Weekly Pulse: End-of-Life Counseling Returns, But Death Panels Still Nonsense

by Lindsay Beyerstein, Media Consortium blogger

A proposed program to cover counseling sessions for seniors on end-of-life care has risen from the ashes of health care reform and found a new life in Medicare regulations, Jason Hancock of the American Independent reports.

In August, former Alaska governor Sarah Palin started a rumor via her Facebook page that the the Obama administration was backing “death panels” that would vote on whether the elderly and infirm had a right to live. In reality, the goal was to have Medicare reimburse doctors for teaching patients how to set up their own advance directives that reflect their wishes on end-of-life care.

Patients can use their advance directives to stipulate their wishes for treatment in the event that they are too sick to make decisions for themselves. They can also use those directives to demand the most aggressive lifesaving interventions.

Waste not, want not

Though end-of-life counseling was ultimately gutted from the Affordable Care Act (ACA), the legislation will eventually ensure health coverage for 32 million more Americans. However, Joanne Kenen in The American Prospect argues it will do comparatively less to curb the high costs of health care. The architects of the ACA had an opportunity to include serious cost-containment measures like a robust public health insurance option to compete with private insurers, but they declined to do so.

Kenen argues that the government should more aggressively target waste within the health care delivery system, especially Medicare and Medicaid. Unchecked and rising health care costs through Medicare and Medicaid are a significantly greater driver of the deficit than Social Security or discretionary spending:

“The waste is enormous,” says Harvard health care economist David Cutler. “You can easily convince yourself that there is 40 to 50 percent to be saved.” Squeezing out every single bit of that inefficient or unnecessary care may not be realistic. But it also isn’t necessary; eliminating even a small fraction of the current waste each year over the next decade would make a huge difference, he added. Health care would finally start acting like “a normal industry.” Productivity would grow, in the one area of the economy where it has not, and with productivity gains, prices could be expected to fall.

The new end-of-life counseling program will help reduce waste in the system, not by pressuring people to forgo treatments they want, but by giving them the tools to refuse treatments they don’t want.

Teen births down, but why?

The teen birth rate has dropped again, according to the latest CDC statistics. Births to women under the age of 20 declined by 6% in 2009 compared to 2008. One hypothesis is that the reduction is an unexpected consequence of the recession, an argument we pointed to in last week’s edition of the Pulse. John Tomasic of the Colorado Independent is skeptical of the recession hypothesis. He writes:

Emily Bridges, director of public information services at Advocates for Youth, agrees with other observers in pointing out that teens aren’t likely to include national economics as a significant factor in pondering whether or not to have unprotected sex. Peer pressure, badly mixed booze, general awkwardness, for example, are much more likely than the jobless recovery to play on the minds of horny high schoolers.

Some states with weak economies actually saw a rise in teen birth rates, Tomasic notes. However, this year’s sharp downturn in teen births parallels a drop in fertility for U.S. women of all ages, which seems best explained by economic uncertainty.

It’s true that prospective teen moms are less likely to have jobs in the first place, and so a bad job market might be less likely to sway their decisions. However, young women who aren’t working are unlikely to have significant resources of their own to draw on, which means that they are heavily dependent upon others for support. If their families and partners are already struggling to make ends meet, then the prospect of another mouth to feed may seem even less appealing than usual.

Abortion is the elephant in the room in this discussion. The CDC numbers only count live births. Logically, fewer live births must be the result of fewer conceptions and/or more terminations. Some skeptics doubt that economic factors have much to do with teens’ decisions about contraception. However, it seems plausible that decisions about abortion would be heavily influenced by the economic health of the whole extended family.

Last year’s decrease was notably sharp, but teen birth rates have been declining steadily for the last 20 years. The Guttmacher Institute, a New York-based non-profit that specializes in research on reproductive choice and health, suggests that successive generations of teens are simply getting savvier about contraception. Births to mothers between the ages of 15 and 17 are down 48% from 1991 levels, and births to mothers ages 18 to 19 are down 30%.

Stupid drug dealer tricks

Martha Rosenberg of AlterNet describes 15 classic dirty tricks deployed by Big Pharma to push drugs. These include phony grassroots patient groups organized by the drug companies to lobby for approval of dubious remedies. Another favorite money-making strategy is to overcharge Medicare and Medicaid. Pharmaceutical companies have paid nearly $15 billion in wrongdoing settlements related to Medicare and Medicaid chicanery over the last five years.

This post features links to the best independent, progressive reporting about health care by members of The Media Consortium. It is free to reprint. Visit the Pulse for a complete list of articles on health care reform, or follow us on Twitter. And for the best progressive reporting on critical economy, environment, health care and immigration issues, check out The Audit, The Mulch, and The Diaspora. This is a project of The Media Consortium, a network of leading independent media outlets.

Weekly Pulse: End-of-Life Counseling Returns, But Death Panels Still Nonsense

by Lindsay Beyerstein, Media Consortium blogger

A proposed program to cover counseling sessions for seniors on end-of-life care has risen from the ashes of health care reform and found a new life in Medicare regulations, Jason Hancock of the American Independent reports.

In August, former Alaska governor Sarah Palin started a rumor via her Facebook page that the the Obama administration was backing “death panels” that would vote on whether the elderly and infirm had a right to live. In reality, the goal was to have Medicare reimburse doctors for teaching patients how to set up their own advance directives that reflect their wishes on end-of-life care.

Patients can use their advance directives to stipulate their wishes for treatment in the event that they are too sick to make decisions for themselves. They can also use those directives to demand the most aggressive lifesaving interventions.

Waste not, want not

Though end-of-life counseling was ultimately gutted from the Affordable Care Act (ACA), the legislation will eventually ensure health coverage for 32 million more Americans. However, Joanne Kenen in The American Prospect argues it will do comparatively less to curb the high costs of health care. The architects of the ACA had an opportunity to include serious cost-containment measures like a robust public health insurance option to compete with private insurers, but they declined to do so.

Kenen argues that the government should more aggressively target waste within the health care delivery system, especially Medicare and Medicaid. Unchecked and rising health care costs through Medicare and Medicaid are a significantly greater driver of the deficit than Social Security or discretionary spending:

“The waste is enormous,” says Harvard health care economist David Cutler. “You can easily convince yourself that there is 40 to 50 percent to be saved.” Squeezing out every single bit of that inefficient or unnecessary care may not be realistic. But it also isn’t necessary; eliminating even a small fraction of the current waste each year over the next decade would make a huge difference, he added. Health care would finally start acting like “a normal industry.” Productivity would grow, in the one area of the economy where it has not, and with productivity gains, prices could be expected to fall.

The new end-of-life counseling program will help reduce waste in the system, not by pressuring people to forgo treatments they want, but by giving them the tools to refuse treatments they don’t want.

Teen births down, but why?

The teen birth rate has dropped again, according to the latest CDC statistics. Births to women under the age of 20 declined by 6% in 2009 compared to 2008. One hypothesis is that the reduction is an unexpected consequence of the recession, an argument we pointed to in last week’s edition of the Pulse. John Tomasic of the Colorado Independent is skeptical of the recession hypothesis. He writes:

Emily Bridges, director of public information services at Advocates for Youth, agrees with other observers in pointing out that teens aren’t likely to include national economics as a significant factor in pondering whether or not to have unprotected sex. Peer pressure, badly mixed booze, general awkwardness, for example, are much more likely than the jobless recovery to play on the minds of horny high schoolers.

Some states with weak economies actually saw a rise in teen birth rates, Tomasic notes. However, this year’s sharp downturn in teen births parallels a drop in fertility for U.S. women of all ages, which seems best explained by economic uncertainty.

It’s true that prospective teen moms are less likely to have jobs in the first place, and so a bad job market might be less likely to sway their decisions. However, young women who aren’t working are unlikely to have significant resources of their own to draw on, which means that they are heavily dependent upon others for support. If their families and partners are already struggling to make ends meet, then the prospect of another mouth to feed may seem even less appealing than usual.

Abortion is the elephant in the room in this discussion. The CDC numbers only count live births. Logically, fewer live births must be the result of fewer conceptions and/or more terminations. Some skeptics doubt that economic factors have much to do with teens’ decisions about contraception. However, it seems plausible that decisions about abortion would be heavily influenced by the economic health of the whole extended family.

Last year’s decrease was notably sharp, but teen birth rates have been declining steadily for the last 20 years. The Guttmacher Institute, a New York-based non-profit that specializes in research on reproductive choice and health, suggests that successive generations of teens are simply getting savvier about contraception. Births to mothers between the ages of 15 and 17 are down 48% from 1991 levels, and births to mothers ages 18 to 19 are down 30%.

Stupid drug dealer tricks

Martha Rosenberg of AlterNet describes 15 classic dirty tricks deployed by Big Pharma to push drugs. These include phony grassroots patient groups organized by the drug companies to lobby for approval of dubious remedies. Another favorite money-making strategy is to overcharge Medicare and Medicaid. Pharmaceutical companies have paid nearly $15 billion in wrongdoing settlements related to Medicare and Medicaid chicanery over the last five years.

This post features links to the best independent, progressive reporting about health care by members of The Media Consortium. It is free to reprint. Visit the Pulse for a complete list of articles on health care reform, or follow us on Twitter. And for the best progressive reporting on critical economy, environment, health care and immigration issues, check out The Audit, The Mulch, and The Diaspora. This is a project of The Media Consortium, a network of leading independent media outlets.

Weekly Pulse: End-of-Life Counseling Returns, But Death Panels Still Nonsense

by Lindsay Beyerstein, Media Consortium blogger

A proposed program to cover counseling sessions for seniors on end-of-life care has risen from the ashes of health care reform and found a new life in Medicare regulations, Jason Hancock of the American Independent reports.

In August, former Alaska governor Sarah Palin started a rumor via her Facebook page that the the Obama administration was backing “death panels” that would vote on whether the elderly and infirm had a right to live. In reality, the goal was to have Medicare reimburse doctors for teaching patients how to set up their own advance directives that reflect their wishes on end-of-life care.

Patients can use their advance directives to stipulate their wishes for treatment in the event that they are too sick to make decisions for themselves. They can also use those directives to demand the most aggressive lifesaving interventions.

Waste not, want not

Though end-of-life counseling was ultimately gutted from the Affordable Care Act (ACA), the legislation will eventually ensure health coverage for 32 million more Americans. However, Joanne Kenen in The American Prospect argues it will do comparatively less to curb the high costs of health care. The architects of the ACA had an opportunity to include serious cost-containment measures like a robust public health insurance option to compete with private insurers, but they declined to do so.

Kenen argues that the government should more aggressively target waste within the health care delivery system, especially Medicare and Medicaid. Unchecked and rising health care costs through Medicare and Medicaid are a significantly greater driver of the deficit than Social Security or discretionary spending:

“The waste is enormous,” says Harvard health care economist David Cutler. “You can easily convince yourself that there is 40 to 50 percent to be saved.” Squeezing out every single bit of that inefficient or unnecessary care may not be realistic. But it also isn’t necessary; eliminating even a small fraction of the current waste each year over the next decade would make a huge difference, he added. Health care would finally start acting like “a normal industry.” Productivity would grow, in the one area of the economy where it has not, and with productivity gains, prices could be expected to fall.

The new end-of-life counseling program will help reduce waste in the system, not by pressuring people to forgo treatments they want, but by giving them the tools to refuse treatments they don’t want.

Teen births down, but why?

The teen birth rate has dropped again, according to the latest CDC statistics. Births to women under the age of 20 declined by 6% in 2009 compared to 2008. One hypothesis is that the reduction is an unexpected consequence of the recession, an argument we pointed to in last week’s edition of the Pulse. John Tomasic of the Colorado Independent is skeptical of the recession hypothesis. He writes:

Emily Bridges, director of public information services at Advocates for Youth, agrees with other observers in pointing out that teens aren’t likely to include national economics as a significant factor in pondering whether or not to have unprotected sex. Peer pressure, badly mixed booze, general awkwardness, for example, are much more likely than the jobless recovery to play on the minds of horny high schoolers.

Some states with weak economies actually saw a rise in teen birth rates, Tomasic notes. However, this year’s sharp downturn in teen births parallels a drop in fertility for U.S. women of all ages, which seems best explained by economic uncertainty.

It’s true that prospective teen moms are less likely to have jobs in the first place, and so a bad job market might be less likely to sway their decisions. However, young women who aren’t working are unlikely to have significant resources of their own to draw on, which means that they are heavily dependent upon others for support. If their families and partners are already struggling to make ends meet, then the prospect of another mouth to feed may seem even less appealing than usual.

Abortion is the elephant in the room in this discussion. The CDC numbers only count live births. Logically, fewer live births must be the result of fewer conceptions and/or more terminations. Some skeptics doubt that economic factors have much to do with teens’ decisions about contraception. However, it seems plausible that decisions about abortion would be heavily influenced by the economic health of the whole extended family.

Last year’s decrease was notably sharp, but teen birth rates have been declining steadily for the last 20 years. The Guttmacher Institute, a New York-based non-profit that specializes in research on reproductive choice and health, suggests that successive generations of teens are simply getting savvier about contraception. Births to mothers between the ages of 15 and 17 are down 48% from 1991 levels, and births to mothers ages 18 to 19 are down 30%.

Stupid drug dealer tricks

Martha Rosenberg of AlterNet describes 15 classic dirty tricks deployed by Big Pharma to push drugs. These include phony grassroots patient groups organized by the drug companies to lobby for approval of dubious remedies. Another favorite money-making strategy is to overcharge Medicare and Medicaid. Pharmaceutical companies have paid nearly $15 billion in wrongdoing settlements related to Medicare and Medicaid chicanery over the last five years.

This post features links to the best independent, progressive reporting about health care by members of The Media Consortium. It is free to reprint. Visit the Pulse for a complete list of articles on health care reform, or follow us on Twitter. And for the best progressive reporting on critical economy, environment, health care and immigration issues, check out The Audit, The Mulch, and The Diaspora. This is a project of The Media Consortium, a network of leading independent media outlets.

Weekly Pulse: End-of-Life Counseling Returns, But Death Panels Still Nonsense

by Lindsay Beyerstein, Media Consortium blogger

A proposed program to cover counseling sessions for seniors on end-of-life care has risen from the ashes of health care reform and found a new life in Medicare regulations, Jason Hancock of the American Independent reports.

In August, former Alaska governor Sarah Palin started a rumor via her Facebook page that the the Obama administration was backing “death panels” that would vote on whether the elderly and infirm had a right to live. In reality, the goal was to have Medicare reimburse doctors for teaching patients how to set up their own advance directives that reflect their wishes on end-of-life care.

Patients can use their advance directives to stipulate their wishes for treatment in the event that they are too sick to make decisions for themselves. They can also use those directives to demand the most aggressive lifesaving interventions.

Waste not, want not

Though end-of-life counseling was ultimately gutted from the Affordable Care Act (ACA), the legislation will eventually ensure health coverage for 32 million more Americans. However, Joanne Kenen in The American Prospect argues it will do comparatively less to curb the high costs of health care. The architects of the ACA had an opportunity to include serious cost-containment measures like a robust public health insurance option to compete with private insurers, but they declined to do so.

Kenen argues that the government should more aggressively target waste within the health care delivery system, especially Medicare and Medicaid. Unchecked and rising health care costs through Medicare and Medicaid are a significantly greater driver of the deficit than Social Security or discretionary spending:

“The waste is enormous,” says Harvard health care economist David Cutler. “You can easily convince yourself that there is 40 to 50 percent to be saved.” Squeezing out every single bit of that inefficient or unnecessary care may not be realistic. But it also isn’t necessary; eliminating even a small fraction of the current waste each year over the next decade would make a huge difference, he added. Health care would finally start acting like “a normal industry.” Productivity would grow, in the one area of the economy where it has not, and with productivity gains, prices could be expected to fall.

The new end-of-life counseling program will help reduce waste in the system, not by pressuring people to forgo treatments they want, but by giving them the tools to refuse treatments they don’t want.

Teen births down, but why?

The teen birth rate has dropped again, according to the latest CDC statistics. Births to women under the age of 20 declined by 6% in 2009 compared to 2008. One hypothesis is that the reduction is an unexpected consequence of the recession, an argument we pointed to in last week’s edition of the Pulse. John Tomasic of the Colorado Independent is skeptical of the recession hypothesis. He writes:

Emily Bridges, director of public information services at Advocates for Youth, agrees with other observers in pointing out that teens aren’t likely to include national economics as a significant factor in pondering whether or not to have unprotected sex. Peer pressure, badly mixed booze, general awkwardness, for example, are much more likely than the jobless recovery to play on the minds of horny high schoolers.

Some states with weak economies actually saw a rise in teen birth rates, Tomasic notes. However, this year’s sharp downturn in teen births parallels a drop in fertility for U.S. women of all ages, which seems best explained by economic uncertainty.

It’s true that prospective teen moms are less likely to have jobs in the first place, and so a bad job market might be less likely to sway their decisions. However, young women who aren’t working are unlikely to have significant resources of their own to draw on, which means that they are heavily dependent upon others for support. If their families and partners are already struggling to make ends meet, then the prospect of another mouth to feed may seem even less appealing than usual.

Abortion is the elephant in the room in this discussion. The CDC numbers only count live births. Logically, fewer live births must be the result of fewer conceptions and/or more terminations. Some skeptics doubt that economic factors have much to do with teens’ decisions about contraception. However, it seems plausible that decisions about abortion would be heavily influenced by the economic health of the whole extended family.

Last year’s decrease was notably sharp, but teen birth rates have been declining steadily for the last 20 years. The Guttmacher Institute, a New York-based non-profit that specializes in research on reproductive choice and health, suggests that successive generations of teens are simply getting savvier about contraception. Births to mothers between the ages of 15 and 17 are down 48% from 1991 levels, and births to mothers ages 18 to 19 are down 30%.

Stupid drug dealer tricks

Martha Rosenberg of AlterNet describes 15 classic dirty tricks deployed by Big Pharma to push drugs. These include phony grassroots patient groups organized by the drug companies to lobby for approval of dubious remedies. Another favorite money-making strategy is to overcharge Medicare and Medicaid. Pharmaceutical companies have paid nearly $15 billion in wrongdoing settlements related to Medicare and Medicaid chicanery over the last five years.

This post features links to the best independent, progressive reporting about health care by members of The Media Consortium. It is free to reprint. Visit the Pulse for a complete list of articles on health care reform, or follow us on Twitter. And for the best progressive reporting on critical economy, environment, health care and immigration issues, check out The Audit, The Mulch, and The Diaspora. This is a project of The Media Consortium, a network of leading independent media outlets.

Weekly Audit: Curbing the Deficit, Cat Food, and You

by Lindsay Beyerstein, Media Consortium blogger

The deficit commission released its much anticipated list of helpful money-saving tips for the federal government last week. These tips include tax cuts for the rich, reducing unnecessary printing costs, and cutting the jobs of federal contractors.

The recommendations are more like a menu than a program. As Mark Schmitt of The American Prospect notes, there’s no coherent vision, just a list of possible tax increases and program cuts with projected savings attached.

The commission was dubbed the Cat Food Commission by critics who see the project as an attempt by the Obama administration to provide political cover to gut Social Security, thereby forcing the elderly to subsist on cat food.

Officially, the commission is charged with making suggestions to balance the budget by 2015. Kevin Drum of Mother Jones is surprised at the hype the presentation has attracted, considering that it’s not a piece of legislation, or even proposed legislation, or even the actual report by the deficit commission, but rather a draft presentation by “two guys in a room” (co-chairs former Sen. Alan Simpson (R-WY) and Erskine Bowles).

Hope is not a plan

Drum has trouble taking the draft seriously because its main focus is cutting discretionary spending, which according to the Congressional Budget Office, only accounts for about 10% of our projected deficit. The secondary focus of the report is Social Security, which only accounts for a small share of the projected deficit, and moreover, is easily fixable with very small tax increases and tiny decreases in benefits phased in over a long period of time.

Rising health care costs account for the lion’s share of our projected deficit, but as Drum notes, the draft doesn’t get into detail about how to contain those costs, the authors simply stress that someone had better get on that. No kidding. The authors assert that that the government should never take in more than 21% of GDP in total taxes. Drum dismisses this suggestion as completely unrealistic seeing as the authors have no plan to slow the growth of health care costs.

Note to workers: “Drop dead”

Roger Bybee of Working In These Times takes aim at the presentation’s suggestion to cut taxes on the rich. The deficit chairmen urge legislators to cut the top tax rate from 35% to 23%, which as Bybee notes, would actually add to the deficit. The presentation also favors cutting corporate taxes and taxes on American expatriates. Hardly deficit-friendly stuff. Bybee argues that the real goal of this commission is to deflate public expectations about the role of government:

This draft report was thus not about slicing the deficit, but shrinking those portions of the government on which the poor and working class depend and shoveling new benefits to corporations and wealthy, at a time when the richest 1% already rakes in 23.5% of all U.S. income.

According to AFL-CIO head Richard Trumka, whom Bybee quotes, the message to the American worker is: “Drop dead.”

Gawker vs. the Cat Food Commission

Astute commenters at the media gossip blog Gawker discovered, via a New York Times interactive feature, that the entire problem could be solved by rolling back the Bush tax cuts and ending foreign wars. John Tomasic of the Colorado Independent explains how they did it:

The Gawkers simply let the non-job-making Bush tax cuts expire (because they were never meant to be permanent and because most Americans don’t want them extended) and they ended Bush’s (now Obama’s) overseas military adventures, which cost more money every week ($2 billion!) than the Rolling Stones have made in the last forty years, our contemporary version of the Cold War space race taking place not in space but in Afghanistan and Iraq, where the United States is racing only against itself to borrow and spend as much money as possible every single day– almost none of that money spent on the troops who come home wounded and sad and totally screwed up.

Nine out of ten grandmas prefer the fiscal policies of the Clinton administration to Meow Mix.

Extending unemployment = Jobs

Ed Brayton of the Michigan Messenger argues that extending long term unemployment insurance benefits would benefit the economy to the tune of half a million jobs. The unemployed still have to eat. Their children still need shoes. If unemployment benefits are extended, the unemployed will spend their benefits quickly in order to live, which is exactly what an economic stimulus is designed to do. Grocery stores and shoe stores employ people. Checkers and shoe salesmen also spend their wages in their communities, thereby sustaining the jobs of still more people.

Pension plan bets green on green

Investing in green jobs is sound economic policy, but governments can’t do it alone. The private sector has to help finance the greening of our economy, too. One California pension plan is stepping up and betting big, investing $500 million on green projects, according to Mikhail Zinshteyn of Campus Progress. The California Public Employees’ Retirement System (CalPERS) has a green portfolio worth $2.5 billion, which it has amassed since 2006. CalPERS is betting that low carbon energy programs and other clean energy initiatives will be a lucrative place to park their members’ money.

Hopefully, these investments will also benefit the economy in the short term by creating jobs, including jobs for some California public employees. However, some analysts are skeptical that these investments will yield the handsome dividends that CalPERS analysts are projecting.

This post features links to the best independent, progressive reporting about the economy by members of The Media Consortium. It is free to reprint. Visit the Audit for a complete list of articles on economic issues, or follow us on Twitter. And for the best progressive reporting on critical economy, environment, health care and immigration issues, check out The Mulch, The Pulse and The Diaspora. This is a project of The Media Consortium, a network of leading independent media outlets.

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