August 22, 2009

Latest Pajamas Media Column (‘Meet Rahm Emanuel’s Brother: Dr. Zeke the Bleak’) Is Up (See UPDATE for WaPo Editorial)

EzekielEmanuel081109It’s here.

Sub-headline:

Despite his recent attempted reputation rehab, Zeke always ends up at the same place: not treating the somehow unworthy or letting them die.

It will go up at BizzyBlog on Monday morning (link won’t work until then) under my originally submitted title (“Zeke the Bleak Tries a Sneak”) after the blackout expires.

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The column’s early paragraphs remind readers of the three central incurable moral problems with ObamaCare, first mentioned in my “ObamaCare as a Moral Clunker” column a couple of weeks ago, and how they are still quite present:

…. there are three insurmountable moral objections to the president’s and Democrats’ versions of mislabeled “health care reform”:

  1. They are all designed and destined to ration care. This will lead, as it has in state-run systems virtually everywhere, to long waits for even critical services. In Tuesday’s Wall Street Journal, Harvard professor and chairman of President Ronald Reagan’s Council of Economic Advisers Martin Feldstein confirmed this obvious and inconvenient truth, writing that “rationing health care is central to President Barack Obama’s health plan.”
  2. Under the idea of “Comparative Effectiveness Research” (CER), which has already been funded to the tune of over $1 billion, the inevitable and unavoidable rationing just described would more than likely be carried out under a regime of care denial driven by age-based and “quality of life” criteria. This will, formally or informally, lead to a system similar to that found in the UK, where its National Health Service, under the concept of “Quality-Adjusted Life Years” (QALY), won’t pay for medical procedures that “cost” more than $50,000 for each year of additional life expected to be gained (“cost” is in quotes because I believe that such “costs” are often overloaded with fixed overhead that largely should not be relevant to such decisions).
  3. The people who would be in charge of implementing a state-controlled system, which remains the objective of President Obama and Congress as long as they seek any kind of “public option” or government-managed “co-operative” set-up, have viewpoints that are ethically questionable at best and morally abhorrent at worst.

Ezekiel Emanuel is, of course, primarily a Point 3 problem, because his track record indicates no qualms about the presence of Points 1 and 2. There are many others who hang with President Obama who hold to similar beliefs. The president’s indifference to infanticide, and his suggestion at the ABC infomercial in June that the mother of the woman who had a pacemaker installed at age 99 would have been better off taking a pill instead, are both strong indicators that he is a kindred spirit with Zeke et al.

Zeke, as I refer to him, is attempting to rehabilitate his reputation based on an alleged conversion during the last “five to seven years.” He now wants us to believe that statist health care can be managed without rationing. The column shows that positions he has taken on health matters in just the past few years render that claim an epic fail.

Read the rest at PJM.

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UPDATE: There’s a great comment at PJM from “jerryofva” (after correcting typos) –

This is fundamentally a story about ethics. The question one has to ask is how did a Jew like Ezekiel Emanuel become a proponent of a medical care regime that Henrich Himmler would applaud. The entire idea of “QALY” based system smacks of disposing of the “lives unworthy of living” criteria established by Nazi Germany.” Is there a Rabbi in America who will step up and condemn Dr. Emanuel to the Jewish community?

That transitions into a reminder to anyone who believes otherwise that the regime that attempted to exterminate the Jews was socialist and left-wing. Here are 10 reasons. More discussion is here. A good related vid is here.

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UPDATE 2, August 23: The Washington Post editorially attempted to defend Emanuel yesterday, ginning up as much “we’re outraged” language as it could in a few paragraphs.

But the WaPo unwittingly ended up proving opponents’ point by citing the Lancet study I mentioned in the column –

Critics also point to a January 2009 piece in the Lancet in which Dr. Emanuel and co-authors discuss how to determine which patients should obtain scarce resources such as organs for transplant. The authors consider various possibilities — lotteries; first-come, first-served; sickest first — and propose a combined “complete lives” approach that would consider age, prognosis and maximizing lives saved. Importantly, this would not apply to all health care — only “when genuine scarcity makes saving everyone impossible.” Ms. Palin misleadingly describes this as a “rationing system” that “would refuse to allocate medical resources to the elderly, the infirm, and the disabled who have less economic potential.”

First of all, compare the full range of considerations Emanuel said he would include at Lancet — “youngest-first, prognosis, save the most lives, lottery, and instrumental value” — to what WaPo listed above (“age, prognosis and maximizing lives saved”). Conveniently editing, don’t you think?

Then go back to Point 1 at the very beginning of this post — “They (state-controlled health care systems) are all designed and destined to ration care. This will lead, as it has in state-run systems virtually everywhere, to long waits for even critical services.”

State-run care inevitably creates the conditions for what WaPo itself described as “genuine scarcity that makes saving everyone impossible.” It imposes those conditions on a nation as a permanent part of the landscape, causing a top-down care-decision process that the likes of Zeke Emanuel would manage, a la NICE in the UK, to inevitably kick in. NICE currently and routinely does what Sarah Palin describes and decries, i.e., it “refuse(s) to allocate medical resources to the elderly, the infirm, and the disabled who have less economic potential.”

Q.E.D.

Thanks, WaPo.

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8 Comments

  1. RE: “a state-controlled system,
    …as long as they seek any kind of “public option” or government-managed “co-operative” set-up”

    Is the key to avoid a coop that is “government-managed”? Or to avoid it being “government subsidized”.

    Theoretical chain of events problem: Subsidize it just enough so it becomes part of the status quo and a “right” of the subsidized segment. Then, with the moral right to the subsidized plan, politicians would have an incentive to continuously gradual increase plan benefits. But, this sets up the transfer of wealth in a gradual transition: gradually increasing the government subsidy, gradually adding government coverage mandates to justify the “need” for the subsidy increases, and thus “need” for government spending increases, and thus “need” for government revenues via tax increases.

    A different question: Is there a distinction between a coop that is “government-managed” versus one that is “government regulated”?

    I think the key is to avoid a federal government involvement, since we’ll certainly end up with state regulations. There are already state-level health coops.
    I get advertisements in the mail regularly for a rural coop. I think Sam’s club membership means you can buy health insurance through them. If they’d just equalize the tax treatment of an individual buying into one of those group plans instead of the employer group, then I think more insurance competition would occur.

    Comment by Cornfed — August 22, 2009 @ 3:07 pm

  2. And if Nazi Germany hadn’t broken the pact it made, the Soviets and Stalin wouldn’t have even fought against them.

    Comment by zf — August 22, 2009 @ 3:31 pm

  3. Tom, you are way off base here.
    http://www.time.com/time/nation/article/0,8599,1915835,00.html
    This guy is nothing like his brother.

    Comment by Al on Main — August 23, 2009 @ 12:55 am

  4. #3, No, I’m not. If anything, I understated the case against his involvement in a statist health care regime.

    There is plenty of justification, based on what Emanuel himself has written, to go in this direction on top what was already demonstrated in the column.

    Oh, and check out the definition of “communitarian.”

    Comment by TBlumer — August 23, 2009 @ 5:16 am

  5. Some thoughts on trends in the “health care reform” discussion:

    - A national version of Commonwealthcare (aka Romneycare) was stopped by defeating Romney in the 2008 GOP Presidential Primaries. Kudos to Mr. Blumer for his contributions to this, both during 2008 and continuing to keep it that way, such as the recent post on the Hannity interview.

    - The “public option” can’t pass; e.g. see Sunday’s interview with Grassley(R) and Conrad(D). It’s not dead yet (still too prominent in the public discussion, e.g. Pelosi must advocate it to get re-elected in her district); but it hopefully will be dead after the 2010 elections.

    So finally, the health care reform debate is beginning to move on from the big-government extremes of single-payer or the public option. The increasing numbers of op-eds on co-ops, tort reform, and tax reform are the beginnings of detailed critique discussions from which consumer-oriented reforms may emerge.

    But meanwhile, government-managed care needs more beatings. My comment above wasn’t expressed well. Perhaps the op-ed says it better:

    =================================================
    http://www.nypost.com/php/pfriendly/print.php?url=http%3A%2F%2Fwww.nypost.com%2Fseven%2F08242009%2Fpostopinion%2Fopedcolumnists%2Fos_insurance_scam_186178.htm

    “[If] people would get medical services no matter what, and thus have no need to weigh their costs and benefits, government rules would wind up doing it for them, through rationing.

    Obama doesn’t need a “public option” to do this — regulating insurers can reach the same goal. Either way, government would end up effectively:

    * Mandating how much money is to be spent on health care.
    * Socializing costs.
    * Deciding what kind of care Americans must buy.

    And, again, you don’t need a “public option” to accomplish this. On a New York Times blog Monday, Princeton University economist Uwe Reinhardt pointed to Holland, Germany and Switzerland, where private insurers “are goaded by tight regulation to work toward socially desired ends.”

    Yet there are plenty of ways to unleash capitalist forces to drive costs down and fix current woes, like the risk of losing your insurance when you switch jobs.
    For starters, there’s no reason to ban folks from buying policies out of state, as is the case now. Nor to give tax breaks only for employer-provided insurance.
    Dropping state mandates for unnecessary benefits can also cut costs and broaden “choice.” And, of course, the unmentioned elephant in the room: medical-malpractice tort relief.
    But again, fixing such problems isn’t ObamaCare’s chief goal. It’s using the powers of government to redistribute costs and dictate spending. Whether through a public plan or intensive regulation.

    “[If] people would get medical services no matter what, and thus have no need to weigh their costs and benefits, government rules would wind up doing it for them, through rationing.”

    Comment by Cornfed — August 24, 2009 @ 9:22 am

  6. Add “Observable Prices” to the list of reform sub-topics.

    http://bloomberg.com/apps/news?pid=20601039&sid=a3L2uToJHKiw

    Comment by Cornfed — August 24, 2009 @ 9:35 am

  7. [...] VA Death Book: So much for dignity. It seems that the Deatheaters are hungry, [...]

    Pingback by The Anchoress — A First Things Blog — August 24, 2009 @ 3:37 pm

  8. Is not Obama the benefactor of the most campaign contributions from Wall Street in the history of the Senate, really the second. McCain and Biden have been in the senate half of Obama life but conbined they have less contributions from Wall Street. Obama is only going to hurt the small business man but the way how much income of the Obamas will be taxed by his own law. Nothing because he will put his away and avoid being a patriot. Obama is doing everything in his power to avoid being a patriot.

    Comment by Newcelebrityblog — August 27, 2009 @ 1:17 am

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