It is worth some time learning about the man who will be playing a pivotal role in Obamacare (should it come to pass), and who is already playing a pivotal role in Obama’s version of Medicare.
He is Dr. Ezikiel Emanuel, and, if the name sounds familiar, he is the brother of Rahm Emanuel, the White House Chief of Staff. So far, Dr. Emanuel has been appointed by the President to two very important positions…health policy advisor to the Office of Management and Budget, and, a member of the Federal Council on Comparative Effectiveness Research.
What does Dr. Emanuel think of Obama’s statement that we will cover some of the costs of Obamacare by cutting waste, etc.?
Vague promises of savings from cutting waste, enhancing prevention and wellness, installing electronic medical records and improving quality of care are merely ‘lipstick’ cost control, more for show and public relations than for true change.
So, how would Dr. Emanuel control costs?
To him, the issue is the Hippocratic Oath. Here is what he says about that,
“Medical school education and post graduate education emphasize thoroughness,” he writes. “This culture is further reinforced by a unique understanding of professional obligations, specifically the Hippocratic Oath’s admonition to ‘use my power to help the sick to the best of my ability and judgment’ as an imperative to do everything for the patient regardless of cost or effect on others.”
Although most would find that approach to the practice of medicine laudable, in Dr. Emanuel’s mind, adhering to the Hippocratic Oath is a problem because it does not “control costs”. His solution…change the Hippocratic Oath. Medical students should be trained,
to provide socially sustainable, cost-effective care. [emphasis supplied]
Exactly what is socially sustainable, cost effective care? According to Dr. Emanuel, it is,
adding the communitarian perspective to ensure that medical resources will be allocated in a way that keeps society going: “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. [emphasis supplied]
Thus, according to Dr. Emanuel, health care is a basic right if you fit the above description. Conversely, it is not a basic right if you fit the following description:
Covering 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. [emphasis supplied]
And who decides whether someone is “prevented” from becoming a participating citizen? Given his leadership role in Obamacare, I suppose Dr. Emanuel gets to make that decision.
I wonder what medical care he would have given to Helen Keller had he been her family’s doctor?
One further insight into Dr. Emanuel’s thinking…
“Every favor to a constituency should be linked to support for the health-care reform agenda,” he wrote last Nov. 16 in the Health Care Watch Blog. “If the automakers want a bailout, then they and their suppliers have to agree to support and lobby for the administration’s health-reform effort.”
Hum…could there be a connection between the union support for Obamacare, and the auto bailout?