I did not realize where they were getting this stuff, then I did a search on Ezekiel Emanuel to see how much influence he is having on the health care. He is an advisor to Peter Orszag with access to the president's Chief of Staff, his brother, Rahm.
Then I realized some writings of his were being used by the right wing to make it sound as though old people would be deprived of care. I have not read the works of Ezekiel Emanuel, but the quotes they are using can be read several ways out of context. It is all over right wing blogs that he believes in health care rationing by age and by a person's quality of life. On the surface that sounds scary, but it is already being done by health insurance companies.
Jake Tapper covered part of this recently on how Zeke's words are being interpreted.
When Academic Words Become Political AmmunitionAs head of the Department of Bioethics at The Clinical Center of the National Institutes of Health, and someone who has devoted his life to bioethics issues, Ezekiel J. Emanuel has spent much of his career discussing and writing about some of the most ethically complicated issues about health care reform. In 1996, for example, Emanuel contributed an article to the Hastings Center Report, in which he discussed “the need for public forums to deliberate about which health services should be considered basic and should be socially guaranteed.”
Emanuel said that under the “civic republican or deliberative democratic” construct, “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."
In the hands of academics and those with the time and inclination to see such writings as exercises in philosophy, Emanuel’s writings might be par for the course.
But Emanuel is the older brother of White House chief of staff Rahm Emanuel, and he now serves as health-policy adviser at the White House’s Office of Management and Budget and as a member of Federal Council on Comparative Effectiveness Research.
Another site goes into his words more thoroughly. I don't know if they are misinterpreting Emanuel's intent, most likely they are. But this is what is being spread around right wing blogs and site, and no one from our side is effectively countering it.
Head NIH bioethicist supports health care rationing by age and quality of lifeHere are Emanuel’s own words:
"Unlike allocation by sex or race, allocation by age is not invidious discrimination; every person lives through different life stages rather than being a single age. Even if 25-year-olds receive priority over 65-year-olds, everyone who is 65 years now was previously 25 years. Treating 65-year-olds differently because of stereotypes or falsehoods would be ageist; treating them differently because they have already had more life-years is not."
More of his words which they are using apparently to spread such fear.
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.
This blog appears to be referring to many right wing sites, but it is indicative of what they are looking at and how they are interpreting it.
The "Complete Lives SystemThey refer to a book co-written by Ezekiel Emanuel. Again I have not read the book, I am aware that health care is already being rationed and thwarted and denied by private companies. But the right is using this, and we are not countering it.
The basic premise seems to be that since someone or some entity must allocate scare medical resources there should be a "morally" acceptable method for such allocation. The authors, which include Dr. Ezekiel J Emanuel, brother of President Obama's Chief of Staff, and "Special Advisor for Health Policy" to the president presents a detailed proposal of how this allocation should be done. (Using the passive voice here serves the purpose or not having to say that the government will do the allocation.)
The authors begin with a critical review of the currently in existence allocation systems and finding flaws in each proceed to devise their own "hybrid" supposedly salvaging the good and casting out the less desirable elements of the various systems.
...."The authors describe their system:
This system incorporates five principles ... youngest-first, prognosis, save the most lives, lottery, and instrumental value. As such, it prioritises younger people who have not yet lived a complete life and will be unlikely to do so without aid. Many thinkers have accepted complete lives as the appropriate focus of distributive justice: “individual human lives, rather than individual experiences, are the units over which any distributive principle should operate.”Although there are important differences between these thinkers, they share a core commitment to consider entire lives rather than events or episodes, which is also the defining feature of the complete lives system.
A little more on Zeke from Howard Fineman from Febuary. He mentions the goals of cutting Medicare and Medicaid to help with national health care...which of course puzzles the hell out of me because they ARE a national health care.
The Real Emanuel Brother to WatchIn the view of the health-care industry, Zeke is a fundamentalist. He favors guaranteed care for everyone through a system of government vouchers; national boards, he says, should help decide which treatments work most effectively. Costs should be funded by a dedicated national value-added tax. It's the rational way to do it, he said at the Aspen Institute last summer.
..."In the federal budget he'll unveil this week, Orszag plans to offer a fiscal "path to sustainability." But the only way to get there is to cut the growth of spending on health care for 83 million Americans via Medicare, Medicaid, SCHIP and veterans' programs. "This is the ballgame for our long-term fiscal future," he says.
Zeke would prefer to phase out Medicare by adding no new people to it. I don't like the idea at all, I think Medicare should be opened up to more and more people and fixed to add dental and eye care. It could be done if we were not trying to change the Middle East.
Our Democrats should be out there talking about all this. If it is true that it is Zeke's words causing so much of the turmoil, let them explain what he really meant. I don't know what Zeke meant, but I can see from searching the web that the right wing is panicking over some things he has said. Those words are taken by hate radio and twisted and turned around to fit their purpose.
Educate the right about what we mean instead of lecturing "the left" who run ads to advocate for a real reform of health care.