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Deadly Doctors, You’d think the central planners at the White House would go outside their small group of relatives for some top-notch expertise when they’re trying to revamp something as big and complex as one-sixth of the American economy.
When Bill Clinton sought to radically overhaul American health care, he put Hillary in charge.
This time around, Ezekiel Emanuel, brother of White House chief of staff Rahm Emanuel, is on the Obama team as a special adviser on health policy to the director of the White House Office of Management and a member of the Federal Coordinating Council for Comparative Effectiveness Research.
What Hillary’s months of closed-door meetings produced was a top-down, command-and-control plan that put federal bureaucrats in charge of the decision-making and conduct of doctors, patients, employers, hospitals, pharmaceutical companies and state governments.
Mrs. Clinton sought a mandate that required employers to pick up the health insurance tab for all their employees.
This ended with HillaryCare being defeated and Republicans gaining 52 House seats and eight Senate seats in the 1994 election, plus five more seats in the House and two in the Senate because of party-switching, giving Republicans control of both the House and Senate for the first time in 40 years.
The promise from today’s White House is that ObamaCare somehow will provide universal coverage while simultaneously increasing quality and cutting costs.
The writings of Obama health adviser Emanuel provide some insight into how our current crop of central planners might well be intending to accomplish these seemingly conflicting goals.
Last year in Health Affairs: The Policy Journal of the Health Sphere, Emanuel wrote that “Vague promises of savings from cutting waste, enhancing prevention and wellness, installing electronic medical records and improving quality are merely ‘lipstick’ cost controls, more for show and public relations than for true change.”
In other words, the billions in the House and Senate health reform bills for “infrastructure” pork — i.e., “wellness” by way of jungle gyms and walking paths — are just so much “lipstick.”
In her recent article “Deadly Doctors: O Advisers Want to Ration Care,” former New York Lt. Gov. Betsy McCaughey, founder of the Committee to Reduce Infection Deaths, reports on where Emanuel sees the real savings, citing an article he wrote last year in the Journal of the American Medical Association: “Savings, he writes, will require changing how doctors think about their patients: Doctors take the Hippocratic Oath too seriously ‘as an imperative to do everything for the patient regardless of the cost or effects on others.’”
The “effects on others” is the key. He’s saying we’ve got to think more collectively and less about ourselves. “Emanuel,” explains McCaughey, “wants doctors to look beyond the needs of their patients and consider social justice, such as whether the money could be better spent on somebody else.”
If “social justice” demands more spending on the young and less on the old, Emanuel explains why this isn’t a case of discrimination: “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.”
Granny, in short, should move on because she’s had her chance.
An essay co-authored by Emanuel on the “just allocation of health care resources” in the Hasting Center Report (November-December 1996) provides some detail regarding who should be rationed out of the system: “(S)ervices 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.”
We should die, in short, if we’re deemed by the authorities to be insufficiently participating.
reprint from the Pittsburgh Tribune-Review By Ralph R. Reiland