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Archive for July 30th, 2009

The weekend leading up to the election of Brother O in November, I wrote the commentary, “What Lurks over the Horizon?,” warning Americans of the danger they would face if they elected Obama and increased the power of the progressives in Congress.  Although the piece was too bombastic and over-the-top for publication by any of the Web’s reputable gatekeepers, its opening, “America stands poised at the edge of a precipice; her next step could send her plummeting headlong to an untimely death” may prove to be remarkably precient. 

The worst is not. So long as we can say ‘This is the worst.’ Nix the Hippocratic Oath, and make way for the new paradigm for applying health care coverage; the bad gets worse; see “Deadly Doctors” by Betsy McCaughey (McCoy).  According to McCaughey at least two of Brother O’s health advisors think Americans are consuming too much health care and are planning to stop it for the social good.  

The parallel with Hitler’s healthcare system is ominous for it targeted “lives not worthy to be lived,” and provided a “merciful death” for those for whom treatment would be “ineffective” or “futile.”  Like the Nazis, Brother O’s advisors propose to establish a National Heath Board, modeled after the British National Institute for Health and Clinical Excellence (NICE), to decide who should live and who should die.  

Dr. Ezekiel Emanuel, health-care advisor to the director of the Office of Management and Budget, advocates establishing an advisory board “to reduce political interference and allow the necessary tough choices to be made.” Its members will be nominated by the President, confirmed by Congress, and funded independently of Congressional appropriations.

In order to guarantee care for those who can fully participate in and give back to society, Emanuel’s proposed board will deny care to those whose age, illness, and disability drive up the collective health care costs.  Although couched in euphemisms, Emanuel’s model for applying health care coverage is strikingly reminiscent of Hitler’s 1939 directive denying medical care to “useless eaters.”  

“Of all tyrannies,” writes C.S. Lewis, “a tyranny sincerely exercised for the good of its victims may be the most oppressive. It would be better to live under robber barons than under omnipotent moral busybodies. The robber baron’s cruelty may sometimes sleep, his cupidity may at some point be satiated; but those who torment us for our own good will torment us without end for they do so with the approval of their own conscience.” 

 

I.M. Kane

 

DEADLY DOCTORS

By BETSY MCCAUGHEY

July 24, 2009   

THE health bills coming out of Congress would put the decisions about your care in the hands of presidential appointees. They’d decide what plans cover, how much leeway your doctor will have and what seniors get under Medicare

Yet at least two of President Obama’s top health advisers should never be trusted with that power. 

Start with Dr. Ezekiel Emanuel, the brother of White House Chief of Staff Rahm Emanuel. He has already been appointed to two key positions: health-policy adviser at the Office of Management and Budget and a member of Federal Council on Comparative Effectiveness Research

Emanuel bluntly admits that the cuts will not be pain-free. “Vague promises of savings from cutting waste, enhancing prevention and wellness, installing electronic medical records and improving quality are merely ‘lipstick‘ cost control, more for show and public relations than for true change,” he wrote last year (Health Affairs Feb. 27, 2008). 

Savings, he writes, will require changing how doctors think about their patients: Doctors take the Hippocratic Oath too seriously, “as an imperative to do everything for the patient regardless of the cost or effects on others” (Journal of the American Medical Association, June 18, 2008). 

Yes, that’s what patients want their doctors to do. But Emanuel wants doctors to look beyond the needs of their patients and consider social justice, such as whether the money could be better spent on somebody else

Many doctors are horrified by this notion; they’ll tell you that a doctor’s job is to achieve social justice one patient at a time. 

Emanuel, however, believes that “communitarianismshould 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). 

Translation: Don’t give much care to a grandmother 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). 

The bills being rushed through Congress will be paid for largely by a $500 billion-plus cut in Medicare over 10 years. Knowing how unpopular the cuts will be, the president’s budget director, Peter Orszag, 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 Medicare was founded in 1965, seniors’ lives have been transformed by new medical treatments such as angioplasty, bypass surgery and hip and knee replacements. These innovations allow the elderly to lead active lives. But Emanuel criticizes Americans for being too “enamored with technology” and is determined to reduce access to it.

Dr. David Blumenthal, another key Obama adviser, agrees. He recommends slowing medical innovation to control health spending.

Blumenthal has long advocated government health-spending controls, though he concedes they’re “associated with longer waits” and “reduced availability of new and expensive treatments and devices” (New England Journal of Medicine, March 8, 2001). But he calls it “debatable” whether the timely care Americans get is worth the cost. (Ask a cancer patient, and you’ll get a different answer. Delay lowers your chances of survival.) 

Obama appointed Blumenthal as national coordinator of health-information technology, a job that 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.

Americans need to know what the president’s health advisers have in mind for them. Emanuel sees even basic amenities as luxuries and says Americans expect too much: “Hospital rooms in the United States offer more privacy . . . physicians’ offices are typically more conveniently located and have parking nearby and more attractive waiting rooms” (JAMA, June 18, 2008). 

No one has leveled with the public about these dangerous views. Nor have most people heard about the arm-twisting, Chicago-style tactics being used to force support. In a Nov. 16, 2008, Health Care Watch column, Emanuel explained how business should be done: “Every favor to a constituency should be linked to support for the health-care reform agenda. 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.” 

Do we want a “reform” that empowers people like this to decide for us? 

Betsy McCaughey is founder of the Committee to Reduce Infec tion Deaths and a former New York lieutenant governor.

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