Ezekiel Emanuel, Rham Emanuel's brother, both advisers to Barack Hussein Obama, wrote a paper on the Complete Lives System which is the foundation of Obamacare. You can read his paper that outlines the principles now known as the Complete Lives System in his published paper titled Principles for Allocation of Scarce Medical Interventions for yourself. In 2009, The Wall Street Journal ran an OpEd titled Obama's Health Rationer-in-Chief
In his paper, Dr. Emanuel outlines how to ration care via life-years. If you are young and disabled, you are low priority. If you are old, you are a low priority. Since teenagers have more life years and have already had education resources invested in them to be future workers, it benefits the collective that they should receive the most care. It's communist. You receive care based on how beneficial you are to society- also Plato's view of medicine. If you are no longer of value to society/the collective, then you can have assisted suicide instead of treatment. This is the opposite of Hippocratic medicine that treats the individual and refuses to administer a poison to take the life of anyone.
Remember the Obama official caught on tape last year saying the words *death panels* do not appear in the law, but they are there...they just could never call them what they are. When we on the right point it out, we are called conspiracy theorist and whack jobs. Can the left read medical papers? These are the people who advised Obama and IPAB is clearly spelled out in the law. Furthermore, Hillarycare was the same way- remember Tom Daschel's book where he wrote that old people have pain as part of aging and thus should not receive pain meds? These are sick communists! They prefer Platonic medicine vs Hippocratic medicine.
Here is Betsy's OpEd. Read it an weep. It's coming to a hospital near you.
OBAMA'S HEALTH RATIONER-IN-CHIEF
The health bills being pushed through Congress put important
decisions in the hands of presidential appointees like Dr. Emanuel. They
will decide what insurance plans cover, how much leeway your doctor
will have, and what seniors get under Medicare. Dr. Emanuel, brother of
White House Chief of Staff Rahm Emanuel, has already been appointed to
two key positions: health-policy adviser at the Office of Management and
Budget and a member of the Federal Council on Comparative Effectiveness
Research. He clearly will play a role guiding the White House's health
Dr. Emanuel says that health reform
will not be pain free, and that the usual recommendations for cutting
medical spending (often urged by the president) are mere window
dressing. As he wrote in the Feb. 27, 2008, issue of the Journal of the
American Medical Association (JAMA): "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."
True reform, he argues, must include redefining doctors' ethical
obligations. In the June 18, 2008, issue of JAMA, Dr. Emanuel blames the
Hippocratic Oath for the "overuse" of medical care: "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."
In numerous writings, Dr. Emanuel chastises physicians for thinking
only about their own patient's needs. He describes it as an intractable
problem: "Patients were to receive whatever services they needed,
regardless of its cost. Reasoning based on cost has been strenuously
resisted; it violated the Hippocratic Oath, was associated with
rationing, and derided as putting a price on life. . . . Indeed, many
physicians were willing to lie to get patients what they needed from
insurance companies that were trying to hold down costs." (JAMA, May 16,
Of course, patients hope their doctors will have that single-minded
devotion. But Dr. Emanuel believes doctors should serve two masters, the
patient and society, and that medical students should be trained "to
provide socially sustainable, cost-effective care." One sign of progress
he sees: "the progression in end-of-life care mentality from 'do
everything' to more palliative care shows that change in physician norms
and practices is possible." (JAMA, June 18, 2008).
"In the next decade every country will face very hard
choices about how to allocate scarce medical resources. There is no
consensus about what substantive principles should be used to establish
priorities for allocations," he wrote in the New England Journal of
Medicine, Sept. 19, 2002. Yet Dr. Emanuel writes at length about who
should set the rules, who should get care, and who should be at the back
of the line.
"You can't avoid these questions," Dr. Emanuel said in an Aug. 16
Washington Post interview. "We had a big controversy in the United
States when there was a limited number of dialysis machines. In Seattle,
they appointed what they called a 'God committee' to choose who should
get it, and that committee was eventually abandoned. Society ended up
paying the whole bill for dialysis instead of having people make those
Dr. Emanuel argues that to make such
decisions, the focus cannot be only on the worth of the individual. He
proposes 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. 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." (Hastings
Center Report, November-December, 1996)
In the Lancet, Jan. 31, 2009, Dr. Emanuel and co-authors presented a
"complete lives system" for the allocation of very scarce resources,
such as kidneys, vaccines, dialysis machines, intensive care beds, and
others. "One maximizing strategy involves saving the most individual
lives, and it has motivated policies on allocation of influenza vaccines
and responses to bioterrorism. . . . Other things being equal, we
should always save five lives rather than one.
"However, other things are rarely equal—whether to save one
20-year-old, who might live another 60 years, if saved, or three
70-year-olds, who could only live for another 10 years each—is unclear."
In fact, Dr. Emanuel makes a clear choice: "When implemented, the
complete lives system produces a priority curve on which individuals
aged roughly 15 and 40 years get the most substantial chance, whereas
the youngest and oldest people get changes that are attenuated (see Dr.
Emanuel's chart nearby).
Dr. Emanuel concedes that his plan appears to discriminate against
older people, but he explains: "Unlike allocation by sex or race,
allocation by age is not invidious discrimination. . . . 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."
The youngest are also put at the back of the line: "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. . . . As the legal philosopher Ronald
Dworkin argues, 'It is terrible when an infant dies, but worse, most
people think, when a three-year-old dies and worse still when an
adolescent does,' this argument is supported by empirical surveys."
(thelancet.com, Jan. 31, 2009).
To reduce health-insurance costs, Dr.
Emanuel argues that insurance companies should pay for new treatments
only when the evidence demonstrates that the drug will work for most
patients. He says the "major contributor" to rapid increases in health
spending is "the constant introduction of new medical technologies,
including new drugs, devices, and procedures. . . . With very few
exceptions, both public and private insurers in the United States cover
and pay for any beneficial new technology without considering its cost. .
. ." He writes that one drug "used to treat metastatic colon cancer,
extends medial survival for an additional two to five months, at a cost
of approximately $50,000 for an average course of therapy." (JAMA, June
Medians, of course, obscure the individual cases where the drug
significantly extended or saved a life. Dr. Emanuel says the United
States should erect a decision-making body similar to the United
Kingdom's rationing body—the National Institute for Health and Clinical
Excellence (NICE)—to slow the adoption of new medications and set limits
on how much will be paid to lengthen a life.
Dr. Emanuel's assessment of American medical care is
summed up in a Nov. 23, 2008, Washington Post op-ed he co-authored: "The
United States is No. 1 in only one sense: the amount we shell out for
health care. We have the most expensive system in the world per capita,
but we lag behind many developed nations on virtually every health
statistic you can name."
This is untrue, though sadly it's
parroted at town-hall meetings across the country. Moreover, it's an odd
factual error coming from an oncologist. According to an August 2009
report from the National Bureau of Economic Research, patients diagnosed
with cancer in the U.S. have a better chance of surviving the disease
than anywhere else. The World Health Organization also rates the U.S.
No. 1 out of 191 countries for responsiveness to the needs and choices
of the individual patient. That attention to the individual is imperiled
by Dr. Emanuel's views.
Dr. Emanuel has fought for a government takeover of health care for
over a decade. In 1993, he urged that President Bill Clinton impose a
wage and price freeze on health care to force parties to the table. "The
desire to be rid of the freeze will do much to concentrate the mind,"
he wrote with another author in a Feb. 8, 1993, Washington Post op-ed.
Now he recommends arm-twisting Chicago style. "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."
Is this what Americans want?
Ms. McCaughey is chairman of the Committee to Reduce Infection Deaths and a former lieutenant governor of New York state.