medical wait times.
Residents of Canada and the United Kingdom are all too familiar with long waits for medical care in a government-run system. Their governments publish yearly reports on how long they have to wait to see a doctor, and politicians run for cover when waits grow longer. But in the U.S., most Americans who can’t get a timely appointment with one doctor or hospital have the freedom to call another. Sadly, veterans are captives of the VA system, enduring the shortcomings of a single-payer system. It’s time to give our vets other options.

Betsy McCaughey is a former lieutenant governor of New York and the author of “Beating Obamacare.”


http://www.humanevents.com/2014/05/0...ing-at-the-va/