Who are Obamas Healthcare advisors?
Ezekiel Emanuel (brother of Rahm Emanuel) More info:
The Real Emanuel Brother to Watch
Emanuel is the health-policy adviser at the Office of Management and Budget and a member of Federal Council on Comparative Effectiveness Research.
Video of Ezekiel Emanuel
on Euthanasia
Ezekiel Emanuel denies proposing euthanasia, but he does propose denying treatment to those not worthy of the expense. Those people die. That is euthanasia.
He is a supporter of health care rationing, which is relevant to the current health care debate. In a Lancet article earlier this year, he suggested that age be a proper method of allocating scarce resources, and indeed, stated that age based allocation is not invidious discrimination.
June 2008 JAMA Article where he call's for a reinterpretation of the physician's Hippocratic Oath to take account of "costs" and "effect on others".
The prudent physician is not deemed particularly competent, but rather inadequate. This culture is further reinforced by a unique understanding of professional obligations, specifically, the Hippocratic Oath's admonition to "use my power to help the sick to the best of my ability and judgment" as an imperative to do everything for the patient regardless of cost or effect on others.
A lot of people are frightened that someone who thinks like Emanuel is at the center of an administration seeking to remake the entire health care system. Having read these two articles, I think there is very real cause for concern.
Source:
Principles for allocation of scarce medical interventions, January 2009
Unlike allocation by sex or race, allocation by age is not invidious discrimination; every person lives through different life stages rather than being a single age. Even if 25-year-olds receive priority over 65-year-olds, everyone who is 65 years now was previously 25 years. Treating 65-yearolds differently because of stereotypes or falsehoods would be ageist; treating them differently because they have already had more life-years is not.
He seems to be saying, be ageist, just call it something different. Since when is health care a "scarce resource?" Another trumped up term used to instill fear and uncertainty, IE: Never let a good crisis go to waste.
In the
Hastings Center Report, in which
he explicitly advocates rationing based on what appears to be a quality of life measurement. From the piece:
This civic republican or deliberative democratic conception of the good provides both procedural and substantive insights for developing a just allocation of health care resources. Procedurally, it suggests the need for public forums to deliberate about which health services should be considered basic and should be socially guaranteed.
Substantively, it suggests services that promote the continuation of the polity-those that ensure healthy future generations, ensure development of practical reasoning skills, and ensure full and active participation by citizens in public deliberations-are to be socially guaranteed as basic.
Conversely, services provided to individuals who are irreversibly prevented from being or becoming participating citizens are not basic and should not be guaranteed. An obvious example is not guaranteeing health services to patients with dementia.
Cass R. Sunstein
Columbia Law Review 2004:
In protecting safety, health, and the environment, government has increasingly relied on cost-benefit analysis. In undertaking cost-benefit analysis, the government has monetized risks of death through the idea of the value of a statistical life (VSL), currently assessed at about $6.1 million. But the government should rely instead on the value of a statistical life-year (VSLY), in a way that would likely result in lower benefits calculations for elderly people, and higher benefits calculations for children. The hard question involves not whether to undertake this shift, but how to monetize life-years, and here willingness to pay (WTP) is generally the place not to end but to begin.
A
recent report from President Obama's Council of Economic Advisors (CEA), which he has touted as showing how his health plan would reduce health costs, elaborates even more explicit and comprehensive government rationing of health care.
The CEA report says 30% of American health care is waste, which government bureaucracy is going to eliminate under Obama's health reforms. What is the difference between waste and the health care you want? Answer: a government bureaucrat.
The CEA says the government will reduce health costs by deciding for doctors and hospitals across the country what health care works and what doesn't. Even worse, it will decide what health care is cost effective, which means the government will decide whether your health care is worth the cost, not you and your doctor. This will be enforced through the payments to doctors and hospitals. Those who follow the government's dictates on your health care get paid, those that don't don't get paid.
