Emanuel’s Ideas for Rationing Health Care
August 29, 2009 Posted by Amy Hall
Obama’s health advisor, Ezekiel Emanuel, explains his philosophy on the kind of rules that ought to be created for health care rationing:
True reform, he argues, must include redefining doctors’ ethical obligations…. Dr. Emanuel argues that to make such [rationing] 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….
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).
Read the whole article in the Wall Street Journal.
This is not the government’s job. Bureaucrats with lists are not able to make good decisions for individuals far removed from them. They’re simply not connected to the situation. And it is certainly not the government’s job to determine which citizens have more “investments” in their lives and which have lived just about long enough and so are not as valuable to society. No entity with the power of law and police behind it should ever be given this kind of power.
And it gets worse because Emanuel’s ideas will also lead to less innovation:
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….”
If, in the future, the government controls the prices of health care, those prices will be artificially lowered as they currently are in governmental health care programs already in place. Right now, doctors make up the money they lose on these patients by charging everyone else more, but as soon as everyone is under artificially controlled prices, we will have fewer doctors (because the incentive to become a doctor will be lowered), fewer procedures to go around, and less innovation. The rationing will only get increasingly worse.
But I have to say that the most chilling part of all of this is the idea that doctors will cease to consider patients as individuals and start making decisions based on the good of the collective (not simply the good of other individual patients, but the good of “society”–that is, the state). They will be serving the state, not us. None of these things is a positive development.
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Posted in Amy's Posts, Politics
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