Decisions Congress shouldn’t make

English: View of Capitol Hill from the U.S. Su...
English: View of Capitol Hill from the U.S. Supreme Court Česky: Pohled na Kapitol z budovy Nejvyššího soudu Spojených států (Photo credit: Wikipedia)

A recent New York Times op ed piece by Judy Nicastro tells the wrenching story of an abortion she had at 23 weeks.

The decision — which involved aborting a fetus that would have faced only suffering if it survived — was made after agonizing weeks. It was informed by sonograms, an M.R.I., tests, studies and extensive discussions between Nicastro, her husband and many medical professionals.

The decision to tell her story was prompted by the House vote on June 18 to ban abortion after 22 weeks. No one among those who voted for the bill (which is not expected to pass the Senate) has experienced anything like the agonizing struggle Nicastro and her husband went through, or even just a troubled pregnancy — most of the votes were cast by men, after all.

The decision was anguished, soul-searching, unique — and above all, private.

Which raises the question:

Should a decision about an unintended or unadvised pregnancy be made by the woman involved, with advice from medical professionals, after discussion with her partner, in consideration of the unique circumstances that apply?

Or by the U.S. Congress?

Catholic nuns urge passage of health bill

There’s hope. The U.S. Conference of Catholic Bishops may be trying to sink health reform because they feel they know best about women, but a few thousand good sisters are raising their own voices. And not just your everyday sisters.

Catholic nuns are urging Congress to pass President Barack Obama’s health care plan, in an unusual public break with bishops who say it would subsidize abortion.

Some 60 leaders of religious orders representing 59,000 Catholic nuns Wednesday sent lawmakers a letter urging them to pass the Senate health care bill. It contains restrictions on abortion funding that the bishops say don’t go far enough.

The letter says that “despite false claims to the contrary, the Senate bill will not provide taxpayer funding for elective abortions.” The letter says the legislation also will help support pregnant women and “this is the real pro-life stance.”

This space, a space which claims several priests as good friends despite our frequent and vehement disagreements, hereby sides with the sisters. And offers a sincerely respectful three cheers.

Catholic nuns urge passage of Obama’s health bill – Politics – Wire – TheState.com.

Health reform: Are we there yet?

Nancy Pelosi is known around San Francisco — and in a few other spots — as one tough politician. She likes being Speaker of the House, and she doesn’t much like losing. So this week’s do-or-die health reform bill is going to get all the muscle she can manage. It is, Pelosi has declared, “a moral and political imperative.”

Okay, it’s not what we hoped, it’s too complicated and too fraught, it’s going to be full of little gifties given to get votes. If we don’t get something America will be stuck with a non-functional system and millions will remain without health care at all. So I for one am on Pelosi’s side.

The plan is for the House to pass the Senate version and send it to Obama for his signature and enactment. Certain fixes the House is demanding for passage of the more conservative Senate bill will be included in a separate, special measure that will go to the Senate for an up-or-down vote that avoids a filibuster.

But once the House passes the base legislation and Obama signs it, the measure becomes law regardless of what the Senate does.

Democrats do not yet have the votes in hand and Pelosi will not call a vote until they do. Liberal lawmakers have deep reservations about the Senate bill, and fights over abortion and immigration have yet to be resolved. But Pelosi has set the legislative train in motion, even as Republicans have publicly begun to express doubt that they can stop it.

Pelosi laid down the law to wavering Democrats who are threatening to bolt. “It’s not about abortion, it’s not about immigration,” she said. “The only reason, therefore, to oppose the bill is that you do not support health care reform.”

A lot of people don’t support health care reform. The Republicans, the insurance industry, the anti-abortion folks and the anti-immigration folks and more than a few people who feel pretty much okay with what they’ve got and frankly don’t care a lot about what others don’t have.

But health care reform is a moral imperative.

Pelosi: Dems will have votes to OK health care.

Health Bill Should not Pit Women against Seniors

The health care issue is, one would think, too important for partisan games pitting one group against another. Especially when huge portions of each group are one and the same. But as Robert Pear and David M. Herszenhorn report in today’s New York Times, that seems to be happening.

In a day of desultory debate on sweeping health care legislation, senators appealed to two potent political constituencies on Tuesday, with Democrats seeking additional medical benefits for women and Republicans vowing to preserve and protect Medicare for older Americans.

The Democrats’ first amendment, offered by Senator Barbara A. Mikulski of Maryland, would require insurers to cover more screenings and preventive care for women, with no co-payments.

‘Women often forgo those critical preventive screenings because they simply cannot afford it, or their insurance company won’t pay for it unless it is mandated by state law,’ Ms. Mikulski said.

I met with my oncologist two days ago and decided to have a mammogram. It’s been two years since the last one. She and I agree that, having had breast cancer in 2006 and breezed through a mastectomy, and being fit and healthy overall, my particular situation suggests the potential benefits — catch another cancer early, gain another good decade or so of life — outweigh the risks.  This is what the whole thing is about: every woman is different, every woman should be allowed to decide, with her doctor, on screening and preventive care. The Mikulski amendment will insure that can happen, whatever one’s age and circumstances.

The first Republican proposal, offered by Senator John McCain of Arizona, would strip the bill of more than $450 billion of proposed savings in Medicare. The savings would curb the growth of Medicare payments to hospitals, nursing homes, health maintenance organizations and other providers of care.

‘The cuts are not attainable,’ Mr. McCain said. ‘And if they were, it would mean a direct curtailment and reduction in the benefits we have promised to senior citizens.’

Senators said that debate on the bill, which embodies President Obama’s top domestic priority, would last for several weeks and perhaps continue into January. A vote on Ms. Mikulski’s amendment has not been scheduled but could come Wednesday.

The health care bill would require most Americans to carry insurance. It would subsidize coverage for people with moderate incomes, expand Medicaid and create a government insurance plan, which would compete with private insurers. The House passed a similar bill last month.

Ms. Mikulski’s proposal was prompted, in part, by the recent furor over new recommendations from a federal task force that breast cancer screenings begin later for many women.

The Senate majority leader, Harry Reid, Democrat of Nevada, hailed Ms. Mikulski’s proposal, saying: ‘The decision whether or when to get a mammogram should be left up to the patient and the doctor. That decision should not be made by some bureaucrat, a member of Congress or someone they’ve never met.’

As health costs and insurance premiums rise, Mr. Reid said, ‘more women are skipping screenings for cervical and breast cancer, and doctor visits that can catch problems like postpartum depression and domestic violence.’

Votes on the Mikulski amendment will show whether Republicans “truly want to improve this bill or just want to play games, stall,” Mr. Reid said.

Ms. Mikulski said her proposal would ‘shrink or eliminate the high cost of co-payments and deductibles’ for women who receive screenings for cancer, heart disease, diabetes and other conditions.

Senator Kay Bailey Hutchison, Republican of Texas, criticized the proposal, saying it would ‘allow yet another government agency to interfere in the relationship between a woman and her doctor.’

No, Senator Hutchison, the government isn’t interfering in my relationship with my doctor, nor will it do so by insuring other women’s choices and coverage.

Republicans argued that the bill would be paid for on the backs of older Americans.

‘We are receiving incredible and overwhelming response from seniors all over America,’ Mr. McCain said. ‘They paid all their working lives into the Medicare trust fund, and now they’re in danger of having $483 billion cut out of it.’

Mr. McCain’s proposal would effectively cripple the bill, because Democrats are relying on savings in Medicare to help offset the cost of providing coverage to more than 30 million people who are now uninsured.

This senior would like to add a word to that “overwhelming response” Mr. McCain reports. I paid all my working life into Medicare (which, by the way, was not exactly a gift to America from the Republican party) and I want a decent health bill more than I want every penny of my Medicare coverage protected.

A lot of us have come to terms with the fact that the health bill we may get is a long way from the health bill we so fervently wanted. We are still hoping that something survives the attempts to sink it at any cost.

Senators Pitch to Women and Elderly on Health Bill – NYTimes.com.

Counseling Improves Life's End. Surprise!

Knowledge, care and compassion really do bring peace. Why should this be a surprise? And why should a few strident opponents prevent those approaching life’s end from having this benefit?

A study appearing in today’s Journal of the American Medical Association points out the benefits of end-of-life counseling, although the widespread misinformation loose in the land may have doomed what should be a significant piece of health reform.

As a political uproar rages over end-of-life counseling, a new study finds offering such care to dying cancer patients improves their mood and quality of life.

The study of 322 patients in rural New Hampshire and Vermont also suggests the counseling didn’t discourage people from going to the hospital.

The Senate bill provision axed by Finance Committee chair Charles Grassley would have allowed coverage for conversations with physicians about things like hospice care, advance directives and treatment options.  But to opponents of reform, it was a handy attack mechanism. They enlisted a few standard bearers like former Alaska Gov. Sarah Palin and media darling Rush Limbaugh to twist the issue into menacing “death panels,” and in no time at all Sen. Grassley had his excuse to excise.

Losers in this are all of us. Eventually, 100% of us will die. Aggressive treatment and expensive, futile procedures are common today to that experience; compassion and peace are harder to come by.

In the new study, trained nurses did the counseling with patients and family caregivers using a model based on national guidelines. All the patients in the study had been diagnosed with terminal cancer. Half were assigned to receive usual care. The other half received usual care plus counseling about managing symptoms, communicating with health care providers and finding hospice care.

Patients who got the counseling scored higher on quality of life and mood measures than patients who did not.

Could someone please get this information to Sarah Palin?

Study: End-of-life advice aids terminally ill.

End-of-Life Care is Losing to Lies

Here is some of the current worst news on health reform:

The Senate Finance Committee’s health care plan will not include provisions dealing with end-of-life care, now one of the more controversial topics in the health care debate, the committee’s top Republican said on Wednesday.

Senator Charles E. Grassley of Iowa said in a statement that the committee “dropped end-of-life provisions from consideration entirely because of the way they could be misinterpreted and implemented incorrectly.”

If anyone knows misinterpretation, it’s Senator Grassley. He’s the originator of such enlightened parting phrases as the one he tossed out at an Iowa meeting Wednesday, about not wanting a health plan “that will pull the plug on grandma.” There is, of course, no grain of truth in that phrase, but its repetition does exactly what Sen. Grassley and his ilk wish: whip the opposition to any real reform into an emotional, unthinking frenzy. And they are winning the war against reason one battle at a time.

A Senate Finance Committee aide confirmed that the panel was not discussing end-of-life measures, adding that they were “never a major focus” of the committee’s negotiations.

House committees have passed legislation that would provide Medicare coverage for optional counseling sessions on end-of-life services.

But as people like Senator Grassley, and former N.Y. Lt. Governor Betsy McCaughey who sought fame and perhaps fortune by starting this whole flap, keep the country inflamed with misinformation the chances of decent legislation rising from these ashes grow dim.

The hopeless optimists of the land continue to believe that calls and letters and e-mails of sanity will convince our legislators that the country will rally around a decent bill… but Mr. Grassley and Ms. McCaughey are making optimism difficult.

via Senate Bill Will Not Address End-of-Life Care – Prescriptions Blog – NYTimes.com.