Skip to comments.Electing God
Posted on 07/07/2009 1:15:06 AM PDT by Avoiding_Sulla
Ezekiel Emmanuel MD, Rahm Emmanuel’s brother, who is Barack Obama’s “Special Advisor for Health Policy”, is described by the  Huffington Post article as engaged in a very important mission: redesigning the US health care system.
Emanuel and the White House are attempting to reorganize the delivery and reimbursement systems of health care, changing what the types of procedures doctors rely on, making people more aware of disease prevention, encouraging insurance companies to expand coverage, and so on. It is a process rife with sensitivities, trickeries and, of course, the potential for failure. It is not, he insists, impossible.
“It is a complicated process and we have to try and make the choices clear and give people good reasons for making them,” Emanuel explains. “I don’t think that’s an impossible task and thankfully we have one of the great communicators, Barack Obama, at the helm of this ship of state.”
Emmanuel recently authored an article in the Lancet describing the various models of non-market health care rationing. Titled  “Principles for allocation of scarce medical interventions”, its is co-authored with Govind Persad and Alan Wertheimer. In it the authors simply review the pros and cons of the various ways of deciding who gets treated and who doesn’t. The allocation mechanisms they discuss are divided into strategies and substrategies. The pros and cons of each are laid out.
Treating People Equally
The authors are not very satisfied with the current metrics used for making medical decisions based on saving the most life-years. Both the “Quality-adjusted life-years” model and the “Disability-adjusted life-years” have shortcomings which they believe can be addressed by another model of their own: “The complete lives system”, which takes all the factors into account. They write:
Because none of the currently used systems satisfy all ethical requirements for just allocation, we propose an alternative: the complete lives system. This system incorporates five principles: youngest-first, prognosis, save the most lives, lottery, and instrumental value. … 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 … the complete lives system is least vulnerable to corruption. Age can be established quickly and accurately from identity documents. Prognosis allocation encourages physicians to improve patients’ health, unlike the perverse incentives to sicken patients or misrepresent health that the sickest-first allocation creates.
Under this system, patients would receive scarce care according to the graph shown below.
The paper concludes: “the complete lives system combines four morally relevant principles: youngest-first, prognosis, lottery, and saving the most lives. In pandemic situations, it also allocates scarce interventions to people instrumental in realising these four principles. Importantly, it is not an algorithm, but a framework that expresses widely affirmed values: priority to the worst-off, maximising benefits, and treating people equally. To achieve a just allocation of scarce medical interventions, society must embrace the challenge of implementing a coherent multiprinciple framework rather than relying on simple principles or retreating to the status quo.”
What’s not mentioned anywhere in the discussion, except by implication is the identity of the narrator. Who is the “we” in “Principles for allocation of scarce medical interventions” that decides who gets scarce medical care? The answer is tangentially provided in the paper itself, which writes that “the complete lives system is least vulnerable to corruption”.The “we” is a system; a system that can possibly be corrupted; hence Dr. Emmanuel’s efforts to design one in which such distortions will be held to a minimum.
Ultimately health care reform is as much about politics as it is about medicine. The discussion in Dr. Emmanuel’s paper is incomplete if limited to pure public health considerations. Politics is central to the whole issue. Whatever “guidelines” are chosen, however rational, however humane, can never implement themselves. Human beings in positions of power are required to do that. And while it is important to note that even under the current system these decisions are being made by someone or by some consensus, it is also vital to realize that in any “health care reform” effort, one of the principal outcomes is to shift the power to make those decisions to someone else. That may not be a fit subject for the Lancet, but it is the elephant in the operating room in the national health care debate.
out in an open paper, the Lancet for the first time since the Third Reich.
Thanks for the ping....
abigail2...you see the graph???? Pass along to Jesse!!
These Liberal ghouls plans will include (this time) Christians, gun owners, Conservatives, extremists (to be determined by those in power), anyone over 50 and the list goes on. Welcome to the new version of Hitler’s Nazi Germany.
The Nazi Euthanasia Program: Forerunner of Obamas Death Council
Wednesday, June 17th, 2009 - by Terry Melanson
by Anton Chaitkin
At his trial in front of the American National Military Tribunal in 1947, Karl Brandt, Hitlers escort physician and later a leading euthanasia operative, testified that, sometime in 1935, Hitler had informed Reich Health Leader Gerhard Wagner of his intention to implement euthanasia of the mentally disabled once war had begun. According to Brandt, Hitler believed the opposition to euthanasia from church circles would be less pronounced during war than in peacetime.
Michael S. Bryant, Confronting the Good Death: Nazi Euthanasia on Trial, 1945-1953 (Boulder: University Press of Colorado, 2005)
The world economy is teetering With trillions of dollars evaporating in this crisis, millions of middle-class Americans face the prospect of losing their homes and jobs, and witnessing a dramatic contraction of their retirement savings. In response, the public will desperately want financial security . [B]ailing out bankers and other gamblers [and the] huge increase in the federal debt that these bailouts will entail intensifies the pressure to rein in health-care costs .The dean of health-care economists, Victor Fuchs of Stanford, has long maintained that we will get health-care reform only when there is a war, a depression or some other major civil unrest. Its beginning to look like we might just have all three .
Dr. Ezekiel Emanuel, The Financial Crisis and Health Care, the Chicago Tribune, Oct. 12, 2008
I have since looked up Anton Chaitkin. Wiki gives this:
Anton “Tony” Chaitkin is an author, historian and political activist with the LaRouche movement. He serves as History Editor for Executive Intelligence Review.
Why did it fall to a LaRouchian to make the charges against Emanuel and his obamacare? MSM is already writing off opponents as loony, so this just seems to fit the Establishment’s agenda too well.
The most famous last words in history: “It can’t happen here.”
See post #20 and there's a disclaimer in the link.
Our side is apparently *chicken* when it comes to Obama and his minions.
This is precisely how the latest incarnation of "National(ized) Healthcare" must be presented!!! Until people fear their personal ox getting gored, they're gonna play along with our new "we shall overcome" el Presidente/Commandante!!!
Ask those you know on the web and in meat space, as many as you dare, some version of this question And So, Whats the Consequence of Being Deemed Unuseful?
Such a question, presented with enough of this story to set off alarms, has the potential to spur a grassroots revolt against the schemers in Washington unlike anything seen in America in a very long time.
Their gauge of useful is likely the projected future tax payments to be made by the individual.
That makes sense. This is worse than slavery. Non productive slaves were sold to someone else, rarely killed. But this is the nature of statism, isn't it? Human life reduced to a commodity: produce or "be processed."
I'm sure you hear echoes of CSLewis' warning.
If youd like to be on or off, please FR mail me.
I say kill the conservatives first. Who needs their taxes, we'll tax their estates.
You're right, you'll never convince followers of the One as to the error of his ways, but point out to them they'll be unuseful ones, it'll wake a few up.
Your reference to triage only relevant in the context of a true shortage of care. The One and his brother wish to establish an artificial shortage, quite different.
‘swhat I was getting at. If a free market reigns, shortages are unlikely.
A lot of those groups are the ones that the Communists went after in the 1930s and 40s (basically, ordinary and upper-middle class, successful types like my grandparents). Of course the leftists, including Communist-sympathizer FDR, did everything they could to hide what they did and enabled.
And since they "won" and wrote the history, of course most of us never heard much about it.
We escaped from one Communist country only to land in another.
There was a time when people thought that warning was too pessimistic if not paranoid. But maybe it was simply written before its warning became obvious.
The whole set up is a scam to make their personal decisions look reasoned.
For example, if they really wanted to maximize “life years,” the first thing to stop would be abortion, since babies, by definition, have the most life in them.
Your observation is excellent. Reread it often so readily it comes to mind when you need it in the coming debate that doesn’t want to hear you.
Our side will be limited to soundbites, so they must be vibrant and piercingly to the point.
Progressive thought has moved on from Soylent Green to Coma to Death Becomes Her. All that advanced under the influence of Night of the Living Dead.
As to 15% of Americans and Europeans endorsing it, I pray it is that small, but theres cause to doubt it. Recipients of donated organs may be too ready to accept a conscience numbing story as to the origin of their new body part. A scraping of the organ and DNA test could verify the storys veracity. Could their life extension be the product of far Eastern notoriety? Uh, STFU.
Bottom line: Soylent Green seems apropos for some reason because cannibalism is not strictly a gastronomic experience any more.
So here's your soundbite General Sulla.