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Archive for July 2009

Government Will Ration Health Care

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The health bills coming out of Congress would put your care in the hands of presidential appointees who would decide what the plans cover, what leeway doctors have, and what treatments seniors get under Medicare.

Dr. Ezekiel Emanuel (brother of White House Chief of Staff Rahm Emanuel) has been appointed Health policy adviser at the office of Management and Budget,  and he was also appointed a member of Federal Council on Comparative Effectiveness Research.

He says savings will require doctors to look beyond the needs of their patients and to consider social justice — such as whether the money could be better spent on somebody else.  He believes that “communitariansim” should guide decisions on who gets care.

He says medical care should be reserved for the non-disabled, not given to those “who are irreversibly prevented from being or becoming participating citizens. . . An obvious example is not guaranteeing health services to patients with dementia” (Hastings Center Report, Nov-Dec. ‘96).  Examples would be people with Parkinson’s or a child with cerebral palsy.

He explicitly defends discrimination against older patients: “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” (Lancet, Jan. 31, 2009).

But not to worry.  Those with terminal illnesses will get counseling sessions every five years on how to choose different ways of ending their lives.  It’s mandatory.

The bills being pushed through Congress will be paid for largely by a $500 billion-plus cut in Medicare over 10 years. Peter Orszag, the President’s budget director, urged Congress this week to delegate its own authority over Medicare to a new, presidentially-appointed bureaucracy (that wouldn’t be accountable to the public).

Since the time Medicare began in 1965, senior citizens’ lives have been transformed by new medical treatments like angioplasty, bypass surgery, and hip and knee replacements.   Referring to these treatments, Emanuel criticizes Americans for being too “enamored with technology” and is determined to reduce access to it.

David Blumenthal, appointed by the President to be national coordinator of health-information technology, agrees.  He recommends slowing medical innovation to control health spending.  His job involves making sure doctors obey electronically delivered guidelines about what care the government deems appropriate and cost effective.

In the April 9 New England Journal of Medicine, Blumenthal predicted that many doctors would resist “embedded clinical decision support” (a euphemism for computers telling doctors what to do).

But don’t think that just because you have money to pay your own health-care costs you will avoid the system.  That is not permitted under the plan because it would be unequal.  But guess who can avoid the government plan —- you’ve got it — members of the government.

How much chance do we have avoiding the plan?  Here’s the Chicago-style arm-twisting that citizens are up against.  In a Health Care Watch column (Nov. 16, 2008) Emanuel explained how the bill should be passed: “Every favor to a constituency should be linked to support for the health-care reform agenda.  If automakers want a bailout, then they and their suppliers have to agree to support and lobby for the administration’s health-reform effort.”



Written by polemicscat

July 28, 2009 at 10:13 pm

Posted in Current Events