A look back at the week's health policy news with a
focus on ACA implementation
“The only constant in life is change” – Heraclitus
This week I present to you Issue 48 of That Was The Week
That Was. And with mixed emotions I write to tell you that the last edition
will be Issue 52 (to be published on March 13).
I cannot thank the Maine Health Access Foundation enough for
supporting this publication. Through their support I have been able to, as my
wife says, read more about healthcare than is probably good for me. It has been
a tremendous learning experience and a lot of fun. However it’s time for me to
move on to my next adventure.
Like John Stewart (that other guy who announced this week he
was leaving his current gig), I’m not yet sure what my next step will be. I’m
interested in moving back to a full-time position related to health policy,
either here in Maine or elsewhere. For those of you not familiar with my
background, I spent 20 years working in various
capacities for Mercer Human Resource Consulting (employer-sponsored health
care). Since coming to Maine I worked at Health Dialog, where I created a new
department - The Office of Program Coordination, and was the Policy Director at
Consumers for Affordable Health Care. You can read more about me on my LinkedIn Profile. If
any of you have any thoughts or suggestions, please let me know
In the meantime, we still have a month together that will
include the wrap-up of open-enrollment, the Supreme Court hearing oral
arguments on the subsidy case, and I’m sure many surprises. So without further
ado, here is this week’s issue where we look at an ACA replacement plan, more on
the subsidy case, open enrollment ending, Medicaid expanding or not, measles,
provider consolidation, end of life and more. Here we go.
ACA: Opposition
Last week we took an initial look at the “replacement” plan
introduced by Burr/Hatch/Upton. Now other smarter people have taken a more detailed
look and have also found it lacking: “The Hatch-Upton-Burr plan claims to
provide affordable coverage and improved access to care as a replacement for
the Affordable Care Act. But relative to current law, the plan would likely
disrupt existing coverage for millions of people — including many poor
beneficiaries who rely on Medicaid today — and cause many of them to become
newly uninsured or underinsured. It would move the United States backward,
toward the poorly functioning individual market that existed prior to health
reform.” (Republican
Health Plan Would Cause Millions to Lose Current Coverage and Add to the Ranks
of the Uninsured and Underinsured).
And
this: “And there is a deeper lesson. One should not be fooled by slogans and
generalities. One has to examine details in order to know whether a plan is or
is not a basis for negotiation. Make no mistake—details of Obamacare do need
fixing-- but those repairs involve filling holes in coverage, not making more
holes. It requires making benefits more generous, not less. The
Burr-Hatch-Upton plan proposes to move in the wrong direction. Such a plan
cannot serve as a basis for negotiation.” (Not
Ready for Prime Time: The Burr, Hatch and Upton Obamacare Proposal)
ACA: Court Cases
Lots of talk this week about the subsidy case (King v
Burwell). With oral argument less than a month away, the media is taking stock
of all the briefs that have been filed. First let’s note that “… not a single
business group—not the US Chamber of Commerce, not any of the health industry
companies and trade groups that opposed the law when it was being drafted—has
presented a brief endorsing this lawsuit.” (America's
Largest Health Care Company Tells Supreme Court That Anti-Obamacare Argument Is
"Absurd") In addition to
no businesses supporting the suit, many have filed defending the existing
subsidies: “Among those filing amicus briefs defending health reform are HCA,
the American Hospital Association, America's Health Insurance Plans, the
National Alliance of State Health Co-ops, the Catholic Health Association of
the United States, the American Cancer Society, and the National Association of
Community Health Centers.” (Backing
Obamacare Ahead of Supreme Court Hearing).
Also, more theorizing about the case itself. Starting with a
new email unearthed showing intent of the staff that drafted the bill: Key
Premise Of Obamacare Lawsuit Contradicted By Email Senate Aide Sent In 2010
“The premise of the latest legal attack on Obamacare has always been shaky. An
email that a key Senate staffer wrote in January 2010 would appear to make it
even shakier.”
And these two (warning, legal theorizing ahead), the first
deals with federalism: “When it comes to the exchanges, however, the ACA is not
a conditional spending program. And it’s not a close call: the ACA doesn’t look
like any other conditional spending program in the U.S. Code. … For starters,
Congress isn’t coy about what happens when a state fails to participate in a
conditional spending program. It speaks clearly—the state doesn’t get the
money—and that consequence is spelled out in a provision that speaks directly
to states.” (Respecting
the states.) And the second deals with the word “such”: “The fate of
Obamacare might hinge on the Supreme Court’s interpretation of just one word:
“such.” Perhaps never before has so much been asked of “such.” It is a key part
of the Obama administration’s argument urging the high court not to invalidate
the Affordable Care Act’s insurance subsidies in most of the country.” (The
One Word That Could Save Obamacare)
Also this week, the media started to look at the actual
petitioners in the suit – remember, an individual has to be harmed to have standing
to sue. Looks like it was tough to find such people: The
Conservative Obamacare Challenge Has Become an Absurdist Comedy “The Supreme
Court case that could eliminate Affordable Care Act subsidies in 34 states is
nested in a fictional history of Congressional intent, and thus has a lot to
answer for. Its credibility sustained a further hit this week, when reports in
the Wall Street Journal and Mother Jones revealed damaging information about at
least three, and possibly all four, of the King vs. Burwell petitioners.”
“To be clear, the standing questions almost certainly won’t
be enough to disable the lawsuit. All it needs is one plaintiff with standing.
And there are other people out there — on other lawsuits, and beyond — who can
legitimately claim injury. This legal challenge will go forward one way or
another. But all of these new, emerging details feed the generally trumped-up,
circus-like sense that is increasingly enveloping this lawsuit. And there are
plenty of questions about it that remain unanswered.” (Morning
Plum: Anti-Obamacare lawsuit comes under intense media scrutiny)
As the day of reckoning gets closer, a reminder that you
should be careful what you wish for: Health
Law Case Poses Conundrum for Republicans “On the one hand, Republicans in
Congress are urging the Supreme Court to strike down subsidies for health
insurance provided to millions of people in more than 30 states. On the other,
they are chiding the Obama administration because it has no plan to avert the
hardship that could occur if they win in court.” Understanding the consequences, both
practical and political, brings us here: Why
Republicans Secretly Hope the Supreme Court Will Save Obamacare “If the
Court grants Republicans a “victory,” many actual Republicans won’t consider it
a victory at all, and the competing concerns of anti-Obamacare zealots,
industry-friendly pols, swing state incumbents, governors, and presidential
candidates will break out into the open.”
Remember that if the suit is successful, it impacts only
states that use the federal marketplace. That means there are states where the
suit will have no impact, leading to this: Get
ready for deeper polarization of our health care system “For a time, it
looked as if supporters of the Affordable Care Act had reasons for optimism
about the law’s long-term prognosis in red states, as one GOP governor after
another accepted the logic of the Medicaid expansion, which promises state
lawmakers huge amounts of federal dollars to improve the lives of their own
constituents. But it now looks like such optimism may have been premature: That
logic is hitting a wall of opposition from conservative legislators even in
states where GOP governors had thrown themselves behind versions of the
expansion. All this — taken with the possibility that the Supreme Court could
soon gut subsidies in three dozen states – suggests we may be heading for
deeper polarization in our health care system.”
ACA: Enrollment
As I write this on Thursday night, there are three days left
to open enrollment. So if you’re reading this and are not covered, stop reading
and go sign up. OK, everyone else, let’s start by looking at the most recent enrollment
report. It showed the expected uptick for the week before the deadline: Open
Enrollment Week 12: January 31, 2015 – February 6, 2015 “Since Open
Enrollment began on November 15, 7.75 million consumers selected a plan or were
automatically re-enrolled through the HealthCare.gov platform, which includes
the Federally Facilitated Marketplaces, State Partnership Marketplaces and
supported State-Based Marketplaces.”
Here in Maine, last week showed double the activity we had
the week before - mirroring the activity for the week of the Feb 1 effective
date deadline – but remember, unlike that deadline, this one is for keeps
marking the end of the open enrollment period (there are exceptions for life
events, but if you’re reading this you probably know that, if not you can find
info here: Your
options outside Open Enrollment).
| Week Ending | Cumulative | Week |
| 9-Jan | 59,126 | |
| 16-Jan | 61,964 | 2,838 |
| 23-Jan | 62,983 | 1,019 |
| 30-Jan | 64,069 | 1,086 |
| 6-Feb | 66,118 | 2,049 |
The Marketplace has staffed up and is ready for the final
rush since as a species, we do love to wait for the last minute: “Thousands of
more friendly and better-trained call-center employees will be working starting
Monday to deal with the expected late onslaught of people signing up before the
Obamacare open enrollment ends Feb. 15. A 40% increase, to a 14,000-person
workforce, is expected to help with wait times, which averaged about 2 ½
minutes the last week of January, but are likely to get longer as the deadline
nears.” (A
friendlier Healthcare.gov call center prepares for rush)
ACA: Marketplaces
Three reports out this week looking at coverage details on
the marketplace:
Almost 6.5
million consumers qualify for an average tax credit of $268 per month through
the Health Insurance Marketplaces “The U.S. Department of Health and Human
Services released today a report outlining the impact of advanced premium tax
credits on premiums in the Health Insurance Marketplaces. Almost 6.5 million
individuals in the 37 states using the HealthCare.gov platform are estimated to
qualify for an average of $268 per person/month in advanced premium tax
credits. Among consumers who are signed up for 2015 coverage to date in the 37
HealthCare.gov states, 8 in 10 could choose a plan with a premium of $100 or
less after tax credits, based on available options.”
Characteristics
of Those Eligible for Cost-Sharing Reductions and Premium Tax Credits Under the
Affordable Care Act Primary Source – Urban Institute study “The authors
find that if all those eligible enroll in a plan by 2016, they would save, on
average, $479 per year on things like co-pays, deductibles and co-insurance.
Co-insurance is the percentage of the actual cost of health services—things
like prescriptions, imaging tests, hospital stays, etc.—that a person has to
pay out-of-pocket for covered services.”
New
Reports Analyze Cost Sharing in 2015 ACA Marketplace Plans in 37 States “In
a new brief and collection of 36 charts, the Foundation compares cost sharing
across standard silver plans and their variants in federally-facilitated ACA
marketplaces, examining average deductibles and out-of-pocket limits, as well
as copayments and coinsurance for hospital stays, physician visits, emergency
room visits, and prescription drugs.”
ACA: Affordability
Unfortunately, with the battle continuing for the mere existence
of the law, there is little prospect in the near future of trying to improve it.
And make no mistake, as much as an improvement the law was over the status quo,
there is still work that needs to be done. One of the main areas that could be
improved is affordability.
We know that everything is trade-offs. If you want low
premiums, you end up with high cost sharing. The law as it currently exists
tries to soften the blow with cost sharing subsidies and out-of-pocket limits,
however the current situation is not all we might wish it to be. One of the
issues with high cost sharing is that it indiscriminately leads to less care –
both needed and unneeded care and that can have unintended consequences: High
deductibles could stymie efforts to slow healthcare spending “That's
because patients are likely to forgo highly effective treatment to escape
medical bills under high deductibles. The new study found use of preventive
medicine dropped when one employer switched to high-deductible health benefits.
… “This study adds confirmation to the simple adage: If you make people pay
more for something, they will buy less of it, regardless of the clinical
value,” Fendrick said.”
The NY Times also took a look at the issue. However, one
lack in this piece is that it focuses on some examples of people that have real
issues without providing balance or magnitude.
Yes these people need more help, but do they represent 5% of those
covered or 50%? “The Affordable Care Act has ushered in an era of complex new
health insurance products featuring legions of out-of-pocket coinsurance fees,
high deductibles and narrow provider networks. Though commercial insurers had
already begun to shift toward such policies, the health care law gave them
added legitimacy and has vastly accelerated the trend, experts say.” (Insured,
but Not Covered)
But to end on a positive note, a Study
finds it cheaper for students to buy insurance than go without “A new
analysis from the CSU Health Insurance Education Project found that half the
approximately 445,000 students in the CSU system are able to purchase health
insurance for less than they would have to pay in fines for remaining
uncovered.”
ACA: Other
This piece takes a look at Puerto Rico, it is a fascinating
story – they have Medicaid expansion with no insurance subsidies or individual
mandate, but they do have a no pre-existing condition exclusion – a situation
that many states could find themselves in if SCOTUS rules against the
subsidies: In
Puerto Rico, Health Overhaul Gets An Incomplete
Many of the new insurance plans set up with government loans
(COOP plans) are struggling. However the S&P report singled out our own
Maine Community Health Options as the exception: Obamacare
Insurance Co-Ops Struggle With Cash Flow “Obamacare’s startup health
insurance plans are flirting with financial distress, as all but five of the 23
nonprofit companies had negative cash flow from operations in the first three
quarters of 2014, Standard & Poor’s said in a report today.”
Medicaid
Let’s start this week’s Medicaid look with a focus on Maine.
First, Mike Tipping takes a look at the predictions of last year’s Alexander
report in light of the new MaineCare budget, and confirms (yet again) how bad
the report was: LePage-authorized
Alexander Report was a complete con job, new numbers show.
Also a look at the impact of not expanding Medicaid on our
community health clinics: Community
health clinics struggle with impact of MaineCare cuts ‘’ Since Maine
trimmed eligibility for MaineCare, reducing the ranks of Medicaid patients from
357,000 in 2011 to about 290,000 this year, community health centers have
increasingly felt the financial fallout.”
The problems providers face when Medicaid isn’t expanded are
not unique to Maine, here’s a look at Baton Rouge: When
a state blocks Obamacare, ERs close: The lesson of Louisiana “Baton Rouge,
La., is about to lose one of its crucial hospital emergency rooms, and the
reason is clear: The administration of Gov. Bobby Jindal has refused to expand
Medicaid under the Affordable Care Act, and won't put up any other money to
keep the facility open.”
It’s worth remembering that Medicaid is a big program and
there are other topics to discuss besides expansion. While we know the
President’s budget will not be passed as is, there are reforms included that
will become part of the discussion. One important one is this: Is
Obama Budget The Beginning Of The End For Nursing Home-Based Medicaid? “Under
a new pilot program, as many as five states could effectively skip that waiver
process. Instead, they could assess a person’s care needs and simply determine
where she could receive the most appropriate, cost- effective care. No longer
would a nursing home be the default solution.”
And with that exciting news behind us, back to Medicaid expansion… Here is a great review by the NY Times of
this week’s developments. Chief among them are the two red states where the
Governors were supporting expansions but the legislature said no: Complicated
Politics of Medicaid Expansion Are Playing Out State by State “These new
developments underscore just how complicated the politics of expanding Medicaid
have become — and just how different the results of seeking an expansion have
been from state to state.”
Medicare
“On Thursday the CMS issued a national coverage
determination giving certain Medicare beneficiaries immediate coverage for the
screening test.” (Medicare
will pay for lung CT scans for cancer screening)
However, there was those who questioned the decision: Can
I interrupt your repeating a Medicare press release to talk about
cost-effectiveness? “Wait, what? For current smokers, the cost
effectiveness for current smokers of this screening was $116,000 per QALY. For
former smokers – which Medicare is going to cover – the incremental
cost-effectiveness was more than $2.3 million per QALY. And this study was
using 2001 $US, cause it was published back in 2003. Now, people in this
country may think that’s money well spent. That’s fine. But let’s acknowledge
that this is a pretty high cost per QALY gained. I see nothing but praise for
this development in the media, while Sovaldi (incremental cost-effectiveness of
less than $26,000 per QALY $54,000 per QALY) is often portrayed as a
budget-busting, crazily priced monstrosity.”
We know we can’t do everything, so we really do need to be
having frank discussions on what we cover and don’t cover.
Measles
So much has been written in the past few weeks on this
topic, what else is there to say? We are
in the middle of an outbreak that could have been a lot less severe if everyone
was up-to-date on their vaccines. Some want nothing to do with vaccines, some
think they know better and should spread them out more, and some have busy
lives and can’t get everything done on time. All the attention is good, with a
bit of perseverance and luck it will lead to higher vaccination rates.
With that in mind, and again sparing you all the links I
could have shared, here are a few highlights from this week:
A look at the delayers: The
vaccine delayers: They hate anti-vaxxers — but don't quite vaccinate on time
An important public endorsement, once again trying to combat
one of the more pervasive lies about vaccines: Autism
Speaks, leading autism advocate, urges vaccination “A leading autism
advocacy organization, Autism Speaks, is urging parents to vaccinate their
children amid a measles outbreak that has swept 14 states. As some continue to
cite unfounded fears that vaccinations can lead to autism, Autism Speaks chief
science officer Rob Ring has released a statement saying vaccinations cannot
cause the disorder — and telling parents to vaccinate their children.”
Most politicians are rallying together (note I said most,
not all): Bipartisan
support voiced for vaccinations, as one critic stays away ““Too many parents
are turning away from sound science,” said Sen. Lamar Alexander (R-Tenn.),
chairman of the Senate Committee on Health, Education, Labor and Pension during
a hearing. “Sound science is this - vaccines save lives.””
An update to an employment policy that can help those too
young to be vaccinated: KinderCare
requiring measles shots for infants' caregivers “A national day care
provider says that as of next week it will require measles vaccinations for all
staff members who work with children less than months old, after health
officials in Illinois announced measles diagnoses in five infants who attended
a suburban Chicago center.”
And finally a look at the dollars involved in combatting an
outbreak: Measles
Outbreak in Dollars and Cents: It Costs Taxpayers Bigtime “But only a
handful of folks have talked about costs. Measles is expensive. Really
expensive. And even if you live in a highly vaccinated area with no outbreaks,
a measles case in your state – that’s a third of the U.S. right now – still
means health department tax dollars diverted from other programs to deal with a
disease that was eliminated from the U.S. in 2000.”
Drugs
Ever wonder why I’m not a big fan of the pharmaceutical
industry? One big reason is that they
expect profit margins that hospitals, providers, and insurance companies can
only dream of. They claim they deserve that because of the amount they spend on
research. But take a look at this: 9
of 10 top drugmakers spend more on marketing than research “These spending
numbers are at odds with a common claim by pharmaceutical companies that they
need to patent drugs for extraordinary amounts of time to justify the massive
amounts of money spent on research. Not only do many top drugmakers appear to
spend more on advertising, but their profit margins, the BBC noted, are often
larger than their research spending.”
John Oliver in his show this week took a look at the
industry, it’s worth watching if for no other reason than this wonderful line: “"Drug
companies are a bit like high-school boyfriends," Oliver said.
"They're much more concerned with getting inside you than being effective
once they're in there."” (John
Oliver returns with a devastating message about pharmaceutical companies)
When did this country turn its back on science? I have no answer, but I do have two examples
this week.
Prescribing
off-label: It’s gotten out of control “Modern medicine was meant to be
different — it would be based on scientific evidence that could tease out real
effect from placebo effect. Unfortunately, evidence-based medicine is only as
good as the evidence it is based on. And in many instances our evidence is not
very good because it comes from biased drug company studies.”
Stupid
Pills: The Politics of Fraudulent Dietary Supplements “To understand how we got here, you have to go
back to 1994, when Senator Orrin G. Hatch of Utah midwifed through Congress a
new industry protected from all but minimal regulation. It is also an industry
that would make many of his closest associates and family members rich. In
turn, they’ve rewarded him with sizable campaign contributions.”
Costs
Yes cost increases have moderated recently, but don’t be
fooled. We still have a long way to go and worse, we are really not sure of the
path to true cost control.
One possibility is called all-payer rate setting. Here Vox
takes an in-depth look at the issue: All-payer
rate setting: America’s back-door to single-payer? “All-payer rate setting,
as the system is known, shares the same goals of single-payer: it aims to
increase efficiency and reduce insurer overhead in the health care system.
Single payer does this by eliminating private plans for one government plan.
All-payer rate setting gets there by setting one price that every health
insurer pays for any given medical procedure.”
The ACA does not address the issue, but in an interview, the
President seemed to point in that direction (at least when it comes to
prescription drugs): On
health-care prices, Obama goes where Obamacare doesn't “In an interview
with Vox, Ezra Klein asked Obama whether America should have "private
insurers band together with Medicare, with Medicaid, to jointly negotiate
prices." Obama answered by saying: "I think that moving in the
direction where consumers and others can have more power in the marketplace,
particularly when it comes to drugs, makes a lot of sense."”
One sign that we are still figuring things out has to do
with provider consolidation. On the one hand it’s claimed that it improves efficiency
and patient care, on the other hand it gives the consolidated organization more
market power which can lead to higher rates.
This week, the courts weighed in: Courts
prove tough crowd for consolidating providers ““I think this is sort of a
wake-up call for hospital systems,” said Matthew Cantor, an antitrust lawyer
with the firm Constantine Cannon in New York. “Just stating that you're merging
to better patient outcomes to achieve the goals of the Affordable Care Act—that
you somehow intend to gain cost efficiencies without providing the flesh to
that argument—that's not going to work under antitrust laws,” Cantor said.”
One way consolidation contributes to price increases is the
different ways hospitals and independent physicians are compensated. But that
may change: When
Hospitals Buy Doctors’ Offices, and Patient Fees Soar “Still, Robert
Berenson, a physician and a senior fellow at the Urban Institute, said it’s
clear that a lot of recent doctor-hospital mergers have been driven by
Medicare’s disparate pay policies. He thinks the budget proposal lacks needed
subtlety, but he supports equalizing many payments in concept. “If hospitals
are going to employ physicians, it should be done for the right reasons, not
the wrong reasons,” he said.”
And finally, for all the talk about paying for quality
instead of quantity – it’s easier said than done: We really
want to pay for quality, but it’s so darn hard. “Paying for
quality, not quantity is getting to be almost cliché. Recently, the Obama administration
doubled down, however, announcing ambitious targets for Medicare payments to be
“tied to” quality in the future. Unfortunately, the evidence behind such
programs working continues to elude us.”
System Transformation
Quality of Care
Here’s a quick list you should share with your family. We
all are consumers of health care, know what you’re buying: 9 facts
about medical errors you should know before entering a hospital
Unfortunately, all bad treatment is not done unintentionally.
This piece takes a look at overuse of certain cardiac procedures: Are
Doctors Exposing Heart Patients to Unnecessary Cardiac Procedures? ““You
have to wonder what’s going on,” says Harvard physician and historian Dr. David
Jones, author of "Broken Hearts: The Tangled History of Cardiac
Care." “Are these doctors going to get bigger paychecks at the end of the
month for doing more of these procedures? That may be an uncomfortable question
to ask, but it’s something patients should wonder about.””
But knowledge is power, and Google is here to help… They are working to insure that information
you get when you search includes some credible sources: Google
works with Mayo to add medical facts to search results “But the
distinguishing characteristic of the new feature will be added credibility, the
company contends. Each piece of data will be reviewed by an average of 11.1
doctors — led by Google's Dr. Kapil Parakh — before being published, according
to the company.”
Data Security
Last week’s announcement of the Anthem hack continues to
reverberate.
We have the NAIC taking a look at this specific incident: Anthem's
data hack prompts probe by national insurance group ““We are in agreement
that an immediate and comprehensive review of the company's security must be a
priority to ensure protection of consumers who are covered by Anthem,” Monica
Lindeen, the NAIC's president and Montana's insurance chief, said in a news
release.”
In case you were wondering why health care data is a target:
Cyber
hackers see potentially rewarding targets when they attack health care
companies “"If someone steals your credit card and home address, they
might be able to buy something, but you can usually get that locked down
quickly," said Tony Anscombe, a security expert with the cybersecurity
firm AVG Technologies. "With medical records and a social security number,
it's not so simple."”
And no, it’s not just your insurance company, your doctor’s
office is vulnerable too: Is
Your Doctor's Office the Most Dangerous Place for Data? “Last year, more
than million people in the U.S. were affected by health care data breaches —
including hacking or accidents that exposed personal information, such as lost
laptops — according to a government database that tracks incidents affecting at
least 500 people.”
And finally, it’s not going to stop: Experts
Warn 2015 Could Be 'Year of the Healthcare Hack' “Stolen healthcare data
can be used to fraudulently obtain medical services and prescriptions as well
as to commit identity theft and other financial crimes, according to security
experts. Criminals can also use stolen data to build more convincing profiles
of users, boosting the success of scams. "All of these factors are making
healthcare information more attractive to criminals," said Rob Sadowski,
marketing director at RSA, the security division of EMC Corp.”
End of Life Care
It should never come to this (warning, have tissues ready): “Everyone
on the oncology unit chipped in two dollars, and she had enough medication to
last at least ten days. She only needed enough for five days.” She only needed enough for five because she
only lasted that long: Be
aware of cost savings available to every patient
We are still really bad at this stuff. Frontline partnered
with Atul Gawande to take a look at “Being Mortal. Vox reviews the program
here: Atul
Gawande explains the biggest problem with dying in America and you can watch it in full here: Frontline:
Being Mortal. (In case you forgot,
Atul is going to be the keynote speaker at this year’s Quality Counts
Conference – Registration
is now open)
Some say allowing physicians to help ease one’s passing would
be helpful, but it is a topic of great controversy. This week Canada
legalizes physician-assisted suicide: “In a landmark decision, Canada's Supreme Court ruled that
physicians should be allowed to aid a patient in dying so long as "the
person affected clearly consents to the termination of life" and is
suffering from ""grievous and irremediable medical condition."”
While in California, a Lawsuit
Seeks to Exempt Doctors From Assisted Suicide Ban “A cancer patient and
five doctors filed a lawsuit Wednesday seeking to exempt physicians who help
terminally ill patients end their lives from a state ban on assisted suicide.”
Regardless of if we allow for this or not, we have to do
better at handling the last stage of life.
All
comments and suggestions are welcome; please let me know what you think. And as
always, thanks for reading!
Funded by support from
the Maine Health Access Foundation
*The title is a tribute to the BBC show, the NBC show and the amazing Tom Lehrer album "That Was The Year That Was"
