Obama, Ezekiel, and the Rationed Healthcare Lifeboat

(start video around 2:45)

Democrats like to say a lot of things about healthcare, in order to calm the jitters of the voting public. Of course you can keep your current health insurance, they say. The public option will simply keep those private companies in check. Furthermore, they say, fears of rationed care are unfounded — and clearly the fear of mandated euthenasia is pure paranoia.

But are these the facts? Do these calming words have any basis in reality?

As has been noted here and elsewhere, a public option will almost certainly evolve into a single-payer system — and, indeed, that is what it’s designed to do. Rationed care? A necessary symptom of the single-payer system. When a single payer is responsible for the health needs of everybody, there are bound to be some conflicts.

Just ask Ezekiel Emanuel. Ezekiel — Chief of Staff Rham Emanuel’s brother — also works with the Obama administraiton, as a presidential health care advisor. He published an article in January, in a British Medical Journal called ‘Lancet,’ in which he examines, not only the possibility of rationed care, but how to make beaurocratic decisions on who should get limited treatments. (via RightSoup)

E. Emanuel is also, as of March, a member of the Federal Coordinating Council on Comparative Effectiveness Research — tasked with determining a “Federal system for withdrawing care.” He seems more than up to the task.

Writes Emanuel:


“Such an approach accepts a two-tiered health system-some citizens will receive only basic services while others will receive both basic and some discretionary health services… 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.”

Scary enough. It gets worse.


“When implemented, the complete lives system produces a priority curve on which individuals aged between roughly 15 and 40 years get the most substantial chance, whereas the youngest and oldest people get chances that are attenuated.” This may be justified by public opinion, since “broad consensus favours adolescents over very young infants, and young adults over very elderly people.”

Under the Ezekiel Emanuel plan, the infants and the elderly sit rather uncomfortably at the bottom of the food chain, while young adults take precedents over adolescents. And then, incredibly, Emanuel even stipulates that job and social standing will have to be accounted for:


“Social Value Allocation” prioritizes specific individuals to enable them to promote other important values, or rewards them for having promoted these values. In view of the multiplicity of reasonable values in society and in view of what is at stake, social value allocation must not legislate socially conventional, mainstream values.”

“Allocators must also avoid directing interventions earmarked for health needs to those not relevant to the health problem at hand, which covertly exacerbates scarcity. For instance, funeral directors might be essential to preserving health in an influenza pandemic, but not during a shortage of intensive-care beds. For instance, former organ donors seem to deserve reciprocity since they make a serious sacrifice and since there is no surplus of organ donors. By contrast, laboratory staff who serve as vaccine production workers do not incur serious risk nor are they irreplaceable, so reciprocity seems less appropriate for them.”

In short, if you’re an electrician, and both you and a surgeon need the same liver — guess what? If the Government decides it needs surgeons, you’re what they call in the Insurance business SOL.

More on this can be found at the Washington Times. But one has to ask: if it’s true that regular folks don’t have to worry about things like rationed care under a Federally-run system, then why even submit the theory? And what the hell is going on in Georgia?

Are fears of a “Logan’s Run” kind of world under the Obama administration unfounded? When folks like this are the ones making the decisions on the Administration’s health policy, don’t bet on it. It’s time to get our representatives to read these bills they’re trying to pass. It’s time to let Obama and Company know that we aren’t stupid. Stand up against the Trojan Horse of “public options.” And remember not to eat the green crackers.

(Cross-posted at The Minority Report)