Political Discussions
Obama's Health Care Guru
Posted by anticsrocks • 7/30/09 • Subscribe to this Discussion [RSS] • Report This Topic
Topics: end of life, ezekiel emanuel, health care, obama, rationing, reform, socialized medicine
We all know who Rahm Emanuel is - White House Chief of Staff and Obama's political muscle guy. Well there is another Emanuel brother working behind the scenes to try and get socialized medicine pushed through for Obama. His name is Dr. Ezekiel Emanuel and he has some very particular views when it comes to rationing medicine, which to him is a foregone conclusion with socialized medicine.
Briefly, in a paper he co-authored and was published in The Lancet this year in January, titled, "Principles for allocation of scarce medical interventions," he says:
"How can scarce medical interventions be allocated justly? This paper identifies and evaluates eight simple principles that have been suggested. Although some are better than others, no single principle allocates interventions justly. Rather, morally relevant simple principles must be combined into multi-principle allocation systems. We evaluate three existing systems and then recommend a new one: the complete lives system."
www.lancet.com/search/results?fieldName=Authors&searchTerm=Ezekiel%20J+Eman...
(For some reason, I could not get the link to the full text article to work, but this will get you to the article.)
To explain what the "complete lives system" is, let me sum it up. By reading the article, it is basically saying that young people in their 20s or 30s should receive more health care than someone in their 60s, 70s or 80s and more than an infant. Why? Because the infant has not had the “expense” of schooling, teaching, feeding – all considered “investments” (where have we heard that word before? Oh yeah, Obama uses it all the time) by the parents. The elderly person has benefited from all these “investments,” but has fewer productive years left to contribute to society.
A direct quote from Zeke:
"Because none of the currently used systems satisfy all ethical requirements for just allocation, we propose an alternative: the complete lives system. This system incorporates five principles: youngest-first, prognosis, save the most lives, lottery, and instrumental value. As such, it prioritizes younger people who have not yet lived a complete life and will be unlikely to do so without aid. Consideration of the importance of complete lives also supports modifying the youngest-first principle by prioritizing adolescents and young adults over infants. Adolescents have received substantial education and parental care, investments that will be wasted without a complete life. Infants, by contrast, have not yet received these investments. Similarly, adolescence brings with it a developed personality capable of forming and valuing long-term plans whose fulfillment requires a complete life."
That this man has any influence at all on Capitol Hill and in the White House is scary.
User Comments
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That is just scary from Zeke. "save the most lives"? The goal is to save all lives not most of them. It may just be me but that wording is sort of scary. Also, I hope they realize that youth and adults are the ones who need the least medical attention.They should be focusing their attention on infants and the elderly. T -
oh, wow. i'm not much one to get geeked up on the Emmanuel brothers, but it is clear that this article is about instances involving things like organs which there is by nature a short supply.
although I'm pretty unsure of the scheme that is in the works, I think that the "rationing" argument is a pretty overblown. After all, rationing would mean less pork. The argument that it would be the medical equivelent of food rationing is absurd. More likely the problems that will arise will be of the nature of those with the Farm Bill.-
But it's more fun for some people to make like Chicken Little and talk about that there sky falling in. Oh yeah. Someone found a smoking gun. Yeah right. -
"...it is clear that this article is about instances involving things like organs which there is by nature a short supply."
No Agit8r, you are wrong about that.
Zeke says in the paper that medicine should be rationed or "allocated" no matter the supply/demand parameters.
"For some interventions, demand exceeds supply. (As in the instance you are talking about, Agit8r - transplants, etc...)
He goes on to say - For others, an increased supply would necessitate redirection of important resources, and allocation decisions would still be necessary."
So Emanuel believes in allocating or rationing health care no matter what. My OP is addressing that A. this man believes in rationing in all cases and B. he is very powerful and has considerable influence in DC.
It is not, as mark tries to make it out to be just crying "Chicken Little." If for one second, mark could put aside his dislike for me, he might have realized that. But it seems that is beyond his capabilities.
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The last sentence in the OP remains to be proven. In light of that fact, everything else in the OP is pure speculation and no more than an expression of the OP's author's fears. Just like every other thread on the same topic by the same author, for example:
www.blogcatalog.com/politics/discuss/entry/health-rationing-in-our-future
www.blogcatalog.com/politics/discuss/entry/house-bill-outlaws-private-healt...
The only thing different about this OP is that the title contains no verb.-
How is it pure speculation when Emanuel is on record, published even, saying that he approves of medical rationing and the methods he prefers to use?
You talk about my "fears." Are you not afraid of some rationing body telling you what you can and can't have as far as health care? -
Prove the last sentence in the OP, and maybe I'll begin to even think about the rest of it.
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what language from the bill establishes a "rationing body"?
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What? That Zeke Emanuel has power in DC? Okay.
"Dr. Emanuel is a special adviser to the budget director, Peter R. Orszag. He is also the older brother of Rahm Emanuel, the White House chief of staff."
"Mr. Orszag, himself keenly committed to health care as an economic issue, “has given me the opportunity to stick my nose into anything that’s health-related,” Dr. Emanuel said."
www.nytimes.com/2009/04/18/us/politics/18zeke.html
"With this move, the center of power moves from the White House Office of Health Reform, and Health and Human Services to the OMB and Senate Finance Committee chaired by Max Baucus. So look out for the skinny doctor in the cubbyhole office – he may be at the center of the healthcare reform debate going forward."
www.policymed.com/2009/04/ezekiel-emanuel-----healthcare-reform-moves-to-om...
How is that? Powerful enough for you? -
@Agit8r...You asked where in the bill it mentions rationing health care?
Page 29, Section 122, Lines 4 - 16 of H.R. 3200 states:
"(A) ANNUAL LIMITATION.—The cost-sharing incurred under the essential benefits package with respect to an individual (or family) for a year does not exceed the applicable level specified in subparagraph (B).
(B) APPLICABLE LEVEL.—The applicable level specified in this subparagraph for Y1 is $5,000 for an individual and $10,000 for a family. Such levels shall be increased (rounded to the nearest $100) for each subsequent year by the annual percentage increase in the Consumer Price Index (United States city average) applicable to such year."
Pg 354: SEC. 1177. EXTENSION OF AUTHORITY OF SPECIAL NEEDS PLANS TO RESTRICT ENROLLMENT -
right, but I'm wondering if that also includes catastrophic care. It would seem rather doubtful that it could, for all the obvious practical and political reasons.
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"Prove the last sentence in the OP, and maybe I'll begin to even think about the rest of it."
I didn't think you would respond...
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It seems that there are REAL issues with the bill that are worth debating
like whether it would actually serve the function it is aimed at
whether it is as cost effective as alternatives
whether the measures aimed at making it egalitarian are really egalitarian
whether it focusses enough on care for unpreventable catastrophies
whether it will help alleviate issues with present healthcare programs, like the medicare trust fund etc.
Just throwing ideas out there )_(-
But the bottom line is that why would we want to give up our freedoms and liberties to the Government?
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But Agit8r, the other side on these board is not interested in real issues.
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Did you hear that? It was the sound of the wind rushing through a liberal's head. Good thing the libs don't say things that are rash, or meant to be divisive.
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Had a few spare moments to see that this Dr. is real and even works for the government. However, the OP's interpretation stems from a misreading of the quote. Agit8r's remarks (www.blogcatalog.com/politics/discuss/entry/obamas-health-care-guru#comment_...) are on the money.
Once again we have fear-mongering and only fear-mongering.
You know what I'd like to see? Numbers from supporters of the status quo, if the status quo is so great. I mention that here: www.blogcatalog.com/politics/discuss/entry/health-care-reform-misinformatio...
The same thread is also full of examples of links debunking other products of the right-wing fear machine.-
What part is fear mongering?
That both public options in this country and abroad are all but always coming out more expensive than they thought to begin with?
That countries with public healthcare more often than not have serious issues with wait times for care?
That public healthcare in other countries involve things like Gov't Doctors who never met you determine what treatment you should have?
That countries with public healthcare have significantly higher taxes across the board, regardless of what promises were given at the time of inception?
That other countries with public healthcare often do not let you choose your doctor?
That the US systems that are in place already like Medicare and Medicaid are the largest unfunded deficits of the economy?
That the bills are 1000's of pages and again we are again seeing the "don't have time to read, just vote" mentality?
I Think that the real problems here are:
That those who oppose the bill are "against reform" as opposed to being open to reform and just not liking the enormous black hole the proposed bills are offering to the economy or any of the other potential problems listed above?
But most importantly.
That those who are for this reform use the tactic you constantly display. The good ol left's "Identify, Isolate, Freeze, escalate, in your demonizing and simplifying any opposition as "Fear mongering". Instead of being willing to see that there could actually be a number of unintended consequences that will cause major problems down the road.
Until those that promote this are willing to discuss the problems about to be created in light of reality instead of pretending that "if not this then nothing" (Fear mongering anyone?) is the only other option. I Hope this mess of a system goes the same way past attempts have gone. -
mark views facts that do not support his far left agenda as fear mongering. Never mind that Obama talked the stock market to record lows. Never mind that Obama says we need to rush this through because if not our economy will crash.
Nope, fear mongering is only applicable to the right, according to mark.
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I have a question.
How many of the issues that "ObamaCare" is supposed to fix could be be solved by tweaking the present system of FICA to include catastrophic care for all ages, coupled to a tax rebate to cover most or all child health insurance inacted through our present Income tax system?
It might not be 100% perfect, but I can't imagine it would be as controversial as the present plan... just sayin'-
A huge reason for exploding costs and even the need for catastrophic care for many people is the lack of preventative medicine. You won't get preventative medicine for people without fundamental reform.
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The problem with "preventative" care being such a blanket statement is that again, we are punishing a few, to subsidize stupidity.
A huge portion of all maladies are related to personal choices. Which means that the ones paying for it are forced to pay for other peoples bad chocies on a constant basis.
Obesity, Smoking, Drug use, etc. This is why a lot of people don't want to pay for "preventative" care for everyone.
And don't come tell me "education" you'd have to look REAL hard to find idiots that have no clue eating better, exercising more and not smoking is good for you.
A lot of people have no desire to help pay "preventative care" for people that just throw that money away. -
Your blanket generalization misses a lot of illnesses that have nothing at all to do with lifestyle choices. Breast cancer comes to mind. And I've heard of people getting lung cancer who never smoked or lived or worked with smokers. Moreover, early interventions can help people to begin making better lifestyle choices.
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preventative care is hit and miss. Some people would make the lifestyle changes necessary and some would likely not respond to the "lots of nagging" that was mentioned in another thread.
It seems that an optional healthcare savings account (like in some Republican plans) would serve the purpose of periodic care for adults, who ought not to be required to purchase such insurance/care because... well, they are GROWN-UPS! -
A savings account does nothing to control cost, and it rations care to those who have saved enough for it. Frankly, I thought that notion died with Bush's presidency. Another favorite from those times: privatize social security and give the money to Wall Street. Anyone notice what happened to a lot of 401K plans? Besides, a savings account means a single person is protecting himself against risk. Insurance is designed to pool risk, just like insurance does in other areas.
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Mark, I think you missed the point.
1. Obesity is one of the main causes of any number of healthcare problems. And only a VERY small percentage of Obesity can't be fixed with better habits.
Yes, there is preventative care that doesn't fall within this, but when you have a blanket coverage, you force people to pay for others stupidity.
I don't want to pay for a smokers yearly lung cancer tests. I really dont' want to pay for a drug users OD treatment or the alcoholics broken legs either when he falls down the stairs.
If there was a way to prevent people from paying for others bad chocies all the time, I'd be more inclined to like the argument.
That is the main reason why I don't have a problem with universal care for children.
As far as savings accounts, they are the worst possible way to protect anything. It's the poor persons illusion of getting somewhere. But the simple fact is that the money saved in MOST savings accounts lose money when inflation comes into play.
Savings accounts are great for putting aside liquid funds, for easy but separate access.
They do however not protect anything, since they are in currency, they are directly affected in case of a hyperinflation for instance, where your life savings can be turned into coffee money overnight. -
mark, do my eyes deceive me or are you saying you are in favor of those pesky, greedy insurance companies? Wow.
*reaches for his hard hat for fear the walls are going to cave in* -
One would have to be blinkered to equate seeing the value of insurance with being "in favor of" the insurance companies as they currently operate. Health care legislation needs to regulate that industry and make it play fair. It also needs to help citizens leverage their collective buying power so that the self-employed and small businesses do not get ripped off like at present, often so badly that they drop insurance. (Insurance is supposed to help people manage risk; it is not supposed to become a risk factor all its own through huge rate hikes.) Finally, there needs to be a public insurance option to cover those the private companies are unwilling or unable to cover in a way that everyone can afford.
Of course, the health care legislation is about another set of problems as well: controlling costs, and there should be feedback between that and the various insurance plans on offer. -
Please illuminate us mark. How pray tell would a public option be competitive when the Government needn't worry about the bottom line? Case in point - "Oh, the Cash for Clunkers is out of money already? Well, no problem! Just shove another couple billion into it! We can always (and are already) print more!"
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it seems a little like mark and csi are making some of the same arguments, and perhaps they are right to a point. I'm not sold on "savings accounts." in fact it could be arguable that we should leave the preventative care of adults to the adults to figure out, idk.
I'm just saying that the taking away of adults liberties to do as they like (either real or perceived) is likely what may keep the healthcare for children and catastrophic care from getting passed, and is far less certain to do good for individuals and the country as a whole-
(1) I have no idea how CSI and I could be talking about the same thing, but if you see it, more power to you.
(2) Who said anything about taking away liberties? I mean except the right-wingers, of course.
(3) Seems you're living up to you handle again.
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