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	<title>Comments on: The 30% of Medicare spent on last-year-of-life care: let&#8217;s not forget we&#8217;re humans.</title>
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	<link>http://neurologicalcorrelates.com/wordpress/2008/03/12/about-30-of-medicare-is-spent-on-end-of-life-care-what-should-we-do-about-it/</link>
	<description>The Neuroscience of Dysfunctional Behavior - Mostly Psychopaths and Sociopaths, Narcissists, Obesity and Addiction</description>
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		<title>By: Ken</title>
		<link>http://neurologicalcorrelates.com/wordpress/2008/03/12/about-30-of-medicare-is-spent-on-end-of-life-care-what-should-we-do-about-it/comment-page-1/#comment-43316</link>
		<dc:creator>Ken</dc:creator>
		<pubDate>Wed, 07 Dec 2011 23:30:45 +0000</pubDate>
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		<description>One thing that I&#039;d be critical of, is your posting vaguely remembered &quot;facts&quot; about the Schiavo case, in which you make serious accusations, which are, in fact, wrong.

The husband did not attempt to withdraw treatment until ALL of the money from the settlement had been spent on Terri&#039;s care.  This is all quite clearly documented in the attorney&#039;s book on the case.  The accusations that you cite were the accusations of the opponents of the husband, which were rejected by FIFTEEN different courts.  FIFTEEN different courts.

You also seemed to miss the main issue of the case:   Consent.  Terri had all of the things done to her after a certain point, when her expressed wishes to her husband that no such things should be done.  One can say what one wants, Terri Schiavo made the decision in the light of day who would be the person who spoke for her when she could not, when she married her husband.  One side supported that decision, one side said her decision should be ignored.  What it comes down to, does a person get to decided what happens to them, or will that be the State?

An interesting article on end of life,  by those most expert in what happens:
http://zocalopublicsquare.org/thepublicsquare/2011/11/30/how-doctors-die/read/nexus/</description>
		<content:encoded><![CDATA[<p>One thing that I&#8217;d be critical of, is your posting vaguely remembered &#8220;facts&#8221; about the Schiavo case, in which you make serious accusations, which are, in fact, wrong.</p>
<p>The husband did not attempt to withdraw treatment until ALL of the money from the settlement had been spent on Terri&#8217;s care.  This is all quite clearly documented in the attorney&#8217;s book on the case.  The accusations that you cite were the accusations of the opponents of the husband, which were rejected by FIFTEEN different courts.  FIFTEEN different courts.</p>
<p>You also seemed to miss the main issue of the case:   Consent.  Terri had all of the things done to her after a certain point, when her expressed wishes to her husband that no such things should be done.  One can say what one wants, Terri Schiavo made the decision in the light of day who would be the person who spoke for her when she could not, when she married her husband.  One side supported that decision, one side said her decision should be ignored.  What it comes down to, does a person get to decided what happens to them, or will that be the State?</p>
<p>An interesting article on end of life,  by those most expert in what happens:<br />
<a href="http://zocalopublicsquare.org/thepublicsquare/2011/11/30/how-doctors-die/read/nexus/" rel="nofollow">http://zocalopublicsquare.org/thepublicsquare/2011/11/30/how-doctors-die/read/nexus/</a></p>
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		<title>By: Quora</title>
		<link>http://neurologicalcorrelates.com/wordpress/2008/03/12/about-30-of-medicare-is-spent-on-end-of-life-care-what-should-we-do-about-it/comment-page-1/#comment-43293</link>
		<dc:creator>Quora</dc:creator>
		<pubDate>Sun, 04 Dec 2011 06:49:46 +0000</pubDate>
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		<description>&lt;strong&gt;Should assisted suicide be made legal?...&lt;/strong&gt;

Yes. There are lots of reasons I believe this. I&#039;ll give two of the more convincing ones: From a rights perspective, a person should be free to choose how and when he or she goes and the friends, lovers, and family that participate in that going. See ...</description>
		<content:encoded><![CDATA[<p><strong>Should assisted suicide be made legal?&#8230;</strong></p>
<p>Yes. There are lots of reasons I believe this. I&#8217;ll give two of the more convincing ones: From a rights perspective, a person should be free to choose how and when he or she goes and the friends, lovers, and family that participate in that going. See &#8230;</p>
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		<title>By: Entitlement Spending and the Affluent Elderly - Age, moving, relocation, finance, savings, early, hobbies, nursing homes, Social Security, Medicare - Page 6 - City-Data Forum</title>
		<link>http://neurologicalcorrelates.com/wordpress/2008/03/12/about-30-of-medicare-is-spent-on-end-of-life-care-what-should-we-do-about-it/comment-page-1/#comment-42092</link>
		<dc:creator>Entitlement Spending and the Affluent Elderly - Age, moving, relocation, finance, savings, early, hobbies, nursing homes, Social Security, Medicare - Page 6 - City-Data Forum</dc:creator>
		<pubDate>Mon, 05 Sep 2011 01:57:08 +0000</pubDate>
		<guid isPermaLink="false">http://neurologicalcorrelates.com/wordpress/2008/03/12/about-30-of-medicare-is-spent-on-end-of-life-care-what-should-we-do-about-it/#comment-42092</guid>
		<description>[...] 000. Give me the care!&quot;    I think this is a very important point in this discussion.  This blog author writes about the fact that 30% of Medicare spending is done during the last year of life:   [...]</description>
		<content:encoded><![CDATA[<p>[...] 000. Give me the care!&quot;    I think this is a very important point in this discussion.  This blog author writes about the fact that 30% of Medicare spending is done during the last year of life:   [...]</p>
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		<title>By: McDonalds isn&#8217;t the problem; we are. &#171; My slice of the web</title>
		<link>http://neurologicalcorrelates.com/wordpress/2008/03/12/about-30-of-medicare-is-spent-on-end-of-life-care-what-should-we-do-about-it/comment-page-1/#comment-41542</link>
		<dc:creator>McDonalds isn&#8217;t the problem; we are. &#171; My slice of the web</dc:creator>
		<pubDate>Sun, 31 Jul 2011 02:56:45 +0000</pubDate>
		<guid isPermaLink="false">http://neurologicalcorrelates.com/wordpress/2008/03/12/about-30-of-medicare-is-spent-on-end-of-life-care-what-should-we-do-about-it/#comment-41542</guid>
		<description>[...] choice but to vastly scale back coverage (perhaps starting with reducing end-of-life care, which is estimated to take roughly 30% of Medicare&#039;s budget), followed by probable rationing of key medical resources.  (Read here for a hyperbolic freakout [...]</description>
		<content:encoded><![CDATA[<p>[...] choice but to vastly scale back coverage (perhaps starting with reducing end-of-life care, which is estimated to take roughly 30% of Medicare&#039;s budget), followed by probable rationing of key medical resources.  (Read here for a hyperbolic freakout [...]</p>
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		<title>By: swivelchair</title>
		<link>http://neurologicalcorrelates.com/wordpress/2008/03/12/about-30-of-medicare-is-spent-on-end-of-life-care-what-should-we-do-about-it/comment-page-1/#comment-41488</link>
		<dc:creator>swivelchair</dc:creator>
		<pubDate>Fri, 29 Jul 2011 06:59:12 +0000</pubDate>
		<guid isPermaLink="false">http://neurologicalcorrelates.com/wordpress/2008/03/12/about-30-of-medicare-is-spent-on-end-of-life-care-what-should-we-do-about-it/#comment-41488</guid>
		<description>Unseen,

It is a little sad for your friends, but, the good news is that their undergrad degree can be a Mulligan. Education is a life long process. If your friends end up as dentists and hate it having their hands in other peoples&#039; mouths all day, they can  go back for a Masters in Fine Arts or whatever floats their boat.  (We&#039;re optimistic that high quality education can be delivered (a) cheap or free, and (b) 24/7. )  We have 1000% confidence that you will live a long fulfilling life and make the world a better place while you are at it. Just you and your family stay away from the debt.</description>
		<content:encoded><![CDATA[<p>Unseen,</p>
<p>It is a little sad for your friends, but, the good news is that their undergrad degree can be a Mulligan. Education is a life long process. If your friends end up as dentists and hate it having their hands in other peoples&#8217; mouths all day, they can  go back for a Masters in Fine Arts or whatever floats their boat.  (We&#8217;re optimistic that high quality education can be delivered (a) cheap or free, and (b) 24/7. )  We have 1000% confidence that you will live a long fulfilling life and make the world a better place while you are at it. Just you and your family stay away from the debt.</p>
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		<title>By: Unseen E-mail</title>
		<link>http://neurologicalcorrelates.com/wordpress/2008/03/12/about-30-of-medicare-is-spent-on-end-of-life-care-what-should-we-do-about-it/comment-page-1/#comment-41486</link>
		<dc:creator>Unseen E-mail</dc:creator>
		<pubDate>Fri, 29 Jul 2011 04:15:18 +0000</pubDate>
		<guid isPermaLink="false">http://neurologicalcorrelates.com/wordpress/2008/03/12/about-30-of-medicare-is-spent-on-end-of-life-care-what-should-we-do-about-it/#comment-41486</guid>
		<description>It&#039;s kind of sad though how a lot of my friends, essentially students in college, hear what I say and dismiss it with silence. Essentially, acknowledging that it is how it should be but still continue in majors they dislike just for a job they&#039;ll hate. 

Unfortunately, student debt is inevitable, but I&#039;m pretty lucky. My parents are content with me getting a degree in Computer Science, and they&#039;re putting up the majority of the money for now. I&#039;m also applying to many scholarships and constantly keeping a check on my finances.

Living out my dream seems to be a pain so far, but I can say I have very few regrets. I do regret not going skydiving that one time though...</description>
		<content:encoded><![CDATA[<p>It&#8217;s kind of sad though how a lot of my friends, essentially students in college, hear what I say and dismiss it with silence. Essentially, acknowledging that it is how it should be but still continue in majors they dislike just for a job they&#8217;ll hate. </p>
<p>Unfortunately, student debt is inevitable, but I&#8217;m pretty lucky. My parents are content with me getting a degree in Computer Science, and they&#8217;re putting up the majority of the money for now. I&#8217;m also applying to many scholarships and constantly keeping a check on my finances.</p>
<p>Living out my dream seems to be a pain so far, but I can say I have very few regrets. I do regret not going skydiving that one time though&#8230;</p>
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		<title>By: swivelchair</title>
		<link>http://neurologicalcorrelates.com/wordpress/2008/03/12/about-30-of-medicare-is-spent-on-end-of-life-care-what-should-we-do-about-it/comment-page-1/#comment-41483</link>
		<dc:creator>swivelchair</dc:creator>
		<pubDate>Fri, 29 Jul 2011 02:48:08 +0000</pubDate>
		<guid isPermaLink="false">http://neurologicalcorrelates.com/wordpress/2008/03/12/about-30-of-medicare-is-spent-on-end-of-life-care-what-should-we-do-about-it/#comment-41483</guid>
		<description>U E-M: 

&lt;blockquote&gt;. . .Like many other words, [success] can have multiple definitions. I think society and the majority of us have it wrong. I don&#039;t think success should be defined as &quot;The attainment of popularity or profit&quot;, it should be achievement of your goals, essentially of what makes you happy. Where one day, you can literally say, &quot;My life was so worth it&quot;. I think that is true success. Success is a personal and mental attainment of profit, and popularity. &lt;/blockquote&gt;

Welp.  You said it. 
Please do me a personal favor:  don&#039;t rack up student debt.</description>
		<content:encoded><![CDATA[<p>U E-M: </p>
<blockquote><p>. . .Like many other words, [success] can have multiple definitions. I think society and the majority of us have it wrong. I don&#8217;t think success should be defined as &#8220;The attainment of popularity or profit&#8221;, it should be achievement of your goals, essentially of what makes you happy. Where one day, you can literally say, &#8220;My life was so worth it&#8221;. I think that is true success. Success is a personal and mental attainment of profit, and popularity. </p></blockquote>
<p>Welp.  You said it.<br />
Please do me a personal favor:  don&#8217;t rack up student debt.</p>
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		<title>By: Living with Death Panels</title>
		<link>http://neurologicalcorrelates.com/wordpress/2008/03/12/about-30-of-medicare-is-spent-on-end-of-life-care-what-should-we-do-about-it/comment-page-1/#comment-41474</link>
		<dc:creator>Living with Death Panels</dc:creator>
		<pubDate>Thu, 28 Jul 2011 10:05:31 +0000</pubDate>
		<guid isPermaLink="false">http://neurologicalcorrelates.com/wordpress/2008/03/12/about-30-of-medicare-is-spent-on-end-of-life-care-what-should-we-do-about-it/#comment-41474</guid>
		<description>[...] dol­lars are ex­pended dur­ing the last year of life. Blog­ger Swivel­chair has writ­ten a nice sum­mary of the med­ical is­sues sur­round­ing these [...]</description>
		<content:encoded><![CDATA[<p>[...] dol­lars are ex­pended dur­ing the last year of life. Blog­ger Swivel­chair has writ­ten a nice sum­mary of the med­ical is­sues sur­round­ing these [...]</p>
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		<title>By: Unseen E-mail</title>
		<link>http://neurologicalcorrelates.com/wordpress/2008/03/12/about-30-of-medicare-is-spent-on-end-of-life-care-what-should-we-do-about-it/comment-page-1/#comment-41448</link>
		<dc:creator>Unseen E-mail</dc:creator>
		<pubDate>Tue, 26 Jul 2011 20:06:33 +0000</pubDate>
		<guid isPermaLink="false">http://neurologicalcorrelates.com/wordpress/2008/03/12/about-30-of-medicare-is-spent-on-end-of-life-care-what-should-we-do-about-it/#comment-41448</guid>
		<description>Best last paragraph ever. Sorry for making the whole post very disconnected. I think I just spilled my whole brain out. Beware of being very confused after reading it, I know every time I listen to myself think I go insane.

I&#039;m about to start my 3rd year in college, and I&#039;ve been thinking for the longest time. What do I want to do. I tell my family and friends that I&#039;m going to go for a masters or seek a job where I can get to a good position and do something in robotics. I definitely want to do that, in addition to joining the Peace Corps, and maybe trying out some acting or playing my guitar and tabla &lt;- but I&#039;m not very good at any of those, and so my family and friends although they will be supporting they wouldn&#039;t be most supportive of that cause. Their minds and hearts wouldn&#039;t be into it. To be honest, neither am I because I know that I will most probably not be able to make it as an actor as a musician, I&#039;m alright but not good. So looks like I&#039;m going to end up trying to work 80 hours a week to make a lot of money and buy lots of things, because having a future is important and I do want to be successful. 

S So....with all of that, I&#039;ve decided to take on a new motto of &quot;Livin&#039; Life&quot;. I&#039;m just going to go after what I want to. Frankly, I do like robotics as well and am very interested in my major Computer Science, as well as a lot of other things. So I&#039;m going to pursue it all. 

Another thing that I get told a lot, is to be reasonable. I get told that dreaming is good but you have to &#039;grow up&#039;. Last time I was told that, was when I was 12. I&#039;m 7 years older and I will never stop dreaming. Dreaming is the last thing I will ever have. Sure I&#039;m ambitious but I have no idea if I will ever have another one and life is short. 

Now some might say, then why not just make life a big party. And I would say, sure. If that&#039;s what you want. But then you&#039;re wasting your own time and everyone else&#039;s. If partying is really what you want to do your whole life, then I would look down upon it, but again it&#039;s how you choose to live your life. Anyways, I don&#039;t think everyone would choose to party forever, I feel like you would die of many diseases very early. 

Man, I could go on and on about living life. Not just the fact that you should take vacations and see places, but anything you pursue should be because you want to pursue it. I think there are many individuals out there who would be at the forefront of technological progress (maybe not as many but definitely several). I would definitely want to try to develop a humanoid robot and stronger artificial intelligence. I have a never-dying curiosity about space and Earth, and given the opportunity would love to jump in and do research on it.

Summing up a point (not sure if I can), but success is a word. Like many other words, it can have multiple definitions. I think society and the majority of us have it wrong. I don&#039;t think success should be defined as &quot;The attainment of popularity or profit&quot;, it should be achievement of your goals, essentially of what makes you happy. Where one day, you can literally say, &quot;My life was so worth it&quot;. I think that is true success. Success is a personal and mental attainment of profit, and popularity. 

dam swivel....I never had the guts to say any of this because I never thought anyone would listen to a 19 year old kid and because I didn&#039;t think many others would feel this way but now you&#039;ve got me pumped. I&#039;m a little over-excited. All in all great article, I know I got super off-topic, but it was a great article.</description>
		<content:encoded><![CDATA[<p>Best last paragraph ever. Sorry for making the whole post very disconnected. I think I just spilled my whole brain out. Beware of being very confused after reading it, I know every time I listen to myself think I go insane.</p>
<p>I&#8217;m about to start my 3rd year in college, and I&#8217;ve been thinking for the longest time. What do I want to do. I tell my family and friends that I&#8217;m going to go for a masters or seek a job where I can get to a good position and do something in robotics. I definitely want to do that, in addition to joining the Peace Corps, and maybe trying out some acting or playing my guitar and tabla &lt;- but I&#039;m not very good at any of those, and so my family and friends although they will be supporting they wouldn&#039;t be most supportive of that cause. Their minds and hearts wouldn&#039;t be into it. To be honest, neither am I because I know that I will most probably not be able to make it as an actor as a musician, I&#039;m alright but not good. So looks like I&#039;m going to end up trying to work 80 hours a week to make a lot of money and buy lots of things, because having a future is important and I do want to be successful. </p>
<p>S So&#8230;.with all of that, I&#039;ve decided to take on a new motto of &quot;Livin&#039; Life&quot;. I&#039;m just going to go after what I want to. Frankly, I do like robotics as well and am very interested in my major Computer Science, as well as a lot of other things. So I&#039;m going to pursue it all. </p>
<p>Another thing that I get told a lot, is to be reasonable. I get told that dreaming is good but you have to &#039;grow up&#039;. Last time I was told that, was when I was 12. I&#039;m 7 years older and I will never stop dreaming. Dreaming is the last thing I will ever have. Sure I&#039;m ambitious but I have no idea if I will ever have another one and life is short. </p>
<p>Now some might say, then why not just make life a big party. And I would say, sure. If that&#039;s what you want. But then you&#039;re wasting your own time and everyone else&#039;s. If partying is really what you want to do your whole life, then I would look down upon it, but again it&#039;s how you choose to live your life. Anyways, I don&#039;t think everyone would choose to party forever, I feel like you would die of many diseases very early. </p>
<p>Man, I could go on and on about living life. Not just the fact that you should take vacations and see places, but anything you pursue should be because you want to pursue it. I think there are many individuals out there who would be at the forefront of technological progress (maybe not as many but definitely several). I would definitely want to try to develop a humanoid robot and stronger artificial intelligence. I have a never-dying curiosity about space and Earth, and given the opportunity would love to jump in and do research on it.</p>
<p>Summing up a point (not sure if I can), but success is a word. Like many other words, it can have multiple definitions. I think society and the majority of us have it wrong. I don&#039;t think success should be defined as &quot;The attainment of popularity or profit&quot;, it should be achievement of your goals, essentially of what makes you happy. Where one day, you can literally say, &quot;My life was so worth it&quot;. I think that is true success. Success is a personal and mental attainment of profit, and popularity. </p>
<p>dam swivel&#8230;.I never had the guts to say any of this because I never thought anyone would listen to a 19 year old kid and because I didn&#039;t think many others would feel this way but now you&#039;ve got me pumped. I&#039;m a little over-excited. All in all great article, I know I got super off-topic, but it was a great article.</p>
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		<title>By: Steve</title>
		<link>http://neurologicalcorrelates.com/wordpress/2008/03/12/about-30-of-medicare-is-spent-on-end-of-life-care-what-should-we-do-about-it/comment-page-1/#comment-37115</link>
		<dc:creator>Steve</dc:creator>
		<pubDate>Wed, 25 Aug 2010 16:03:44 +0000</pubDate>
		<guid isPermaLink="false">http://neurologicalcorrelates.com/wordpress/2008/03/12/about-30-of-medicare-is-spent-on-end-of-life-care-what-should-we-do-about-it/#comment-37115</guid>
		<description>The problem with our system as is, is that incentives are not properly aligned: medically or financially.  Doctors tend to treat symptoms, or cure diseases; however, life is the most fatal condition of them all.  Therefore, when the end of life nears, doctors are apt to unnaturally delay death.  Patients, of course, have no incentive NOT to delay death: especially those for whom compensation of services provided incurs no personal liability.  Government is prone to not address the issue, as the political price of movement is deemed too high.  The problem, I believe, surrounds incentivizing those that - literally - have nothing to lose. 
I think that creating an incentive for the dying to forego care would serve to better align the incentives of all involved in the decision center; I am not certain that there may not be unintended consequences in the care center.  Might hospitals become more aggressive in treating illness earlier to capture revenues?  Or shy away from providing care to those that have exceeded their actuarial lifespan?
This isn&#039;t an easy subject, but I believe it is one that must be had.</description>
		<content:encoded><![CDATA[<p>The problem with our system as is, is that incentives are not properly aligned: medically or financially.  Doctors tend to treat symptoms, or cure diseases; however, life is the most fatal condition of them all.  Therefore, when the end of life nears, doctors are apt to unnaturally delay death.  Patients, of course, have no incentive NOT to delay death: especially those for whom compensation of services provided incurs no personal liability.  Government is prone to not address the issue, as the political price of movement is deemed too high.  The problem, I believe, surrounds incentivizing those that &#8211; literally &#8211; have nothing to lose.<br />
I think that creating an incentive for the dying to forego care would serve to better align the incentives of all involved in the decision center; I am not certain that there may not be unintended consequences in the care center.  Might hospitals become more aggressive in treating illness earlier to capture revenues?  Or shy away from providing care to those that have exceeded their actuarial lifespan?<br />
This isn&#8217;t an easy subject, but I believe it is one that must be had.</p>
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