SENIORS SAY: “FIRST DO NO HARM”

AMERICA’S SENIORS SAY: “FIRST DO NO HARM”
Mike DeNunzio, Chairman S.F Republican Assembly

“Whether to save one 20 year old who might live 60 years, or three 70 year olds who could live 10 years is unclear. We recommend the "Complete Lives System" that prioritizes younger people. Reform must redefine doctor’s ethical obligations for the greater good.‘

This ominous prognosis for America’s seniors was co written by the distinguished bio-ethicist, Ezekiel Emanuel, MD, PhD in the British Medical Journal, January. 2009. Doctor Emanuel is Special Advisor for Health Policy to the Office of Management and Budget--his brother is Rahm Emanuel, President Obama’s Chief of Staff. Ezekiel Emanuel supports “the 2009 Health Choices Act" (HR3200 it includes: Advance Planning Consultation for End of Life Services; and a “Center for Comparative Effectiveness” to base treatment on cost and patient age. (Section (Sect.1401) Seniors are greatly troubled by HR3200 –Republicans, independents and Democrats.

“Why are we making bad decisions for the sake of passing something on a self imposed deadline. I don’t know why our Senators -Feinstein and Boxer allowed it to happen.” Willie Brown, former Mayor of San Francisco asked this question in his column in the S.F. Chronicle, Dec. 27, 2009. Most seniors agree with “Da Mayor: Senior’s don’t buy from people in a hurry to sell something they won't buy for themselves. Americas seniors do not want their intelligence insulted: They question why Congress exempts itself and 2.4 million federal employees from HR3200. They also ask why a reform to reduce health costs excludes mal practice lawsuits that increase costs $200 million a year; and why health care leaders endorse a bill they never read. HR3200 will take over one sixth of the US economy and affect 300 million Americans from womb to tomb,

America’s forty million seniors age 65 and over, and fifty million “boomers” 50 to 64 are active, accomplished and informed: Millions work, run businesses, serve on boards, donate funds and volunteer hours valued at billions. They read, watch, listen and discuss health issues; half are married, own homes, assist their families- including aged parents. Eighteen million are veterans, and eight of ten votes regularly. Many face health and financial challenges and require costly assistance; two of ten live below poverty. They helped pay for and create a health care system that is the envy of the world. Medicare is not charity - seniors have earned it-and they don’t want it cut.

In 2008 both parties called for reforms to make health insurance and health care more affordable and available and America agreed, especially seniors. Today over half the nation opposes HR3200, and seniors oppose it most: Seniors know good intentions can cause harm; they remind proponents of HR3200– First do no harm”--the caveat of Hippocrates- the father of western medicine: HR3200 harms seniors; it cuts $500 billion from Medicare’s hospital and home care, nursing facilities, hospice, rehab, Medicare Advantage Insurance and especially the aged, disabled and terminally ill. HR3200 also increases taxes $400 billion; they include medical devices, stints and wheelchairs; and increases insurance premiums and total health costs.

Seniors ask why the American Medical Association, the American Nurses and Hospital Associations, and the AARP and PhARMA endorse a bill that cuts their Medicare. They’ve learned these health care leaders negotiated self serving deals: The AMA to protect certain billing rights; the AARP to protect sales of insurance; PhARMA to restrict drug imports; the Hospital Association to get insured patients, and the Nurses Association for pro union legislation. The AFL- CIO and SEIU and the American Bar Association also endorsed HR3200- but they don’t take care of the sick and never took an oath to ”do no harm.” Seniors now know eighty percent of America’s 800,000 doctors do not belong to the AMA -and most oppose HR3200, and over 60,000 members have quit the AARP since June..

The health care and government officials who endorse HR3200 know health budgets of countries with “government care” prioritize lower costs over patient care. Canada and European Union nations uses fewer MRIs, CT scans, advanced drugs and fewer beds per capita. They also report higher mortality for cancer and heart disease. In the EU the death rate from cancers in Great Britain is second only to Denmark, and only the German regions of Saarland, Bremen and Rheinland-Pfalz have a higher death rate from heart disease. Britain’s National Health Service also uses a system called “Quality Adjusted Life Years” to determine treatment based on cost and patient age; and it restricts renal dialysis for the aged, as do other EU nations: In Belgium and the Netherlands, euthanasia is legal; the Dutch also permit neo natal intensive care units to give lethal injections to newborns diagnosed unable to have “meaningful relationships. The entire EU invests only 16% of the world's biotech research; the US invests 78 percent for new drugs and technologies that save lives worldwide. Every year thousands from Europe seek treatment in the US; last year 39,282 came from Canada where the Supreme Court ruled: “Access to a waiting list is not health care.

Seniors know Medicare’s greatest costs are in the final years of life. they are wary of a “Center for Comparative Effectiveness” to recommend treatment based on cost and age. They also oppose federalized "Advance Consultation for "End of Life Service."(Sect.1233) Seniors have caring families and trusted advisors; those who need assistance can receive it at no cost; Every state has agencies and protective laws for Advance Directives -like California Probate Code 4700, and the national hot line (800-222-1753)

Seniors and most Americans now know the “47 million” reported to lack health insurance includes ten million who are not US citizens. The uninsured citizens include nine million that earn over $75,000 and eight million over $50,000. Another ten million citizens are eligible for insurance but not enrolled in Medicare or Medicaid, S-Chip, veterans or employer’s plans. The ten million Americans who need assistance can be insured with patient centered options that preserve choice. They include; portability, interstate sales, group purchase, cash subsidies, risk pools for pre existing conditions, and tax exempt medical savings accounts.

Congress is buying the votes and will change anything to pass HR3200- and “fix it later.” Seniors know they will be first to lose most care -and the most years of life: They don’t want health policies for the “greater good,” from countries with moribund populations rampant with and anti life pathologies: The average “population replacement rate” in the EU is 1.5 per couple, and suicide, abortion and substance abuse is record high. The EU defense budget to protect its population is a telling 1.6 percent of GDP, and Canada is 1.1 percent. The US expends 6.1 percent of GDP to protect American lives- and Canadians and Europeans.

The 1991 national best seller “Parliament of Whores” by P.J. O’Rourke was hailed a “perceptive indictment of Congress.” A 2009 version could be titled “Parliament of Charlatans,” and indict health care and government officials that support HR3200. The Surgeon General should declare them "Dangerous to America's health." America's Senior’s will remind them 21st century America is not 8th century Sparta where ailing seniors and sickly newborns were left on a hillside to die: In America the right to life is inalienable, America is not the EU- “first do no harm.”

NOTE TO READERS:
SPEAKING CLEARLY presents personal views of Mike DeNunzio: They do not represent opinions or recommendations of any commission or other public or private organization of which he is a current or past member. Mike DeNunzio is Chairman of Development Services Group, Inc.-consultants to non profit organizations for health care, educational, and social services. He has guided clients throughout the U.S. and in Canada, Europe, Central America and Asia. He serves on the board of the American Institute of Ethics and "The Handicapables." Governor Schwarzenegger appointed him to the California Commission on Aging, and he was a San Francisco Commissioner on Aging-Adult Services, appointed by Mayor Willie Brown, and reappointed by Mayor Gavin Newsom. He is a thrice elected past Chairman of the San Francisco Republican Party and currently Chairman of the S.F. Republican Assembly.