Saturday, October 10, 2009

VA "Death Book"


http://www.huffingtonpost.com/2009/08/22/how-conservatives-got-the_n_266275.html
How Conservatives Got The Facts Wrong On Their Latest Obsession: The "Death Book" For Veterans
***UPDATE*** Assistant Secretary of Veterans Affairs Tammy Duckworth appeared on Fox News Sunday this morning to combat the false allegations that the VA is using...


Marcus Baram
Marcus@huffingtonpost.com |

How Conservatives Got The Facts Wrong On Their Latest Obsession: The "Death Book" For Veterans


First Posted: 08-22-09 10:08 PM | Updated: 09-22-09 05:12 AM


***UPDATE***

Assistant Secretary of Veterans Affairs Tammy Duckworth appeared on Fox News Sunday this morning to combat the false allegations that the VA is using a "death book" to encourage veterans to end their lives.

WATCH:



The latest conservative obsession - dutifully spread via Sarah Palin's Facebook page - is marked by the same alarmism and factual inaccuracy as the hysteria over "death panels."

According to this tale, America's veterans are being steered into ending their lives via a "death book" distributed by the government.

It all started with Jim Towey, the former president of the White House Office of Faith-Based Initiatives under George W. Bush, who penned an op-ed in the Wall Street Journal describing how the Department of Veterans Affairs was using an end-of-life planning document that was aimed at steering veterans toward choosing death.

Towey stated that the message of the veterans' health-care system to its patients was "hurry-up-and-die" and he contrasted the "death book" with "Five Wishes," his own advance care planning document.

In dramatic language, he wrote:

"One can only imagine a soldier surviving the war in Iraq and returning without all of his limbs only to encounter a veteran's health-care system that seems intent on his surrender."

Soon enough, Palin linked to the piece, stating that "the Veterans Administration encourages veterans to forego care as they make end-of-life decisions." And Fox News' Sean Hannity and RNC chair Michael Steele were calling it the equivalent of "death panels" for military veterans.

They failed to mention that the so-called "death book" contains the same advance-care planning required of all health care organizations under federal law, has been in use since 1997 and was developed with the input of interfaith ministers.

In addition, Towey seems to have his own axe to grind. He has repeatedly tried to get the government to spend millions to purchase his "Five Wishes" book, which is published by Aging With Dignity, a non-profit group he founded, to distribute to veterans across the country, according to sources within the VA. Towey used his influence with the White House to get a meeting with VA officials, including then-Secretary of Veterans Affairs Jim Nicholson. At one meeting, Towey was informed that the VA could not act on such an unsolicited proposal without violating federal procurement regulations, according to VA sources.

The VA's policy is in accordance with the 1990 Patient Self Determination Act, which requires all institutions receiving Medicare funds to provide information to patients regarding end of life, living will and other advance directives. During the Bush administration, the VA changed its regulation to extend the act to cover all VA facilities.

In 2007, after Towey complained that the so-called "death book," "Your Life, Your Choices - Planning for Future Medical Decisions," was biased against the right-to-life viewpoint, the VA convened an outside panel of experts to assess and update the booklet.

In his op-ed, Towey stated that this panel did not include any representatives of faith groups or disability rights advocates. In fact, according to the VA, the panel included a priest, a rabbi, a renowned disability rights advocate, and the president of the organization that produces "Five Wishes," the alternative advance care planning document that Towey is promoting and selling.

The panel supported the use of the "Your Life, Your Choices" booklet but included some suggestions for revising its content. The plans to update and release the booklet were developed under the Bush administration and it is due for release in 2010.

Towey, along with Assistant Secretary Of Veterans Affairs Tammy Duckworth are scheduled to discuss the issue on "Fox News Sunday" tomorrow.

Dr. Ellen Fox, the Chief Officer for Ethics in Health Care at the Veterans Health Administration, defended the use of the booklet:

Your Life, Your Choices is an educational workbook that was designed specifically for Veterans. The authors went to great lengths to ensure it would be meaningful and helpful to all Veterans, regardless of their religious and cultural backgrounds. I am impressed by the development process they used, which included extensive input and testing by different Veterans groups, religious leaders from 10 different faiths, elderly and disabled individuals, and experienced doctors and nurses.

They even made sure to incorporate everyday language that Veterans commonly use to describe medical conditions, while at the same time providing accurate information from the physician's perspective. Over the past 10 years it has been tested through scientific research, endorsed by many respected professional organizations, and widely used throughout the U.S. health care system. It is one of many educational resources we provide to help Veterans and their families. As a Federal agency we have an obligation to be responsible stewards of taxpayer dollars by maximizing the services we provide our Veterans. Providing an educational resource like Your Life, Your Choices at no cost to Veterans is one of the many ways we fulfill this mission. The whole purpose of this workbook is to encourage more conversations between patients, families, and health care teams. Anyone who is seriously interested in ensuring that Veterans receive the best care possible should recognize this.

Towey did not return calls placed to St. Vincent College, where he is the president.


Read more at: http://www.huffingtonpost.com/2009/08/22/how-conservatives-got-the_n_266275.html


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http://www.huffingtonpost.com/2009/08/26/huffposts-marcus-baram-de_n_269483.html
HuffPost's Marcus Baram Debates Jim Towey Over VA's Use Of "Your Life, Your Choices"

Huffington Post Night Editor Marcus Baram defended The Veterans Administration's use of the end-of-life planning document "Your Life, Your Choices" Tuesday, on CBS News' Washington Unplugged.

Baram pointed out that the controversy seems like a manufactured one; "Your Life, Your Choices" was in use for more than ten years.

Jim Towey, the former president of the White House Office of Faith-Based Initiatives under George W. Bush, was the counterpoint. According to Towey, "Your Life, Your Choices" is not sensitive enough.

The host asked Towey if his arguments can be interpreted as "sour grapes." Towey tried selling his own two-page, end-of-life booklet to the VA at a cost of $5 per veteran, but the VA declined. VA Assistant Secretary Tammy Duckworth mentioned Towey's booklet during an interview on Fox News, Sunday, Aug. 23




Watch CBS News Videos Online

Read more at: http://www.huffingtonpost.com/2009/08/26/huffposts-marcus-baram-de_n_269483.html

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More inacuracies: Political infighting to discredit Obama. Obama did not reinstate it. It has been on the VA website all along with a notation that it was being revised. It has been available and used for TEN YEARS.

VA Death Book -"Your Life, Your Choices"- Reinstated Under ...

VA Death Book -"Your Life, Your Choices"- Reinstated Under Obama ... 52-page VA Death Book deals with end-of-life choices in which a decision has to ...
nowpublic.com/world/va-death-book-your-life-your-

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I'm not an Obama supporter but neither am I an Obama detractor. I figure the man deserves a chance. He inherited a pile of doo the size of Mount Everest from the previous administration and has only a kiddy sand shovel to clean it up with. That pile has been growing for years and he can't reduce it in just a few months. He gets blamed for all the mess of the Bush/Cheney years and is bombarded with lies, lies and more lies. The Repubs are mad because the Democrats got back in power so they want to destroy any possibility that Obama and the Dems might win enough favor to get re-elected next term . The sheeple who tolerated Bush/Cheney's lies and destruction now fall for the manipulative tactics of the Obama haters and rise up in a howling rage.

Sarah Palin loved her little taste of power, has dreams of glory of being the first female president so tries to curry favor with the Repubs, hoping they'll nominate her and give her backing in the 2012 election. She leaped on the destroy-Obama bandwagon and started the Death Panel lies about the Obama Health Care reform: Gonna euthanize Grandma because she costs too much to keep alive. Kill off all the old, handicapped and non-productive members of society. Shows the Repubs she's a Team Player and panders to the megarich Insurance Companies. Gotta keep the super rich happy, you know.




Palin's Death Panels -Unplug Grandma Crap

VA Death Book Lies

Death Panels - Unplug Grandma Crap

Palin vs. Obama: Death Panels

August 14, 2009

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Like many disagreements in the digital age, it all started with a post on Facebook. Last Friday, former Alaska Gov. Sarah Palin posted a note to her Facebook page and introduced a new term to the health care debate:

Palin, Aug. 7: 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.

Unsurprisingly, the phrase "death panel" does not appear in the health care bill that passed House committees last month. And Palin’s post did not make entirely clear what she might interpret as a "death panel." Nonetheless, the phrase stuck. It skyrocketed up the Google search index and was quoted by George Stephanopoulos while interviewing former Speaker of the House Newt Gingrich on ABC News’ "This Week." Republican Sen. Chuck Grassley of Iowa made similar claims while speaking out against "a government run plan to decide when to pull the plug on grandma” at a town hall on Wednesday.

President Obama addressed these concerns about death panels and unplugged grandmothers during a town hall meeting in New Hampshire on Tuesday. He said:

Obama, Aug. 11: The rumor that’s been circulating a lot lately is this idea that somehow the House of Representatives voted for "death panels" that will basically pull the plug on grandma … this arose out of a provision in one of the House bills that allowed Medicare to reimburse people for consultations about end-of-life care, setting up living wills, the availability of hospice, et cetera. So the intention of the members of Congress was to give people more information so that they could handle issues of end-of-life care when they’re ready, on their own terms. It wasn’t forcing anybody to do anything. This is I guess where the rumor came from.


Obama is referring to Section 1233 of H.R. 3200, which is titled “Advance Care Planning Consultation.” As we explained a few weeks ago, it "would require Medicare to pay for some end-of-life planning counseling sessions with a health care practitioner." Our previous article was a response to the false claim that the health care bill would require forced counseling to push euthanasia. And it’s this provision on end-of-life counseling that’s the primary basis for Palin’s remarks.

On Aug. 12, Palin attempted to clear up her argument with a detailed Facebook post. She discussed Section 1233 and said that "it’s misleading for the President to describe this section as an entirely voluntary provision that simply increases the information offered to Medicare recipients." Palin goes onto argue:

Palin, Aug. 12: The issue is the context in which that information is provided and the coercive effect these consultations will have in that context. … These consultations are authorized whenever a Medicare recipient’s health changes significantly or when they enter a nursing home, and they are part of a bill whose stated purpose is “to reduce the growth in health care spending.” Is it any wonder that senior citizens might view such consultations as attempts to convince them to help reduce health care costs by accepting minimal end-of-life care?

The fact remains that the bill wouldn’t require patients to receive counseling sessions, nor would it require a doctor to offer one. Rather, it modifies Section 1861(s)2 of the Social Security Act, defining what services Medicare will pay for. So if a patient receives a counseling session from a doctor or health care practitioner, he or she doesn’t have to pay for it – Medicare will. As we pointed out in our earlier story, Medicare will also pay for prosthetic limbs, but that doesn’t mean that every recipient gets those, too.

And the concern that these sessions are "part of a bill whose stated purpose is ‘to reduce the growth in health care spending,’ " while true, is hardly the whole story. One of the bill’s other goals is to "provide affordable, quality health care for all Americans." The legislation is 1,017 pages long with sections that cut costs, some that increase care, and some that do both. In fact, the counseling sessions would add to government expenses since Medicare would have to reimburse doctors. The nonpartisan Congressional Budget Office estimates officially that Section 1233 will cost a net total of $2.7 billion over 10 years.

Furthermore, proposals to offer reimbursement for such counseling have attracted bipartisan support. Republican Sen. Johnny Isakson of Georgia, a sponsor of one such measure, gave an interview to the Washington Post on August 10, in which he discussed the benefits of these counseling sessions "both for the sanity of the family and what savings the family has." Isakson also commented on the recent confusion around the issue:

Isakson, Aug. 10: I just had a phone call where someone said Sarah Palin’s web site had talked about the House bill having death panels on it where people would be euthanized. How someone could take an end of life directive or a living will as that is nuts. You’re putting the authority in the individual rather than the government. I don’t know how that got so mixed up.

Palin also attempts to buttress her case by quoting some writings by Dr. Ezekiel Emanuel, a health policy adviser to the president. Here she’s echoing claims made elsewhere, twisting the meaning of Emanuel’s writings and taking them out of context. We examined those claims in an Ask FactCheck item we posted earlier today, and won’t repeat the details here.

Finally, for those inclined to get their information from Facebook postings, may we suggest FactCheck.org’s own page?

Posted by Justin Bank on Friday, August 14, 2009 at 5:43 pm
Filed under The FactCheck Wire · Tagged with , , ,

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  1. President Hits Back at Claims That Government Wants to "Pull the Plug on Grandma" ... Palin brought out the Death Panel which I believe they had but ...
    cbsnews.com/blogs/2009/08/11/politics/.../entry5234477.shtml - 217k - Cached
st 11, 2009 2:42 PM

Obama: I Don't Want "Death Panels"


(AP Photo/Jim Cole)
Updated 5:15 p.m. ET

Shortly after telling Americans that some opponents are trying to "scare the heck out of folks" by misleading them about his health care reform efforts, President Obama told a town hall audience in New Hampshire that he is "not in favor" of so-called "death panels" in which the government would decide who does and does not qualify for care to keep them alive.

The notion that the president and Congressional Democrats are seeking to institute such panels has been pushed by former Vice Presidential candidate Sarah Palin and some activists.

House Republican Leader John Boehner (R-Ohio) and Republican Policy Committee Chairman Thaddeus McCotter (R-Mich.) put out a statement last month claiming the health care legislation "may place seniors in situations where they feel pressured to sign end of life directives they would not otherwise sign. This provision may start us down a treacherous path toward government-encouraged euthanasia if enacted into law."

Some Republicans have disavowed the "death panel" claim, which several media outlets have noted is false. It was among the "10 Health Care Myths" debunked on this site last week. The provision cited by critics, the president said today, would allow Medicare to pay doctors to counsel those seeking information about end-of-life care issues, such as living wills and hospice care.

It would not, he said, "basically pull the plug on grandma because we decided that it's too expensive to let her live anymore."

Mr. Obama noted that a Republican, Johnny Isakson, was an initial sponsor of the provision. The president said lawmakers "very sensibly thought this was something that would expand people's options."

Isakson called the notion that the provision meant euthanasia "nuts." He later disavowed the president's comments, however, writing in a statement, "I categorically oppose the House bill and find it incredulous that the White House and others would use my amendment as a scapegoat for their misguided policies."

In a Facebook post Friday, Palin wrote this: "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. Such a system is downright evil."

The president said in a response to such claims that Americans should not listen to efforts by those seeking to "scare and mislead the American people."

"Where we disagree, let's disagree over things that are real, not these wild misrepresentations that don't bear any resemblance to anything that's actually being proposed," he said.

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  1. Sorry, Sarah Palin -- rationing of care? Private companies are already doing it, with sometimes fatal results ... Gingrich backs Palin on "death panels" ...
    www.salon.com/news/feature/2009/08/11/denial_of_care

The "death panels" are already here

Sorry, Sarah Palin -- rationing of care? Private companies are already doing it, with sometimes fatal results

By Mike Madden

Read more: Republican Party, Insurance, Newt Gingrich, Politics, News, Healthcare, Barack Obama, Sarah Palin, Mike Madden

News

iStockphoto

Aug. 11, 2009 | The future of healthcare in America, according to Sarah Palin, might look something like this: A sick 17-year-old girl needs a liver transplant. Doctors find an available organ, and they're ready to operate, but the bureaucracy -- or as Palin would put it, the "death panel" -- steps in and says it won't pay for the surgery. Despite protests from the girl's family and her doctors, the heartless hacks hold their ground for a critical 10 days. Eventually, under massive public pressure, they relent -- but the patient dies before the operation can proceed.

It certainly sounds scary enough to make you want to go show up at a town hall meeting and yell about how misguided President Obama's healthcare reform plans are. Except that's not the future of healthcare -- it's the present. Long before anyone started talking about government "death panels" or warning that Obama would have the government ration care, 17-year-old Nataline Sarkisyan, a leukemia patient from Glendale, Calif., died in December 2007, after her parents battled their insurance company, Cigna, over the surgery. Cigna initially refused to pay for it because the company's analysis showed Sarkisyan was already too sick from her leukemia; the liver transplant wouldn't have saved her life.

That kind of utilitarian rationing, of course, is exactly what Palin and other opponents of the healthcare reform proposals pending before Congress say they want to protect the country from. "Such a system is downright evil," Palin wrote, in the same message posted on Facebook where she raised the "death panel" specter. "Health care by definition involves life and death decisions."

Coverage of Palin's remarks, and former House Speaker Newt Gingrich's defense of them, over the weekend did point out that the idea that the reform plans would encourage government-sponsored euthanasia is one of a handful of deliberate falsehoods being peddled by opponents of the legislation. But the idea that only if reform passes would the government start setting up rationing and interfering with care goes beyond just the bogus euthanasia claim.

Opponents of reform often seem to skip right past any problems with the current system -- but it's rife with them. A study by the American Medical Association found the biggest insurance companies in the country denied between 2 and 5 percent of claims put in by doctors last year (though the AMA noted that not all the denials were improper). There is no national database of insurance claim denials, though, because private insurance companies aren't required to disclose such stats. Meanwhile, a House Energy and Commerce Committee report in June found that just three insurance companies kicked at least 20,000 people off their rolls between 2003 and 2007 for such reasons as typos on their application paperwork, a preexisting condition or a family member's medical history. People who buy insurance under individual policies, about 6 percent of adults, may be especially vulnerable, but the 63 percent of adults covered by employer-provided insurance aren't immune to difficulty.

"You're asking us to decide that the government is to be trusted," Gingrich -- who may, like Palin, be running for the GOP's presidential nomination in 2012 -- told ABC's "This Week With George Stephanopoulos" on Sunday. But as even a quick glance through news coverage of the last few years shows, private insurers are already doing what reform opponents say they want to save us from. (The insurance industry, pushing back against charges that they're part of the problem, said last month that "healthcare reform is far too important to be dragged down by divisive political rhetoric." The industry has long maintained that its decisions on what to cover are the result of careful investigations of each claim.) Here is a look at a handful of healthcare horror stories, brought to you by the current system. It took Salon staff less than an hour to round these up -- which might indicate how many other such stories are out there.

-- In June 2008, Robin Beaton, a retired nurse from Waxahachie, Texas, found out she had breast cancer and needed a double mastectomy. Two days before her surgery, her insurance company, Blue Cross, flagged her chart and told the hospital they wouldn't allow the procedure to go forward until they finished an examination of five years of her medical history -- which could take three months. It turned out that a month before the cancer diagnosis, Beaton had gone to a dermatologist for acne treatment, and Blue Cross incorrectly interpreted a word on her chart to mean that the acne was precancerous.

Not long into the investigation, the insurer canceled her policy. Beaton, they said, had listed her weight incorrectly when she bought it, and had also failed to disclose that she'd once taken medicine for a heart condition -- which she hadn't been taking at the time she filled out the application. By October, thanks to an intervention from her member of Congress, Blue Cross reinstated Beaton's insurance coverage. But the tumor she had removed had grown 2 centimeters in the meantime, and she had to have her lymph nodes removed as well as her breasts amputated because of the delay.

-- In October 2008, Michael Napientak, a doorman from Clarendon Hills, Ill., went to the hospital for surgery to relieve agonizing back pain. His wife's employer's insurance provider, a subsidiary of UnitedHealthCare, had issued a pre-authorization for the operation. The operation went well. But in April, the insurer started sending notices that it wouldn't pay for the surgery, after all; the family, not the insurance provider, would be on the hook for the $148,000 the hospital charged for the procedure. Pre-authorization, the insurance company explained, didn't necessarily guarantee payment on a claim would be forthcoming. The company offered shifting explanations for why it wouldn't pay -- first, demanding proof that Napientak had tried less expensive measures to relieve his pain, and then, when he provided it, insisting that it lacked documentation for why the surgery was medically necessary. Napientak's wife, Sandie, asked her boss to help out, but with no luck. Fortunately for the Napientaks, they were able to attract the attention of a Chicago Tribune columnist before they had to figure out how to pay the six-figure bill -- once the newspaper started asking questions, the insurer suddenly decided, "based on additional information submitted," to cover the tab, after all.

-- David Denney was less than a year old when he was diagnosed in 1995 with glutaric acidemia Type 1, a rare blood disorder that left him severely brain damaged and unable to eat, walk or speak without assistance. For more than a decade, Blue Cross of California -- his parents' insurance company -- paid the $1,200 weekly cost to have a nurse care for him, giving him exercise and administering anti-seizure medication.

But in March 2006, Blue Cross told the Denney family their claims had exceeded the annual cost limit for his care. When they wrote back, objecting and pointing out that their annual limit was higher, the company changed its mind -- about the reason for the denial. The nurse's services weren't medically necessary, the insurers said. His family sued, and the case went to arbitration, as their policy allowed. California taxpayers, meanwhile, got stuck with the bill -- after years of paying their own premiums, the Denney family went on Medi-Cal, the state's Medicaid system.

-- Patricia Reilling opened an art gallery in Louisville, Ky., in 1987, and three years later took out an insurance policy for herself and her employees. Her insurance provider, Anthem Health Plans of Kentucky, wrote to her this June, telling her it was canceling her coverage -- a few days after it sent her a different letter detailing the rates to renew for another year and billing her for July.

Reilling thinks she knows the reason for the cutoff, though -- she was diagnosed with breast cancer in March 2008. That kicked off a year-long battle with Anthem. First the company refused to pay for an MRI to locate the tumors, saying her family medical history didn't indicate she was likely to have cancer. Eventually, it approved the MRI, but only after she'd undergone an additional, painful biopsy. Her doctor removed both of her breasts in April 2008. In December, she went in for reconstructive plastic surgery -- and contracted a case of MRSA, an invasive infection. In January of this year, Reilling underwent two more surgeries to deal with the MRSA infection, and she's likely to require another operation to help fix all the damage. The monthly bill for her prescription medicines -- which she says are mostly generics -- is $2,000; the doctors treating her for the MRSA infection want $280 for each appointment, now that she's lost her insurance coverage. When she appealed the decision to cancel her policy, asking if she could keep paying the premium and continue coverage until her current course of treatment ends, the insurers wrote back with yet another denial. But they did say they hoped her health improved.

-- Additional reporting by Tim Bella

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click link to view article. 2 videos at bottom.
Insurance employee flips off grieving mother of dead daughter

Insurance company denied liver transplant to teen aged daughter of insured, using the excuse the procedure was "experimental". This is an excuse often used by insurers to weasle out of paying for an expensive procedure. See links below: Liver transplants have been done for over 38 years at a rate of about 5,000 a year. Hardly an "experimental procedure".

  1. Action Plan for Liver Disease Research - Minutes : NIDDK... approximately 5,000 liver transplants are done yearly in the U.S. at more than ... The challenges in liver transplantation are many. ...niddk.nih.gov/AboutNIDDK/ResearchAndPlanning/... - 65k - Cached

  2. What I need to know about Liver Transplantation... surgery has been done for more than 38 years. Many people have had liver transplants and now lead ... of Health of the U.S. Department of Health and Human ...digestive.niddk.nih.gov/ddiseases/pubs/livertransplant_ez - 36k -




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Who has a death panel?

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Pros and Cons Re: "Death Book"

http://www.huffingtonpost.com/2009/08/22/how-conservatives-got-the_n_266275.html
How Conservatives Got The Facts Wrong On Their Latest Obsession: The "Death Book" For Veterans
***UPDATE*** Assistant Secretary of Veterans Affairs Tammy Duckworth appeared on Fox News Sunday this morning to combat the false allegations that the VA is using...


Marcus Baram
Marcus@huffingtonpost.com |

How Conservatives Got The Facts Wrong On Their Latest Obsession: The "Death Book" For Veterans


First Posted: 08-22-09 10:08 PM | Updated: 09-22-09 05:12 AM


***UPDATE***

Assistant Secretary of Veterans Affairs Tammy Duckworth appeared on Fox News Sunday this morning to combat the false allegations that the VA is using a "death book" to encourage veterans to end their lives.

WATCH:



The latest conservative obsession - dutifully spread via *Sarah Palin's Facebook page - is marked by the same *alarmism and *factual inaccuracy as the hysteria over "death panels."

According to this tale, America's veterans are being steered into ending their lives via a "death book" distributed by the government.

It all started with Jim Towey, the former president of the ***White House Office of Faith-Based Initiatives under George W. Bush, who penned an op-ed in the Wall Street Journal describing how the Department of Veterans Affairs was using an end-of-life planning document that was aimed at steering veterans toward choosing death.

Towey stated that the message of the veterans' health-care system to its patients was "hurry-up-and-die" and he contrasted the "death book" with "Five Wishes," his own advance care planning document.

In dramatic language, he wrote:

"One can only imagine a soldier surviving the war in Iraq and returning without all of his limbs only to encounter a veteran's health-care system that seems intent on his surrender."

Soon enough, *Palin linked to the piece, stating that "the Veterans Administration encourages veterans to forego care as they make end-of-life decisions." And Fox News' Sean Hannity and RNC chair Michael Steele were calling it the equivalent of "death panels" for military veterans.

They failed to mention that the so-called "death book" contains the **same advance-care planning required of all health care organizations under federal law, has been in use since 1997 and was **developed with the input of interfaith ministers.

In addition, Towey seems to have *his own axe to grind. He has repeatedly tried to get the government to spend millions to purchase his "Five Wishes" book, which is published by Aging With Dignity, a non-profit group he founded, to distribute to veterans across the country, according to sources within the VA. Towey used his influence with the White House to get a meeting with VA officials, including then-Secretary of Veterans Affairs Jim Nicholson. At one meeting, Towey was informed that the VA could not act on such an unsolicited proposal without violating federal procurement regulations, according to VA sources.

The VA's policy is in accordance with the 1990 Patient Self Determination Act, which requires all institutions receiving Medicare funds to provide information to patients regarding end of life, living will and other advance directives. During the Bush administration, the VA changed its regulation to extend the act to cover all VA facilities.

In 2007, after Towey complained that the so-called "death book," "Your Life, Your Choices - Planning for Future Medical Decisions," was biased against the right-to-life viewpoint, the **VA convened an outside panel of experts to assess and update the booklet.

In his op-ed, Towey stated that this panel did *not include any representatives of faith groups or disability rights advocates. *In fact, according to the VA, *the panel included a *priest, a *rabbi, a renowned *disability rights advocate, and the *president of the organization that produces "Five Wishes," the alternative advance care planning document that Towey is promoting and selling.

The panel supported the use of the "Your Life, Your Choices" booklet but included some suggestions for revising its content. The plans to update and release the booklet were developed under the Bush administration and it is due for release in 2010.

Towey, along with Assistant Secretary Of Veterans Affairs Tammy Duckworth are scheduled to discuss the issue on "Fox News Sunday" tomorrow.

Dr. Ellen Fox, the Chief Officer for Ethics in Health Care at the Veterans Health Administration, defended the use of the booklet:

Your Life, Your Choices is an educational workbook that was designed specifically for Veterans. The authors went to great lengths to ensure it would be meaningful and helpful to all Veterans, regardless of their religious and cultural backgrounds. I am impressed by the development process they used, which included *extensive input and testing by *different Veterans groups, *religious leaders from *10 different faiths, *elderly and *disabled individuals, and experienced *doctors and nurses.

They even made sure to incorporate everyday language that Veterans commonly use to describe medical conditions, while at the same time providing accurate information from the physician's perspective. Over the past 10 years it has been tested through scientific research, endorsed by many respected professional organizations, and widely used throughout the U.S. health care system. It is one of many educational resources we provide to help Veterans and their families. As a Federal agency we have an obligation to be responsible stewards of taxpayer dollars by maximizing the services we provide our Veterans. Providing an educational resource like Your Life, Your Choices at no cost to Veterans is one of the many ways we fulfill this mission. The whole purpose of this workbook is to encourage more conversations between patients, families, and health care teams. Anyone who is seriously interested in ensuring that Veterans receive the best care possible should recognize this.

Towey did not return calls placed to St. Vincent College, where he is the president.


Read more at: http://www.huffingtonpost.com/2009/08/22/how-conservatives-got-the_n_266275.html


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http://www.huffingtonpost.com/2009/08/26/huffposts-marcus-baram-de_n_269483.html
HuffPost's Marcus Baram Debates Jim Towey Over VA's Use Of "Your Life, Your Choices"

Huffington Post Night Editor Marcus Baram defended The Veterans Administration's use of the end-of-life planning document "Your Life, Your Choices" Tuesday, on CBS News' Washington Unplugged.

Baram pointed out that the controversy seems like a *manufactured one; "Your Life, Your Choices" was *in use for more than ten years.

Jim Towey, the former president of the *White House Office of Faith-Based Initiatives under George W. Bush, was the counterpoint. According to Towey, "Your Life, Your Choices" is not sensitive enough.

The host asked Towey if his arguments can be interpreted as "sour grapes." Towey tried selling his own two-page, end-of-life booklet to the VA at a cost of $5 per veteran, but the VA declined. VA Assistant Secretary Tammy Duckworth mentioned Towey's booklet during an interview on Fox News, Sunday, Aug. 23




Watch CBS News Videos Online

Read more at: http://www.huffingtonpost.com/2009/08/26/huffposts-marcus-baram-de_n_269483.html

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