Take a seat on a ‘death panel.’ Here’s your first case

There were — and are — no “death panels” in President Obama’s health-insurance reform legislation. No panel of federal bureaucrats is going to sit down and decide whether Trig, Sarah Palin’s son, deserves to live or die because he has Down’s Syndrome, as his mother once suggested.

In fact, that whole false “death panel” controversy illustrates the intellectual bankruptcy of much of this country’s political debate as well as our inability to deal with complex moral and financial issues.

Consider the example of Provenge.

Provenge is a cancer vaccine, a very expensive cancer vaccine. It has been approved by the FDA for treatment of patients with advanced stages of prostate cancer. It is expensive in part because it cannot be mass produced — each dose is prepared individually, using a patient’s own immune cells.

Provenge does not cure prostate cancer. In trials, it succeeded in extending the lifespan of those with advanced prostate cancer by an average of 4.1 months. The treatment costs $93,000 per patient.

As The Washington Post points out in a story on Provenge and its implications, most men with advanced prostate cancer tend to be older, meaning that in most cases, Medicare would pick up the cost of the drug.

Should your government cover that cost? Do you believe that to be an acceptable use of taxpayers’ money? Other drugs are expected to come on line that raise similar issues, compounding Medicare’s already dire financial challenges.

If $93,000 is an acceptable price for buying four months of life, would $193,000 also be acceptable? How about $293,000?

And understand, of course, that the point at which you say no, it is not worth it, becomes the point at which you are rationing health care.

Would you be willing to deny a patient access to Provenge?

Would you be willing to deny your own father access to Provenge?

How would a compassionate society handle such an issue?

How would a fiscally prudent society handle such an issue?

I’ll be curious to see how this debate goes.

300 comments Add your comment

Scout

November 9th, 2010
1:20 pm

Jay:

The “death panel” met last Tuesday.

JDW

November 9th, 2010
1:21 pm

I would say this is one Medicare should not cover. It is not a cure and at $93K doesn’t make much sense for 4 months. Now if there are some number of patients that have used the drug and been cured that would be a different discussion.

Bosch

November 9th, 2010
1:22 pm

Well, if it only extends your life for 4.1 months, then it doesn’t seem like such a good “vaccine” to me — if it can be considered a vaccine at all.

Mr_B

November 9th, 2010
1:26 pm

I’d really be curious to see how many private insurers would cover the cost of this stuff.

Jay

November 9th, 2010
1:29 pm

Mr. B, as the Post story points out, private insurers generally match Medicare’s coverage decisions.

Scout

November 9th, 2010
1:29 pm

Jay:

Can you please tell us (just an average will be fine) how much of our tax money the government gives to defense attorneys to help them keep the most sadistic child murderers from getting the “bye bye juice” ?

When medical care for an individual (who wants it) goes over that figure then I’ll consider whether or not I think that is too much.

Ragnar Danneskjöld

November 9th, 2010
1:29 pm

Government subsidies drive all prices higher. In a rational world, Medicare/Medicaid would not pay for any drugs or any other bills. If one starts with an assumption that other taxpayers ought to be mugged to pay medical bills or housing bills or cable television bills for others, then that personal subsidy ought to have a daily maximum limit, then to allow anyone to pay as much (more on his selected bills) as he wishes.

Mr_B

November 9th, 2010
1:29 pm

One way to answer the question: Ask, say 1,000 men picked from a random, healthy population wheter they would spend 93K out of the money they could leave their wife and kids for 4.3 months of fairly miserable life. Dying of prostrate cancer isn’t pretty.

Jay

November 9th, 2010
1:31 pm

So we can list Ragnar as a health care rationer.

Jefferson

November 9th, 2010
1:31 pm

The drug is too damn high, thats the problem.

Road Scholar

November 9th, 2010
1:32 pm

At what level does it extend your life? Can you enjoy life, or is it filled with restrictions?

Oh, and Scout, you are soooooo compassionate!

Jay

November 9th, 2010
1:32 pm

Sorry Scout.

Life doesn’t work like that. Afraid to address the question?

Scout

November 9th, 2010
1:34 pm

Enter your comments here

Ragnar Danneskjöld

November 9th, 2010
1:35 pm

Dear Jay, curious that you deny the intellectual foundation of Sarah Palin’s alleged “death panels.” Your essay here is a perfect example of the life and death decisions that ObamaCare (and similar leftist nationalization schemes) removes from individuals and places with government bureaucrats. Of course, those more-leftist schemes generally prohibit individual practitioners from agreeing to provide services independent of the government payment schemes. Thus ObamaCare differs from British health care in that – in your hypothetical – British healthcare would prohibit any from purchasing the product, whereas ObamaCare would allow men under age 65 to purchase the product that Medicare would deny to men over 65.

Jackie

November 9th, 2010
1:36 pm

The situation presents a mighty dilemma; should we disregarded a promising cure for cancer that has only proven to be effective in extending the patient’s life by a little more than 4 months, or, should we continue to spend money on this experiment, knowing we are in the early stages of development and other procedures will be developed to enhance the effectiveness of the drug and reduce the cost?

Spend large amounts of money up-front with the thought in mind far less will be spent in the future for an effective treatment.

Redneck Convert (R---and proud of it)

November 9th, 2010
1:36 pm

Well, it depends. On whether I’m the one with this advanced prostrate cancer. If so, I say 93,000 bucks is a bargain. But if it’s some old fa_t that just lays around all day and collects guvmint checks, I say spend 30 bucks to give him the same stuff we execute murderers with. We got to be smart about how we spend tax money.

Anyhow, I’m sorry Bookman brought this healthcare mess up. Now I’m thinking of my buddy, poor Joe Bill that fell off of his roof and had to spend around 20 days in the hospitle and another 30 days in rehab. They keep coming after him to pay the bill. Which is mighty close to 200,000 bucks. Joe Bill, see, don’t have no insurance. Don’t beleive in it. He says he’s got as much right as some illegal to stick the taxpayers and the Drs. and hospitles with the bill, but they don’t listen. Anyhow, it looks like he’ll need to go bankrupt just to stick it to them. It ain’t right.

Anyways, if they need somebody to serve on one of the Death Panels, just write me a note up at Simpsons Trailer Park just north of Cumming. I’ll be firm but fair. We don’t need no bleeding hearts when it comes to deciding which people live and which ones die. It’s in the Lord’s hands, but some of us can help Him out a bit.

Have a good p.m. everybody.

Jay

November 9th, 2010
1:36 pm

Well, Road Scholar, maybe it’s just a partial answer, but if I’m reading the literature correctly, treatment begins only after medical or surgical castration.

Scout

November 9th, 2010
1:36 pm

Road Scholar :

More compassionate than the child murderers.

Ragnar Danneskjöld

November 9th, 2010
1:36 pm

Dear Jay @ 1:31, as with all in life, I allow the price mechanism to ration products, rather than yield to the biases of the overlords.

Union

November 9th, 2010
1:37 pm

@ jay.. hope the family is doing well..

if this question were posed in the uk.. the answer would be – the treatment would not be paid for and i seem to recall how much we liked their plan.

Normal

November 9th, 2010
1:38 pm

As one who has had and beaten Prostate Cancer, I’m not sure I’d want to live four more months with the desease in its advanced state. There is no “quality of life” there. All you are doing is taking pain killers for four more months. No thanks.

Jay

November 9th, 2010
1:39 pm

Well Ragnar, in your world this treatment option wouldn’t exist at all, then. Its creators spent more than a billion dollars bringing it to market, an investment that makes sense ONLY with the expectation that Medicare would cover it for the mass market.

The research investment would never have been made in the first place if the company expected the drug to be used only by millionaires.

TaxPayer

November 9th, 2010
1:39 pm

You certainly opened up a can-o-worms, didn’t ya. My wife and I have actually talked on many occassions about such issues and we both agree that such treatments need to stay in the trial stages and be, at best, jointly funded by the taxpayer and private industry and only then if there is something to indicate that such trials have potential to lead to a true value-added treatment — not something that extends life by a few months. Then again, if an individual has non-taxpayer funding available and is willing to spend said money for a few minutes more, then they should certainly have that opportunity. There are just so many caveats to such an issue.

Jay

November 9th, 2010
1:40 pm

So Union, you think we should pay that price? Is that what I’m hearing?

Southern Comfort

November 9th, 2010
1:40 pm

I don’t know anyone personally who’s been diagnosed with prostate cancer, so I have no idea of how much suffering goes on.

$93,000 for 4 months averages out to around $1.85 a minute. It doesn’t sound like much when expressed like that. If I were making a decision for myself, I would not spend that much money for only 4 more months. If it were a cure, then things would be different. I think that’s a decision that should be left up to the individual. I have no problem helping pay for it if they want to prolong their life. Some people are simply afraid of death and will do whatever it takes to avoid it.

Jefferson

November 9th, 2010
1:41 pm

A billion to bring it to market. How much gov’t subsidy was involved, overpaid researchers? In the end, if they spent their own money and that is the price, the answer is hell no.

Nice Guy

November 9th, 2010
1:42 pm

Jay – “The investment would never have been made in the first place if the company expected to be used only by millionaires.”

Now how in the world do you know that? Link please. Or are you just assuming, which, by the way, is a big no-no with you loyal followers.

Nice Guy

November 9th, 2010
1:44 pm

Jay – “Would you be willing to deny your own father access to Provenge?”

This is a personal question, and of course for everyone on here, the answer would be a big “hell no I wouldn’t deny that to my dad.” But the problem is, you see, is if the guvment intervenes, the personability factor flies right out the window.

Bubba Bob

November 9th, 2010
1:45 pm

Very tough one Jay. Everything in me wants to say pay it but $93K for 4 months doesn’t seem very wise.

One question, is the price of this drug higher because of Canadian and European price controls on drugs? That’s one thing we need to stop. We absorb all the costs here to develop the drugs and they use them much more cheaply.

Ragnar Danneskjöld

November 9th, 2010
1:45 pm

Dear Jay @ 1:30, I think you err in your confusion of cost and price (unless you are asserting in this particular case that Provenge is a government-developed product – I don’t hink you are suggesting something like that.)

The makers of Provenge set their price according to what they think they can get. They will independently use the lobby mechanism to attempt to coerce taxpayers into subsidizing the Provenge-manufacturer’s shareholder’s wealth.

The costs the company used to develop Provenge are sunk, and the company will now sell for any amount they can get.

If drug companies come to believe they can compel taxpayers to so-subsidize their development costs, surely they will develop more drugs than that for which there is a natural market.

jm

November 9th, 2010
1:45 pm

I wouldn’t prohibit the use of Provenge. BECAUSE I would replace Medicare recipients with Medicaid / the Insurance Exchanges.

Medicaid for those that are destitute and cannot afford basic healthcare. The Exchanges for everyone that can and wants to buy their own healthcare supplemental.

There. Fixed.

Lonesome Rhodes

November 9th, 2010
1:45 pm

Put me down, not as a rationer, but as a redirector of the funds.

Prostate cancer is, generally speaking, a slow-growing cancer. I am aware of one case where a man had it, and his doctor advised him not to treat it – he was almost certain to die of something else before the cancer became an issue. He did.

Aggregate public health would be better if we spent that $93,000 on early detection and treatment. In the ideal outcome, no man would ever need Provenge, because no prostate cancer ever went untreated to the point where Provenge became necessary.

Scout

November 9th, 2010
1:45 pm

Jay:

I did answer it. Pay it until it goes over the figure for a death penalty case and then we’ll talk.

Afraid to provide the figures ?

Wikianswers :

“At one time someone calculated that with all the appeals, it cost about 12 million dollars to put a person to death in a particular state.”

“Average cost in both Texas and Florida is 2.3 million. This, however includes the multiple appeals, the average 6 year incarceration of the prisoner before appeals are exhausted … ”

“You won’t believe this, but the death penalty actually costs more than sentencing one to life in prison It costs about $3 million to execute one and $1.1 million to keep one in prison for life.”

JohnnyReb

November 9th, 2010
1:45 pm

The cost versus results does not justify taxpayers/Medicare/Medicaid paying for the drug. A tough but not even close call.

Paul

November 9th, 2010
1:45 pm

Tough, tough question with serious implications.

I’ll say right off the bat (at least as I see it) there are going to be inconsistencies and a degree of arbitrariness for anyone who wants to take a serious stab at this.

I read once that the bulk of health care expenditures (and I think this is another of those ‘fun with numbers’ things) comes during the last six months of life, where heroic and costly efforts are expended. If that’s the case, then we’re long past due for a discussion about how much we expect to pay for someone else to live a few more months.

I think that was the same report that said most people say “I wouldn’t want to hang on, just let me get on with things” but when the time actually came, they went for each and every procedure that might provide a few more days’ life.

Hey, just found a study that says about the same:

“Total health care costs in the United States (U.S.) reached $989 billion in 1995 and now exceed $1 trillion, 14% of the Gross Domestic Product (GDP) (1). Of this total, a disproportionate share is attributable to the care of elderly patients shortly before their deaths. According to Lubitz and Prihoda (2) and Lubitz and Riley (3), 6% of Medicare recipients 65 yr of age and older who died in 1978 and 1988 accounted for 28% of all costs of the Medicare program. In the same two years, 77% of the Medicare decedents’ expenditures occurred in the last year of life, 52% of them in the last 2 mo, and 40% in the last month. Inpatient expenses accounted for over 70% of the decedents’ total costs. ”

http://ajrccm.atsjournals.org/cgi/content/full/165/6/750

I guess I’ll have to say some arbitrary number needs to be selected – say, one year, time enough for one to get one’s affairs in order and say ’see you later’ – in cases where it’s absolutely certain no cure or longer life is possible. We’ve built our criminal justice system around the premise it’s okay to spend scads of dollars and let some guilty go free rather than to convict (and possibly put to death) an innocent person. Same principle here.

Granny Godzilla

November 9th, 2010
1:46 pm

Wonder what the co-pay on that puppy is?

The last 4.1 months of any cancer death can get real ugly, real fast for the ill loved one. Why prolong the inevitable? Why not a more dignified passing?

I say nay.

jm

November 9th, 2010
1:46 pm

Ragnar 1:45 – since probably 99% of the customers will be under Medicare, technically the price is limitless. Which is why Medicare costs are so out of whack. There’s no market.

We have to put the seniors in the Exchanges. And also fix how the exchanges work (when they exist). A national insurance charter as suggested in the WSJ is also a good idea.

Jay

November 9th, 2010
1:47 pm

Simple math and economics, Nice Guy.

It costs $93,000 ONLY if the company can sell it to a lot of people through Medicare. The cost would be a whole lot higher if your market was limited to those who could afford to pay for it themselves.

In fact, it would be impossible to recoup a billion-dollar investment from such a limited market.

Nice Guy

November 9th, 2010
1:47 pm

Jay – the last two questions you pose above include the word ’society.’ When the time comes for guvment rationing decisions to be made, all of us will only be numbers. Society will play no part in the decision making process. And when the numbers become too big, well, then you get right back to where we are now with Obama’s spending, do we cut spending or raise taxes? Hmmmmm.

Jackie

November 9th, 2010
1:47 pm

Research shows the US governments contributes roughly 70% of the R&D for drug makers. They drug makers, in turn, spend twice as much on lobbying than it does on R&D costs while the citizens of the USA pay more for their drugs than any other citizen in the world.

http://projects.publicintegrity.org/rx//report.aspx?aid=723

jm

November 9th, 2010
1:48 pm

Jay 1:47 – I agree. This product would not exist but for Medicare. Medicare must stop and be drastically reformed.

Which is impossible since Seniors are terrified, irrational, and vote a lot.

Nice Guy

November 9th, 2010
1:49 pm

Jay – “In fact, it would be impossible to recoup a billion-dollar investment from such a limited market.”

Excuse me? I appreciate your quick little lesson on ‘econ and math’ but you can’t tell me that the investment would not be recouped if only offered to the wealth, all over the world.

Scout

November 9th, 2010
1:50 pm

I had major shoulder surgery 20 years ago (with a 3 day hospital stay) and it was $22,000. The operating room cost alone was $5,000.

Nothing to see here folks. Keep moving.

jm

November 9th, 2010
1:50 pm

Jackie 1:47 – “pay more” and we get the R&D jobs and corporate profits in return.

In the absence of reform of Medicare, I do think Medicare should be able to negotiate prices. It will be an iron hammer on the drug industry and probably lead to them relocating elsewhere. But the current system is whack.

jm

November 9th, 2010
1:51 pm

Jay 1:49 – I don’t think the question is as simple as that. All systems involve rationing. But some are more intelligent and better support the personal freedom of choice than others.

Scout

November 9th, 2010
1:52 pm

Granny Godzilla :

Remind me when it’s your time.

jm

November 9th, 2010
1:53 pm

Um, weird. Where did Jay’s 1:49 comment go? “simple question, to ration or not to ration?” I think….

ByteMe

November 9th, 2010
1:53 pm

This is not a “life or death” decision… it’s a “death now or death now + 4 months” decision.

My call: Spend $10K on family death/grief counseling and tell the pharma company to pound sand.

On the other hand, we are a corporatocracy, so I expect Medicare will cover it at the demand of certain powerful House/Senate members who are/will be in charge of Medicare oversight and who are also in the pocket of Big Pharma.

Bosch

November 9th, 2010
1:54 pm

Would you be willing to deny a patient access to Provenge? Yes.

Would you be willing to deny your own father access to Provenge? Yes.

How would a compassionate society handle such an issue?

A compassionate society would understand that people die and accept that and let them die with some dignity instead of giving away bajillions to drug companies for an iffy product that really does nothing to prevent the inevitable.

I think that answers that last question too.

mrs. w

November 9th, 2010
1:55 pm

What is the profit margin for the drug company on this 93,000.00 “vaccine”? If you have ever spent time with someone with any type of terminal cancer you would know that 4 more months is often not a blessing. For once I agree with Granny. No.

Granny Godzilla

November 9th, 2010
1:55 pm

Scout

I won’t have too.

My wishes are clearly steted in a living will and my children all have copies.

You see, I have faith. When the tome comes I’ll be heading to a far, far better place that this.

What about you Scout?

How much extraordinary care to you want to have to be subjected to inorder to keep your human form alive?

Ragnar Danneskjöld

November 9th, 2010
1:56 pm

Dear jm @ 1:46, I’ll sign on to your proposed reform.

TaxPayer

November 9th, 2010
1:56 pm

The Department of Justice alleges that in 2002, Lauren Stevens of Durham, N.C., signed several letters to the Food and Drug Administration denying that her company had promoted its drug for unapproved uses. But Stevens knew that the company had paid numerous physicians to give talks touting unapproved uses of the drug, according to the indictment filed Monday in the U.S. District Court of Maryland.

A spokeswoman for GlaxoSmithKline PLC confirmed Stevens worked as a vice president in the company’s legal department, but has since retired.

Drug companies are prohibited from promoting drugs for uses not approved by the FDA.

That’s one reason to get FDA approval.

jm

November 9th, 2010
1:56 pm

ByteMe – “pound sand” I agree. A government program given away to Seniors should be entitled to cut costs all day if it wants. If you want it, feel free to go buy it yourself.

But its a very bad system. Requires “intelligent” technocrats instead of the personal individual choice we all cherish in America.

Jay

November 9th, 2010
1:57 pm

I surely can, Nice Guy, and I’d wager a significant amount that Dendreon, the company in question, would tell you the same thing.

This is already a hugely expensive niche drug serving a niche market; ensuring that it can be sold only to a tiny subset of that already small niche would make the whole attempt unviable.

Paul

November 9th, 2010
1:57 pm

Scout

Your comment to Granny – just returned a few weeks ago from the funeral of a very close family friend. The ‘kids’ called her ‘aunt.’ She was in her late 80s, still living in her own home. Found out at her passing she’d been diagnosed with cancer two years earlier. Told the person who handled her medical issues to keep it quiet. Didn’t take hardly any treatment for it. Was not at all afraid of passing.

Right up the street from her’s another old family friend. Mid 80s, vigorous, cycles and walks all over town, works spring and fall in the vineyards. Diagnosed with prostate cancer. Refused treatment. His attitude? “I’m pretty old and have had a good life. If it stops at the prostate, no problem. If it continues, no problem.”

Not every elderly person contributes to the high tab.

Bosch

November 9th, 2010
1:57 pm

“If you have ever spent time with someone with any type of terminal cancer you would know that 4 more months is often not a blessing.”

And in most cases, that would be a curse to live that much longer in that much pain.

Nice Guy

November 9th, 2010
1:57 pm

jm – “Um, weird. Where did Jay’s 1:49 comment go? “simple question, to ration or not to ration?” I think….”

I think I saw another one he directed to me…disappear. That is weird.

jm

November 9th, 2010
1:59 pm

Ragnar 1:56 – thanks. 2 down. 299,999,998 more voters to go….

Mick

November 9th, 2010
1:59 pm

**The cost versus results does not justify taxpayers/Medicare/Medicaid paying for the drug. A tough but not even close call.**

Unless of course it happens to be your mom or dad…

Bosch

November 9th, 2010
1:59 pm

Paul,

The folks I know who’ve had prostate cancer tell me the treatment for it is worse than the disease.

Paul

November 9th, 2010
2:00 pm

Bosch

“A compassionate society would understand that people die and accept that and let them die with some dignity instead of giving away bajillions to drug companies for an iffy product that really does nothing to prevent the inevitable.”

Sometimes… I’m so proud of you!

I felt kinda silly. Your response was a great example of analyzing a question from the “money and power” angle, and I didn’t see it coming.

Live and learn -

Nice Guy

November 9th, 2010
2:00 pm

” surely can, Nice Guy, and I’d wager a significant amount that Dendreon, the company in question, would tell you the same thing.”

Sorry, Jay, but you have this one wrong. Perhaps on paper, you can say only this person, this person, and this person can afford and therefore that is your market. I beleive reality is quite a bit different, especially when you look at this on a global basis. Further, this is the very first (early) stage of the drug, as time goes on it will get cheaper for a variety of reasons.

jm

November 9th, 2010
2:01 pm

Nice Guy 1:57 – goblins in the system. Or Jay electing to retract a comment. Which everyone should be able to do without being shot…

Jay

November 9th, 2010
2:01 pm

I pulled my question because I saw that Nice Guy had addressed it in the interim.

TaxPayer

November 9th, 2010
2:02 pm

I think hedge fund managers should be taxed at 90% and all the proceeds put toward healthcare.

Keep up the good fight!

November 9th, 2010
2:02 pm

I agree with Paul that there are nuances and factors to weigh and consider. Straight cost/benefit (if benefit is limited to the one life) and assuming limited funding and the opportunity cost to others than may beneift…if my life were the one being saved..I would say, use it for someone else.

But the point is to assert that there are no life/death decisions being made every day ignores reality and is pure ignorance. I dont want those decisions in the hands of my for-profit insurance….I want it in the hands of doctors, medical personnel, my family and a decision maker that I or my family can address openly and with a right to appeal.

ByteMe

November 9th, 2010
2:02 pm

Unless of course it happens to be your mom or dad…

Wrong. As someone whose Dad died of cancer a couple years ago, I can tell you that I wouldn’t have wanted to extend his pain one second longer… and neither would he.

stands for decibels

November 9th, 2010
2:02 pm

I’m sure there are Medicare-approved treatments with lousier risk-reward ratios than this, but I’m thinking there shouldn’t be. So, no. as one of Jay’s esteemed Death Panelist, I don’t allow Medicare to reimburse this one, not at that price.

(of course the problem is, what price is reasonable. Scout seems to think several million is reasonable. Nobody’s come in with the low end figure… and I’m not gonna go there.)

Paul

November 9th, 2010
2:02 pm

Bosch

“The folks I know who’ve had prostate cancer tell me the treatment for it is worse than the disease.”

My older brother – mid 50s – had surgery for that a few years’ back. He got the diagnosis, dillied and dallied for about 9 months, and the ’slow growing prostate cancer’ had taken off like wildfire. Surgery got it all, but he’s not too happy with his quality of life. I keep telling him “beats the alternative.”

Bosch

November 9th, 2010
2:03 pm

Paul,

“Sometimes… I’m so proud of you!”

YAY!!! :-)

You didn’t know I had it in me, huh?

Jimmy62

November 9th, 2010
2:03 pm

Someone will have to decide if that $93,000 is covered by Medicare or not. The deciders are, literally, a death panel. Doesn’t mean they shouldn’t exist, or that we should allow all procedures to be covered… But it is is a group that will decide whether people with certain conditions can get the procedures they need, or not. And if not, those people with whatever condition will die.

You basically described something that is in fact a death panel, and then said death panels don’t exist. Do you read your own words?

jm

November 9th, 2010
2:03 pm

Jay 2:01 -ah….

JohnnyReb

November 9th, 2010
2:03 pm

Jay, this YouTube video states there are so-called death panels.

http://www.youtube.com/watch?v=8HnkxIh62dQ

Paul

November 9th, 2010
2:04 pm

TaxPayer

“I think hedge fund managers should be taxed at 90% and all the proceeds put toward healthcare.”

And Wall Street execs. If they’re not in prison, it’s the least they can do to pay back society -

BADA BING

November 9th, 2010
2:05 pm

My decision on my father would have a lot to do with what he wanted. If he wanted to die naturally with dignity, I would support him. If he wanted the treatment, I would support that too.

Nice Guy

November 9th, 2010
2:05 pm

Bosch – “YAY!!! You didn’t know I had it in me, huh?”

Gag.

Paul

November 9th, 2010
2:05 pm

Bosch

Yeah, I knew. There are glimmers every so often…

:-)

jm

November 9th, 2010
2:06 pm

2:01 – nifty….

Nice Guy

November 9th, 2010
2:06 pm

Paul – “And Wall Street execs. If they’re not in prison, it’s the least they can do to pay back society -”

There’s your sign (as someone would say).

stands for decibels

November 9th, 2010
2:06 pm

You basically described something that is in fact a death panel, and then said death panels don’t exist. Do you read your own words?

Did you read Sarah’s? This towering intellect (h/t Ragnar) said:

“The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s ‘death panel’ so his bureaucrats can decide, based on a subjective judgment of their ‘level of productivity in society,’ whether they are worthy of health care.”

This implies that the “death panel” would do it on a case-by-base basis, presumably at the expense of Godly white Alaskans, or some foolishness.

Which is not what Jay is proposing as a hypothetical here.

Jay

November 9th, 2010
2:07 pm

Jimmy, current laws and regulations forbid Medicare from taking costs into consideration when deciding whether to cover a drug.

So … no death panels, except for the imaginary panel being conducted here on the blog.

What’s YOUR vote?

(For the record, I would vote not to cover it. I didn’t include that above because I wanted to leave the question open.)

jm

November 9th, 2010
2:07 pm

Scout

November 9th, 2010
2:07 pm

Granny/Paul :

It’s the individuals choice. If they want the treatment they should get it.

There are many reasons to want to live another “four” months – not the least of which is to hold in their arms a first grandchild, etc.

Bosch

November 9th, 2010
2:07 pm

Paul,

My dad had prostate cancer and the treatment for it, and I’d say that most days my dad wishes he were dead — especially now that mom’s gone.

Normal

November 9th, 2010
2:08 pm

Paul @ 1:45,
Well said, but having said that…
When it’s my time to go, I’m going to Tahiti…

Scout

November 9th, 2010
2:08 pm

jm :

Quit it ! Your “killing” me.

Paul

November 9th, 2010
2:09 pm

Jay

For a bit of background on one of the things that set off this whole ‘death panels’ (by the gov’t, not the system we now have with insurance companies) thing, this WSJ article succinctly lays out some background.

“Ezekiel Emanuel, a top health-care adviser to President Barack Obama and older brother of White House Chief of Staff Rahm Emanuel, is emerging as a target of conservatives critical of Democrats’ health-care effort.”

http://online.wsj.com/article/SB125012376373527721.html

jm

November 9th, 2010
2:09 pm

Does anyone else think it is positively silly that Republicans (mainly just Sarah Palin) think it is dumb for government to get smaller by electing what procedures to pay for, and which not to, under a government created program.

Only in the house of mirrors of Palin’s mind is shrinking a government program a bad idea for fiscal conservatives.

I’m picturing the inside of her mind. I think it looks like the Cali-Mex cruise ship engine room, only permanently in its current condition.

jm

November 9th, 2010
2:10 pm

TaxPayer

November 9th, 2010
2:10 pm

If you have no insurance and your joint bank account has $94,000 in it, which represents the total that your surviving family has to live on since your neighbors voted to privatize social security and the market tanked the day after your money went in because hedge fund managers had shorted all your positions and wiped you and most everyone else out in order to pocket a cool $25 billion for themselves, tax free, what would you do — live an extra four months or not.

Bosch

November 9th, 2010
2:11 pm

“(by the gov’t, not the system we now have with insurance companies)”

Paul,

You mean not the insurance death panels we have in place now, right?

:-)

Off to the races…..later folks.

Scout

November 9th, 2010
2:11 pm

BADA BING :

Exactly !

Nothing to see here folks. Keep moving.

Paul

November 9th, 2010
2:11 pm

Nice Guy

So securities dealers lied to investors (such as Bank of America) about the quality of products they were selling, contributing to a financial meltdown that destroyed the financial security of millions of Americans. None at the top were charged, none made any recompense, none even admitted culpability.

And you think that’s fine.

There’s your sign -

stands for decibels

November 9th, 2010
2:12 pm

Take a seat on a ‘death panel.’

Anyone else hoping this was going to be about a new high-speed rail line?

Nice Guy

November 9th, 2010
2:13 pm

Paul – “And you think that’s fine.”

No, that’s not what I think.

So, wrong again.

~~~~~~~~~~~~~~~~~~~~~~~~~~~

C-ya folks….gotta go.

Ragnar Danneskjöld

November 9th, 2010
2:13 pm

Dear “Stands” @ 2:06, “This implies that the “death panel” would do it on a case-by-base basis, presumably at the expense of Godly white Alaskans, or some foolishness. Which is not what Jay is proposing as a hypothetical here.”

Non-rationing rational conservatives do not regard a collectivized death panel as a superior form of death panel to the case-by-case death panel. Thus the genius of the non-judgmental price mechanism.

jm

November 9th, 2010
2:14 pm

Paul – um, careful now. BofA bought Countrywide. Countrywide may have done a lot of bad things, and those guys got in hot water. BofA’s transgressions were pretty minor by comparison. And they bought countrywide AFTER the meltdown to help bail out the system and save it. Same with Merrill.

But since everyone like to throw everyone under the same bus irrespective of the facts…. by all means, go ahead.

Paul

November 9th, 2010
2:15 pm

Nice Guy

Before you go – so, did I misread the intent of your 2:06? What did you mean by it?

Scout

November 9th, 2010
2:16 pm