Who Is Dr. Eziekiel Emanuel

Words mean things. should you care?

Who is Dr. Ezekiel Emanuel and what does he say? And, why

Dr Emanuel is a bioethicist and a healthcare advisor to the President. He has shaped the health care legislation that is now in the House and the Senate. The President has selected him for two important positions in his proposed healthcare administration. Dr. Emanuel is to be: health-policy adviser at the Office of Management and Budget (which focuses on budgets and costs), and a member of the Federal Council on Comparative Effectiveness Research, (which will evaluate the cost-effectiveness of medical therapies). The Secretary of HHS is to be directed, by law, to use this information to formulate new ‘best practices’ of medicine, which the Secretary will promulgate, monitor, and enforce. Ask yourself, what are the meanings of Dr Emanuel’s words below? Are those meanings important to you and your loved ones? And, do they respect the 14th Amendment rights to equal protection of the laws. Dr. Emanuel has argued that a government-run healthcare system should serve the interests of society as a whole, as opposed to the excessive needs of individual patients, and he cites a social consensus that society should give socially guaranteed access to those who will benefit society the most. In his words (New England Journal of Medicine, Sept. 19, 2002) access is to be “socially guaranteed as basic” for those who: “Promote the continuation of the polity” (‘Polities’ are ‘political organizations,’ and ‘politically organized units,’ like political parties, and politically controlled governmental structures that govern the country. Does Dr Ezekiel mean that medical care is to be socially guaranteed to those who work in, and serve the interests of, political parties? If so, will this include a political party that opposes the ruling political party? Or, one that opposes political control of healthcare services?) “Ensure healthy future generations” (Physicians? Nurses? Suppliers of medical products? Politicians who advocate for, guide, and administer an allencompassing governmental health-care system?) “Ensure the development of practical reasoning skills” (College professors? Teachers of kindergarten thru 12th grade? Members of teachers’ unions?) “Insure full and active participation by citizens in public deliberations” (The news media? Newspapers? Editors? Radio news-reporters? TV reporters and anchors? Will those who oppose the prevailing polity impair their own socially guaranteed access to health care?) In a more recent article (Lancet, Jan. 31, 2009), Dr Emanuel co-recommended a "complete lives system" for allocating scarce medical resources. ". . . things are rarely equal—whether to save one 20-year-old, who might live another 60 years, if saved, or three 70-year-olds, who could only live for another 10 years each—is unclear." However, he goes on to say, "When implemented, the complete lives system produces a priority curve on which individuals aged roughly 15 and 40 years get the most substantial chance [of surviving], whereas the youngest and oldest people get chances that are attenuated.” Thus, retirees, who have paid the most into their government health-insurance plan, will get the lowest priority for medical services.

The “complete lives system” gives priority access to the vast majority of voters who are working and contributing to the economy and making minimal demands on the health-care system. And, it appears to be a political investment in those who have many voting-years ahead of them. Under HR 3200, all physicians will become government-employees. The government will pay them, and it will create and ‘implement’ politically-determined ‘best practices’ for physicians to follow, monitor their compliance through mandated Electronic Health Reports, and discipline physicians who fail to comply. How will this plan treat retirees? And, those who have intellectual, mental, or physical disabilities that make them unable to work productively? Will government-physicians tell medically-stressed retirees, “We’ve done all that can be done for you” as opposed to “We’ve done all that ‘best practices’ allow?” If so, will the patient accept these words as valid medical judgments, and opt for hospice, or perhaps assisted suicide, because those are the only choices presented? Or, perhaps they will they be told that the earliest possible medical intervention is six months away. If this satisfies the patient, no political harm is done. If the patient is dissatisfied, he or she may be too weak for political advocacy, and his or her remaining voting-years are limited, so the political damage is minimal. In any case, his or her voice may be drowned out by the media, politicians, teachers of the young, and other favored interest groups, and he or she may easily be out-voted by the vast number of voters who are quite happy with the plan and see no problem.