Tag Archives for Obamacare

Prominent Oncologist’s Death Wish at Age 75

Published in Pawtucket Times, December 12, 2014

Dr. Ezekiel Emanuel, MD, Ph.D., a nationally-recognized oncologist and bioethicist, definitely marches to a different drummer.  While millions of older Americans pop Vitamins and supplements like M&M Candy, regularly exercise at their local gym, religiously jog and carefully watch what they eat to increase their life span, the chair of medical bioethics and health policy at the University of Pennsylvania, says living past the ripe old age of 75 is not on his bucket list.  We would be doing both society and our loved ones a favor by agreeing with this belief, he says.

When I am 75…

Why not age 80 or even 85?  Emanuel admits that his 75th birthday day was just a randomly chosen number, but the year was selected because scientific studies indicate that increases in physical and mental disability occur around this age, as well as a decline in both creativity and productivity.

The renowned 57-year old breast oncologist is at the top of his professional game.  Emanuel has received dozens of awards from organizations such as the National Institutes of Health and the American Cancer Society, including being elected to the Institute of Medicine (IOM) of the National Academy of Science, the Association of American Physicians, and the Royal College of Medicine (UK). Hippocrates Magazine even selected him as Doctor of the Year in Ethics.

Emanuel is a prolific writer, editing 9 books and penning over 200 scientific articles. He is currently a columnist for the New York Times and appears regularly on television shows including Morning Joe and Hardball with Chris Matthews.  .

The prominent physician, is also considered a key designer of the Affordable Care Act (commonly called Obamacare).  At a personal level, he has two well-known brothers, Chicago mayor Rahm Emanuel, former White House chief of staff, and Hollywood agent Ari Emanuel.

With this prominence, Emanuel’s death wish to die at 75, (the year 2032) before the onset of Alzheimer’s disease and other dementias, and decreased physical stamina (it’s harder to walk a quarter of a mile, even to climb 10 stairs) is drawing the ire of critics who charge that he advocates for health care rationing and legalized euthanasia.

But Emanuel claims that these charges are not true.  Setting his death at 75 is just his personal preference, he says, leaving his mortal coil. In his writings and media interviews he notes that setting the age when he hopes to die just drives his daughters and brothers crazy.

Last October, at the BBC Future’s World-Changing Ideas Summit in Manhattan, Emanuel’s prop, a full-page AARP ad from a newspaper, featuring an older couple hiking above a line of text that read, “When the view goes on forever, I feel like I can, too. Go long.”  Reinforcing his point, Emanuel is not buying AARP’s message pushing the positives of living an extended life.  For him, he doesn’t buy it and most definitely, seventy is not the new 50.

Sharing a Death Wish on the Air Ways

On Dec. 7, on CBC Radio Canada’s Sunday Edition, Emanuel, discussed his controversial October 21, 2014 article published in the The Atlantic, “Why I Hope to Die at 75.”  His Sunday interview detailed his unconventional and controversial stance, especially to AARP, the nation’s largest aging advocacy group, and aging organizations who strongly oppose this type of thinking.

Throughout the 28.12 minute interview with Michael Enright, Emanuel, he warns listeners, “Don’t focus on years, and focus on quality.”

“A good life is not just about stacking up the years and living as long as possible. People need to focus on quality of life,” says Emanuel, noting that “Setting an actual date for a good time to die helps you focus on what is important in your life.”

“It is really about what you are doing to contributing and enriching the world.  I want people to stop focusing on just more years, focusing on quality,” he says.

Emanuel says that you need to be realistic on living forever, your body and mind doesn’t  go on forever.  You should just be satisfied with living a complete life, he says.

By age 75, people will have gone through all stages of life, says Emanuel.  As a child you begin to develop skills and figuring out your place in the world. You go to college, raise a family, work to hone your skills and talents. At the later stages of your life you give advice and mentor people, he says, noting that in your mid-seventies, physical deterioration and mental slowing along with loss of creativity, begin to be felt.

During his radio interview, Emanuel claimed he is very active, recently climbing Mount Kilimanjaro with is two nephews, stressing that he is in relatively good health and doesn’t have a terminal illness and has no plans to commit suicide.   As a matter of fact, the physician even condemned physician-assisted suicide and euthanasia, in a 1997 article published in The Atlantic, a policy allowed in the states of Oregon, Vermont and Washington.  His philosophical view of ending one’s life is to allow the body to age naturally, he stresses.

In eighteen years, Emanuel pledges to refuse all medical procedures and treatments, including taking medications such as statins, cholesterol lowing drugs, and antibiotics that could prevent life-threatening illnesses or extend his life.  He notes that his last colonoscopy will be at 65, to screen for cancer.  No more colonoscopies after 75.  And, he’ll only accept palliative care after that milestone age, too.

“I’m not suggesting people kill themselves at 75 but, rather, let nature take its course,” Emanuel says.

How Others See it

Emanuel’s personal preference not to seek medical procedures or to use medications at age 75 that might lead to his death is not the same as physician assisted suicide, says Rev. Christopher M. Mahar, S.T.L., of the Providence Catholic Diocese, noting that this choice has always been respected by the Catholic Church.

“He is not actively choosing to take his life, and as long as he is not rejecting any of the ordinary means necessary for the preservation of life, such as nutrition and hydration, and is not intentionally destroying his body, he is free to decide for himself, says Mahar.

As Emanuel says, there is a downside to aging.  My 88-year-old mother died after a 14 year battle with Alzheimer’s disease.  At age 89, my father, whose quality of life declined over his later years, died suddenly, by having a pulmonary embolism.

For me, 89 is the year I choose to meet my maker, hanging up my spurs.  Yes, I will let nature take its course, but I will most continue to take Vitamins and antibiotics, even my Lisinopril, for high blood pressure.  I will not turn my back on medical procedures or technology that might enhance the quality of my life, even lengthen it.

I agree with the statement of late Actress Betty Davis stated, “Old age ain’t no place for sissies.”   There is no alternatives, you can only hope for nature to ultimately take its course, and it will.  And so, we all are inclined to pick our own magic number.

Herb Weiss, LRI ’12, is a Pawtucket writer who covers aging, health care and medical issues.

Poll Calls Upon Congress to do “the people’s work”

Published in the Pawtucket Times, January 10, 2014

Four months ago, public anger reached a boiling point when the Republican-led House, controlled by its minority faction of Tea Party members, and the Democratic majority in the Senate failed to agree to an appropriations continuing resolution.
As a result of this budget impasse, a 16 day federal shutdown forced the furlough of 800,000 federal employees and another 1.3 million were required to report to work without known payment dates.

Public polls at that time blamed the GOP for turning its back on the nation by putting partisan politics first rather than doing the People’s business.” The popularity of Congress sank to a new historic low with heated partisan conflict echoing throughout the hallways of Congress.

Hammering Out an 11th Hour Deal

Senator Ted Cruz (R-Texas) with the blessings of conservative groups, including the Heritage Action, the Club for Growth, Freedom Works, and the Senate Conservatives Fund, forcefully pushed House Speaker John Boehner (R-Ohio) to offer continuing resolutions not acceptable to President Obama and Congressional Democrats to politically force a delay or to defund the Patient Protection and Affordable Care Act (called “Obamacare”). Strong GOP opposition, spearheaded by Tea Party lawmakers, to raising the nation’s debt ceiling almost forced the government to run out of money to pay its bills.

After weeks of intense political bickering, Congress finally hammered out a political compromise, one that would open the doors of government, but also raise the debt ceiling to keep the nation from free-falling off the fiscal cliff. A failure to raise the debt ceiling could have resulted in the nation’s credit rating being downgraded. If this occurred, average Americans might have seen higher interest rates for mortgages, car loans, student loans and even credit cards. Higher business expenses, due to expensive borrowing rates, might have forced businesses to stop hiring or even to lay off employees. Housing prices might have drop and retail sales slow. The 11th hour compromise kept the American tax payer and business community from taking a huge hit in their pocketbook.

Although Cruz and Tea Party lawmakers in both chambers viewed shutting down the federal government and not raising the debt ceiling as a way to put excess government spending on the chopping block economy, there was economic damage. According to the economists at Standard & Poors, the total cost of the political gridlock to the nation’s economy that occurred before Christmas was estimated to be $24 billion.
Americans Lack Confidence in Congress

With the new Congressional session beginning this month, a new national poll released last week by AP-NORC Center for Public Affairs reveals that few Americans have faith in the current political status with Congress receiving low marks on its performance of upholding the views of most Americans while only 9 percent say it is doing a good job.

According to the poll that comes months after the first government shutdown in 17 years, 70 percent lack confidence in the federal government’s ability “to make progress on important issues facing the nation in 2014.”

However, the poll findings indicate that the respondents have a little bit more faith in their local and state governments, with 45 percent saying that they are at least moderately confident in their state government and 54 percent having at least moderate confidence with elected officials at the local level.

The federal government receives low marks on its performance. For instance, 55 percent believe the government is doing a poor job of representing the views of most Americans while only 9 percent say it’s doing a good job.

Meanwhile, the poll’s results find Americans are more pessimistic than optimistic on matters such as the nation’s ability to produce strong leaders, America’s role as a global leader, and the opportunity to achieve the American dream.

The People’s preferred agenda for the government in 2014 includes a diverse set of policy issues that range from economic problems to social policies to foreign affairs, notes the poll. Health care reform tops their list of priorities, mentioned by 52 percent of respondents as one of the top ten problems, followed by unemployment (42 percent), the economy in general (39 percent), and the federal deficit (31 percent).

“While it is very easy to ask people to choose a single ‘most important problem’ and to build a list for the answers, the reality is that government has to address many issues at the same time,” said Trevor Tompson, director of the AP-NORC Center. “This survey, with data about the public’s priorities on a range of policy issues, provides policy makers with rigorous data as they seek to understand the public’s outlook on where the country is now and what the action agenda should be for the year ahead.”

Wendy Schiller, Associate Professor of Political Science and Public Policy at Brown University, notes that the AP-NORC poll reveals “broader concerns expressed in national opinion polls, and by the average Rhode Islander “that our country seems to be slipping on lots of levels.”

Schiller, a frequent guest on Rhode Island PBS’s “A Lively Experiment,” notes that aging baby boomers and seniors worry about issues facing the younger generations, personal debt resulting from student loans to national debt. On the other hand, “Younger folks worry about how they will take care of their parents and grandparents, as well as providing for their own retirement,” she says.

“In a state like Rhode Island, which has such a strong family centered culture, these issues weigh heavily on almost everyone’s minds,” observes Schiller.

One of the poll’s positive findings was that the respondents did not cite healthcare for seniors as a pressing issue even though they did express concern over Social Security and health care reform, adds Schiller. “Preserving Medicare is as important, if not more, to the physical and financial well-being of seniors, so I found it striking that it was not as large a concern [as other issues].”

The polls negative findings of a distrust of government, rather than just a disappointment, concerns Schiller, noting that “Democracies do not fare well when the people lose faith in their government.”

As indicated by the poll, Schiller believes that Rhode Island state elected officials are viewed more positively by voters than those serving in Congress. But, 2014 will be a challenging year for them, especially with issues like the 38 Studios debacle, pension reform issues, and Rhode Island job growth. Schiller believes that “If the General Assembly can increase the trend towards greater transparency and accountability, than they might be able to reverse the downward slide of public faith in government.”

As noted in the poll, “public opinion about Congress is at an all-time low,” says Darrell M. West, Ph.D., Vice President and Director of Governance Studies at the Brookings Institution. “People are disenchanted with the hyper-partisanship in Washington, D.C., and the inability of congressional leaders to address major policy problems, he says, noting that the government shutdown was very disturbing to mainstream and people now worry about Congress getting anything done.

West, a former Brown University professor and a prominent Rhode Island political commentator, does not see a major resurgence of bipartisanship in this Congress.
“The parties have incentives to highlight their differences rather than compromise their principles. That will make it difficult for the parties to work together, he says.

But West sees an indicator that the GOP might move away from its ties to the Tea Party that put a damper on reaching across the aisle to get the people’s work done. “The only promising sign is Speaker Boehner’s declaration of independence from the right-wing. A month ago, Boehner criticized outside conservative groups and said they had lost all credibility. If he really believes that, it may embolden him to work on immigration reform and pass needed legislation”, says West.

Because of the complexity of today’s domestic and foreign policy, the People want and need their elected officials to quit this partisan bickering and join together to solve the enormous problems that face the nation, warns well-know Rhode Island activist, Susan Sweet, a keen watcher of state, national, and global politics. “Without the political will to stand together and strengthen the People of America, this great experiment in democracy could decline and fall,” she says.

The AP-NORC national poll was conducted by The Associated Press-NORC Center for Public Affairs Research from Dec. 12-16, 2013, with 1,141 adults. Additional information about how the survey was conducted, including the survey report and the survey’s complete topline findings can be found on the AP-NORC Center’s website at http://www.apnorc.org.

Herb Weiss, LRI ’12, is a Pawtucket-based writer covering aging, health care and medical issues. He can be reached at hweissri@aol.com.

Aging Groups Gear Up to Oppose Cuts in Social Security

Published in Pawtucket Times & Woonsocket
Call, October 18, 2013

Worried Americans woke up to good news yesterday morning. After weeks of political bickering Congress had finally hammered out a political compromise, one that would keep the nation from free-falling off the fiscal cliff.

Over the weeks, Democrats and political pundits had warned that not raising the nation’s debt ceiling by Oct. 17 could lead to the nation’s credit rating being downgraded. If this occurred, average Americans might see higher interest rates for mortgages, car loans, student loans and even credit cards. Higher business expenses, due to expensive borrowing rates, could even force businesses to stop hiring and start laying people off. Housing prices would drop and retail sales slow.

Because of Congressional gridlock, furloughed federal workers, along with the unemployed, would have less money to spend, reinforcing the negative impact on the nation’s economy.

House GOP leadership, catering to its Tea Party allies, led a political impasse between the Democratic-led Senate and President Obama, with demands that the president’s signature “Obamacare” healthcare law be defunded.

But, on the heels of an 11th hour deal, late Wednesday evening, the Senate passed, 81 to 18, a bipartisan temporary fix, supported by a large majority of Senate Republicans, ending the partial federal government shutdown and the threat of default. Hours later, the Tea Party-controlled House conceded to the political reality that any attempt to derail the Senate compromise would have a serious backlash against the GOP brand, passing the measure by 285 to 144.

On day 16 of the closing of the federal government, President Obama with the flick of his pen signed the bill ending the threat of the nation defaulting on paying its bills along with allowing hundreds of thousands of federal workers to return to their jobs.

This agreement raised the U.S. debt ceiling until Feb. 7 and gave the Treasury Department flexibility to temporarily extend its borrowing if Congress does not act before that date. Also, the measure keeps the federal government’s doors open until Jan. 15.

At the end of the Congressional vote, Senator Ted Cruz (R-TX) and his House Tea Party allies saw their efforts fail to delay or to scrap “Obamacare.” However, the GOP Senator did get lawmakers to make a tiny political concession to require the government to verify the eligibility of people receiving federal subsidies under the health care program.

Domestic Entitlements on Chopping Block

Of concern to aging groups, the agreement calls for creating a 12 member House-Senate bipartisan panel that would identify long-term deficit cuts, either overhauling the nation’s tax code or by identifying cuts in entitlement programs like Medicaid, Medicare or Social Security. The panel, led by Budget Committee heads Republican Rep. Paul Ryan of Wisconsin and Democratic Sen. Patty Murray of Washington, is charged with completing its task by December 13, but they are not required to come to an agreement.

“While Washington’s latest self-imposed crisis is over, this is no time to celebrate as another set of random deadlines loom, says Max Richtman, President and CEO of the National Committee to Preserve Social Security and Medicare, remarking “Here we go again.”

“Yet another committee has been formed in which Social Security and Medicare are the big bargaining chips on Washington’s political poker table, noted Richtman, making it clear for him the “economic security of millions of Americans isn’t a game” .

“And while the vast majority of the American people do not support cutting Social Security and Medicare benefits, the President and some in Congress appear ready to do just that through proposals like the Chained CPI, expanding Medicare means testing to the middle class and raising the retirement age,” warns Richtman.

According to Richtman, President Obama stated “what’s good for the American people” is what should guide this next debate. “Cutting benefits to millions of middle-class Americans who took the biggest hit in the recession clearly does not fit that stated goal,” he says.

In a letter to Congress, Richtman, called for other ways to rein in the nation’s budget huge deficient rather than putting Social Security on the chopping block. Richtman suggests that “instead of cutting benefits, comprehensive reforms in the Affordable Care Act (ACA) that are containing costs in the entire health care sector, including Medicare and Medicaid, ought to be given a chance to work and to be strengthened.”

“Moreover, Social Security does not face an immediate crisis and is not driving either the short-term deficit or long-term debt. We believe Social Security should be strengthened for the long-term by raising the current payroll tax cap on earnings,” adds Richtman.

AARP, the nation’s largest aging advocacy group, was quick to comment on the bipartisan-brokered legislative deal, saying that “AARP is pleased that the President and Congress temporarily averted an economic crisis that threatened our members’ access to Social Security and Medicare, but we are deeply concerned that harmful cuts to these vital programs are on the table for a new round of budget negotiations.”

The statement acknowledges that “some Congressional lawmakers want to trade cuts to Medicare and Social Security benefits to pay for other government spending. Others are calling for cuts to these vital programs to reduce the deficit.” However, according to AARP polls, “the American people, on the other hand, across all ages and party lines, are strongly opposed to cuts to Social Security and Medicare.”

“Whether it is cutting their programs to reduce the deficit or using them as a piggy bank to pay for other government spending, their message to the President and Congress is clear: “Don’t bargain away my Medicare and Social Security benefits,” says the AARP statement.

As the House/Senate Bipartisan Committee begins to organize, AARP is preparing to mobilize its massive membership to block any attempts to slash Social Security bennies or cut Medicare, specifically through a Chained CPI to determine cost of living increases and any reductions in Medicare benefits.

Susan Sweet, a well-known aging advocate clearly sees that a Congressional tinkering with Social Security could severely hit the pocketbooks of older Rhode Islanders. She asks, “Is it too much to ask that seniors, disabled people and veterans not pay the price of huge farm subsidies for agribusiness corporations, disgraceful and unnecessary tax benefits for gargantuan oil companies that are making their biggest profits ever, and wasteful pentagon spending for projects in war zones that are either never built or are soon destroyed?”

She calls on Rhode Island’s Congressional delegation to “stay strong and not compromise on keeping Medicare and Social Security fulfill its promises to seniors, disabled people and veterans by keeping benefits at current levels.”

“Dollars to cut the federal deficit might just come from extra revenues which could be generated from allowing Medicare to negotiate with drug companies and lifting the Social Security payroll tax cap so that wealthy people pay the same rate as middle class and poor people,“ she says.

AARP Gears Up for a Fight

This week AARP launched a series of radio and print ads opposing a Chained CPI Social Security benefit cut and harmful cuts to Medicare in the nonprofit organization’s latest discussion of the nation’s fiscal issues. The print and radio ads target members of the House and Senate in 18 states. The ads follow letters to Congress and the White House, as well as postcards, e-mails and calls to members of Congress opposing a budget deal that would balance the budget on the backs of older Americans.

“Americans have paid into Medicare and Social Security and they’re tired of their hard-earned benefits being used as bargaining chips in another last-minute budget deal,” said AARP Senior Vice President Joyce Rogers. “They deserve responsible solutions that will strengthen Medicare and Social Security now and for future generations, not harmful cuts that will hurt all of us.”

Herb Weiss, LRI ’12, is a Pawtucket-based freelance writer who covers aging, health care and medical issues. His weekly commentaries can be found on his blog, herbweiss.wordpress.com. He can be reached at hweissri@aol.com.