Wednesday, July 15, 2009

Dr. Ezekiel Emanuel: Cutting Costs, Costing Lives

Dr. Ezekiel J. Emanuel is as scary as his younger brother, Rahm. Actually, he may be scarier.

R. Emmett Tyrrell Jr., the Washington Times, writes that you better get sick now or you may be sorry.

If you have any sense that you may be getting sick in the years ahead, I suggest you get sick immediately. If you will need of surgery or any medical procedure, do it now! If not immediately, be certain that you hand yourself over to the health care professionals before Oct. 15. That is the date on which President Obama hopes to sign his health care bill once it has gone through the congressional baloney grinder.

At the heart of Mr. Obama's plan is his stated goal to cut medical costs. That might sound good to you, but it means cutting services, nurses, technicians, medical tests and, most prominently, the use of expensive technology. The president's top medical advisers are quite frank about this.

Dr. Ezekiel J. Emanuel, brother of White House Chief of Staff Rahm Emanuel and a health-policy adviser in the Office of Management and Budget, has chided Americans for the expense of their "being enamored with technology." Dr. David Blumenthal, another key Obama adviser, charges medical innovations as being responsible for fully two-thirds of the annual increase in health care spending. Their solution is to limit expensive innovations. A 2008 Congressional Budget Office report agrees with their cost analysis but concludes happily that such innovations "permit the treatment of previously untreatable conditions." As I shall show, there are more humane ways to cut health care costs.

Also at the heart of Mr. Obama's plan is the restriction of services for older people, people 65 and older who, by virtue of modern medicine, may actually be 10 and 15 years younger in terms of good health than they would have been a generation ago. Alas, they still have higher health risks and costs than younger people. Thus, they are going to bear the brunt of the Obama administration's cost cuts, for 27 percent to 30 percent of Medicaid spending is spent for caring for people at the end of their lives.

With the government taking over more of the nation's health care costs under the Obama regime, it has already been decided that government monies are more economically spent on younger people than on older people. If a 65-year-old needs a hip replacement, the government will better spend that money on a younger person whose hip will last longer. Or perhaps the government will decide the money is better spent on preventive medicine for younger people.

In the federal stimulus legislation that the president signed Feb. 17, we find funding for a Federal Coordinating Council for Comparative Effectiveness Research. "Comparative effectiveness research" is a term used by economists in health care for making health comparisons based often on age and for limiting care based on a patient's age. In Great Britain, comparative-effectiveness research is actually used to deny patients treatment for age-related diseases such as heart disease and macular degeneration.

When the federal stimulus bill was going through Congress, there were warnings regarding the consequences of comparative effectiveness research. Rep. Charles Boustany Jr., Louisiana Republican and a heart surgeon, warned it would lead to "denying seniors and the disabled lifesaving care."

Yet the policy remained in the bill along with requirements for doctors' offices and hospitals to maintain data banks on patients while creating a national network to monitor patients' care.

The good side of that is that a central database can send out the latest information on treatments, although doctors who keep up with their medical journals already know about these treatments. The dark side is that it will allow the federal government to control how our doctors treat us. The bill speaks of "appropriate" and "cost-effective" care and provides penalties against doctors beginning in 2014. Now there is an Orwellian twist to the Obama promise of "hope" and "change."

As Betsy McCaughey has written in a groundbreaking analysis of the Obama health care proposals, draconian cost-control measures are not the answer to health care reform, and they are based on erroneous data. Health care's spending increases over the past five years have been about half what they were in the recent period before that. Average family spending on food, energy and health care have remained the same for decades. Moreover, contrary to myth, there are not 47 million uninsured Americans but actually about 22 million. Rather than pass a health care reform that will mercilessly limit health care to older citizens - and to chronically ill citizens - while still increasing federal expenditures by at least a trillion dollars, she suggests a modest reform, to wit, debit cards for the uninsured and the needy.

In a recent installment of, Ms. McCaughey wrote, "Providing sliding scale assistance, based on household income, to families to purchase coverage would cost $20 billion to $25 billion a year." That is one reform that will deal with our present problems. There are others, which I shall take up in later columns. What we do not need is George Orwell's Big Brother overseeing the rationing of health care to senior citizens, particularly senior citizens with years of life ahead of them.

Ezekiel Emanuel isn't a big fan of technology. Of course, it's that remarkable technology that saves lives every day.

Zeke, health-policy adviser to Obama, is looking to save money, not lives.

Just as the stimulus didn't deliver what Obama promised it would, you have to realize that ObamaCare won't fulfill the promises of quality health care for all.

It's another lie.

Don't buy it.


From the Washington Examiner:
No wonder President Obama is in such a rush to get his health care reform package through Congress before the August recess. And before the public finds out about Ezekiel Emanuel, special advisor to Peter Orzag, Obama's director of the Office of Management and Budget (OMB), and brother to White House chief of staff Rahm Emanuel.

Emanuel has written in medical journals of how health care should be rationed, with priority given to younger people over seniors and over those suffering from dementia, according to John Goodman, president of the National Center for Policy Analysis (NCPA). Ezekiel also believes that very young children should be lower on the priority list than younger people who have received public educations.

Goodman cites an article Ezekiel co-authored with two other men that appeared in the January 31, 2009, edition of the British medical journal, The Lancet. Goodman also cites a 1996 article by Ezekiel that appeared in The Hastings Report. In the latter, which was titled "Where civic republicanism and deliberative democracy meet," Ezekiel argued for limiting health care for “individuals who are irreversibly prevented from being or becoming participating citizens.” He cited "not guaranteeing health services to patients with dementia” as an example.

This guy is truly sick.

Where's the compassion?

In effect, the policies Ezekiel Emanuel is encouraging Obama to adopt would create a virtual death camp for seniors and the very young and the mentally challenged.


Related posts:

Ezekiel Emanuel: Complete Lives System, The Lancet, Volume 373, Issue 9661, Pages 423 - 431, 31 January 2009

Ezekiel Emanuel: 'Thinking has Evolved'


Anonymous said...

What I can't understand is why AARP is behind this bill. It is apparent that care for the elderly will be a thing of the past with ObamaCare. I think the AARP is getting bought.

EVERY AARP member needs to drop their membership today!!!!! Send AARP a very loud message. IF they don't get on the side that protects its subscribers there won't be any subscribers. If this bill passes you all better start saving your cash for that hip replacement or life saving heart surgery when you are 70 cause this new plan won't pay for it. But illegals will get care and abortions will be paid for. What is happening to this country and the minds of the people that live here. People wake up....if it sounds too good to be true it generally is.

Mary said...

It's really sleazy of AARP to support legislation that's not in the best interests of its members.

Hopefully, members will cut their ties from this weird group.

Anonymous said...

Read Pages 425 - 430 of H.R. 3200



Tom said...

I can't drop my AARP membership-I dropped it when AARP supported HilliaryCare. TLH

Mary said...

Well, Tom, you can encourage people you know to drop it.

tacotham said...

This is so scary - So if I save up for that hip replacement - where will I go to get It?

Mary said...

Offshore, I suppose.

Anonymous said...

You all should read. Is that too hard to do. Don't let blogs and one-sided argument deceive you.
You have access to the governments' reforms, plans and blueprints.
Studying these things should not be a problem.
I am british and NHS is by far one of the best things that has happend to an average british.

What beats me is the fact that your government can fund wars and nuclear empowerment with tax payers funds but not health care.

Read this,8599,1915835,00.html

Your Dr. Emanuel is not a monster as potrayed by your writeup you know.

Mary said...

I suggest that instead of reading TIME or the New York Times or other lib publications, read Emanuel's writings.

Don't let conservative outlets sway you either.

Read Emanuel's own words.

Decide for yourself if he is a monster, or if he's just a good man who says monstrous things, or if he's just a really good guy.

Anonymous said...

Perhaps if you were capable of reading Dr Emanuel's writings for yourself then you would think differently. In the article he speculates over the allocation of organ donations, which, for a doctor, is a legitimate question to ponder.
You are especially thick skulled on the issue considering the alternative that we face now. An insurance company decides whether or not you get that organ now. Someone who has it in their best interest to deny service because it makes them a profit. Already spent all your allotted health insurance money on dialysis? Good luck getting a replacement kidney my friend.

Also, read the bill, nowhere does it say that the elderly will be denied coverage and subjected to Euthanasia. The idea of providing support for health care directives is not new. In fact, several prominent Republicans have sponsored bills with these directives in the past. How many people over the age of 65 do you know with a living will?

Mary said...

Don't insult me.

Why call me "thick skulled" and incapable of reading?

It seems that you're threatened by people who can read. I understand why. An informed public stands in the way of Obama's government-run, single-payer health care dream.

I'm glad you raised the issue of organ donation. Yes, there are waiting lists for organs because the supply is not as great as the demand. Emanuel has devised a priority curve to address the scarcity. He creates standards to determine the value of lives.

What's alarming is that such a priority curve could be applied in the government-run health care plan. The aim is to cut costs. Cutting services and denying treatments and pressuring people are part of a government-run system.

Obama calls that making "difficult decisions," like not giving a pacemaker to a 100-year-old.

This bill is for the healthy. The people consuming more medical care, the elderly and the seriously ill, will suffer first and the most.

In terms of euthanasia, we're not talking about Dr. Kevorkian methods. But the "expert health panels" Obama talked about will set guidelines that will intrude, impacting the doctor and patient in decision-making.

Obviously, I would have to know an individual well to know if one has a living will. It's not a topic that comes up in casual conversation.

That said, do I know people over 65 with a living will?


It's part of simple estate planning.

Anonymous said...

Sincere apologies for insulting you. It seems to me that people are also insulting Dr. Emanuel for a paper he wrote in 1996, calling him a terribly evil man. I thank you for allowing people to make their own decisions on his merits as you indicated in a previous posts.

I again ask where in the bill does it say that there is this "priority curve" and these "death panels". It seems to me that we have been living in fear for so long that we automatically hit the panic button when the government does something with good intention.

I wish to point out that Dr. Emanuel hypothesized on the same situation that many doctors surely face. When given two patients near death, both of whom it is in their power to save but there is only time for one, which one do you save?

It is not an easy question to answer, and it understandably makes us a little squeamish. Yet in no way does posing that question automatically insinuate that we are going to have death panels in this country.

Thank you for recognizing the problem with organ donation we have currently. We also have to realize that of the tens of millions that are uninsured, NONE of those would qualify for an organ transplant, or a pacemaker, or anything beyond basic ER care. I thank God that neither myself nor my family has fallen into ill circumstances where we can't afford healthcare, but there are too many that have seen their life fall apart because of it.

It's time to protect our greatest asset without allowing someone looking to make tens of millions of dollars (CEO profit) to control it.

Sincere apologies again for the insult, as with many, I tend to get worked up over this issue.

Mary said...

Apology accepted.

You get worked up over this issue.

I understand. It's about life and death.

I hope you're cutting the same slack to the people getting "worked up" at town hall meetings on health care.

Do unto others...

The smear campaign and personal attacks aren't winning any hearts and minds.

I wish Nancy Pelosi and Steny Hoyer and Robert Gibbs and John Dingell and Dick Durbin and Chris Matthews and Keith Olbermann, etc., would stop smearing their fellow Americans for expressing their concerns and voicing their opposition. I wish Obama would stop it, too.

Also, I don't think it's right to demonize the insurance companies and bring up "CEO profit." Class warfare stuff will muddle the debate.

In a way, members of Congress have set themselves up as a privileged class by exempting themselves from government-run care.

I think there's one thing that would put Americans at ease about government-run health care -- Congress and Obama and the unions and other Democrat groups need to be subjected to the exact same plan. If it's universal, make it universal.

Steph said...

I have issues with this "wonderful solution" to our healthcare crisis. But my main concern is that if this is such a fair and medically sound reform plan, why in the world would our reformers choose to exempt themselves from it???????? Unfortunately, there is only ONE answer to this question and that is that they do not want to suffer the awful consequences of this reform that are yet to come. They know that citizens of this country will be unable to receive the healthcare that we need and they are not subjecting themselves to those circumstances. When they are ill, they want to be able to get the healthcare that they need using the tax dollars from the people who will not be able to the exact same thing!!!!! It is criminal!!!!

Tony said...



Lawrence said...

One of the Anonymous posters said he was British and then he wrote that NHS was one of the best things that has happened to an average British. To an average British?? Just does not sound right and does not read like something a Brit would post.

Istvan Gorog said...

With reference to "How Much Does Health Cost" in the NY Times on Oct. 30, 2011 p. SR 5, I am in full agreement with Dr. Emanuel and submit the foloowing supportive argument.

I followed with dismay and great interest the recent US Debt related events in Washington. As most rational people, I am convinced that we need both to reduce expenses and increase revenues. Here I wish to point out a specific Trillion-dollar savings opportunity derivable from eliminating unnecessary, and in fact harmful, excessive medical X-rays.

According to UNSCEAR 2008 (“Sources and Effects of Ionizing Radiation”, United Nations Scientific Committee on the Effects of Atomic Radiation, UNSCEAR 2008, United Nations, New York, 2010, Volume I and United Nations, New York, 2011, Volume II) the average American is exposed to about twice the amount of ionizing radiation relative to the global average; this excess is mostly due to unnecessary X-rays. As a specific comparison: the UK average annual per person dose from X-rays is about 0.5 mSv (milli-Sievert) and in the USA it is about 3 mSv; and according to the CIA World Factbook (on June 25, 2011) the life expectancy at birth in the UK is 80.05 years and in the US it is 78.37 years. Clearly, the extra X-rays we receive are not extending our lives and we do pay for them; I estimate that we pay upwards of $1,000/person annually for unnecessary diagnostic irradiation. Additional medical expenses are incurred for treatments of the damage caused by this unnecessary irradiation.

It is a generally accepted scientific fact that no amount of ionizing radiation is healthy; one unit is harmful and two units are twice as harmful. Using available epidemiological data, the average American life span is shortened by more than a year by excessively aggressive use of radiological diagnostics.

I was originally interested in searching the affects of nuclear fall-out from old weapons tests and rector accidents; until I incidentally stumbled on the X-ray data in the UN reports. Subsequent to the recent Fukushima accident I estimated that the worldwide average radioactive exposure from the worst conceivable reactor meltdown would be a small fraction of what the average American receives and pays for in unnecessary medical diagnostics. Anyone interested in following up with more details, please visit my blog at

Istvan Gorog
Lancaster, PA