Healthcare Advisors to the President
Answering a question during a debate, the president stated to look at his advisors and that would give one an idea what his response would be on issues. President Obama stated that if you want to know his ideas on economics one looks to Warren Buffet and Paul Volcker. If you want to know his views on foreign relations one looks to Republican Senator Lugar of Indiana and General Jim Jones former Supreme Commander of NATO. President Obama stated that as we could see, he has a bipartisan mix of advisors.
We are all familiar with the views of such media prominent Americans as Buffet and Lugar but what do we know about the president’s other “advisors”. Names such as John P. Holdren, Cass R. Sunstein, Dr. Ezekiel Emanuel and Van Jones are not as well known to the average Joe but one should get to know them. They are among the people that are shaping policy in this country and have the ear of President Obama. Now they are not all of the Czars this president has surrounded himself with, but these are the ones that have views on healthcare that one should be aware of.
Dr. Ezekiel Emanuel, not one of the Czars but the brother of the President Obama’s Chief Of Staff Rahm Emanuel, received his degree in medicine in 1988 and a PHD in Political Philosophy in 1989 from Harvard University. Dr. Emanuel was tapped for White House health care advisor in February.
In a 1996 article for the Hastings Center Dr. Emanuel wrote:
“This civic republican or deliberative democratic conception of the good provides both procedural and substantive insights for developing a just allocation of health care resources. Procedurally, it suggests the need for public forums to deliberate about which health services should be considered basic and should be socially guaranteed. 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. A less obvious example is guaranteeing neuropsychological services to ensure children with learning disabilities can read and learn to reason”.
What Dr. Emanuel is suggesting here is that there needs to be rationing. This statement means that the continuation or constitution of a politically organized unit (government run healthcare) is dependent on making sure that only those with “practical reasoning skills” should be guaranteed basic healthcare. One has to ask where that leaves the mentally handicapped, autistic children and others that may not fit Dr. Emanuel’s “practical reasoning skills”.
In Principles for allocation of scarce medical interventions (January 31, 2009), Dr. Emanuel and colleagues Govind Persad and Alan Wertheimer wrote:
“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.”
In the same article Dr. Emanuel and his colleagues write:
“The complete lives system also considers prognosis, since its aim is to achieve complete lives. A young person with a poor prognosis has had few life-years but lacks the potential to live a complete life. Considering prognosis forestalls the concern that disproportionately large amounts of resources will be directed to young people with poor prognoses. When the worst-off can benefit only slightly while better-off people could benefit greatly, allocating to the better-off is often justifiable. Some small benefits, such as a few weeks of life, might also be intrinsically insignificant when compared with large benefits.”
and…
“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.”
In essence some Americans are more worthy than others. Under Dr. Emanuel’s health care, only those who can immediately contribute to society or have a chance to, should be given the best healthcare. One has to ask, am I one of the “worthy” ones.
The next article in this series will focus on John P. Holdren.
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