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Friday, August 14, 2009

Dr. Ezekiel Emanuel Tries To Tap-Dance His Way Out Of His Own Writings

Jake Tapper isn't a hard-core leftist, but he is easily manipulated by the left. Tapper looks at the responses that Dr. Emanuel gives for the recent criticism of his writings about rationing of health care and the "complete lives" philosophy for determining who gets what health care and how much.

According to Tapper at ABC News:

One of the passages written by Emanuel and used as evidence by Palin and others that he would favor withholding medical care from those who aren’t productive members of society include a 1996 contribution to the Hastings Center Report, in which he said that under the “civic republican or deliberative democratic” construct, “services provided to individuals who are irreversibly prevented from being or becoming participating citizens are not basic and should not be guaranteed. An obvious example is not guaranteeing health services to patients with dementia. A less obvious example is guaranteeing neuropsychological services to ensure children with learning disabilities can read and learn to reason."

Is he saying, as Palin and others have suggested, that those who aren’t “participating citizens” should have no guarantee to health care?

“No,” Emanuel says, “and I think I made it pretty clear I wasn’t endorsing that view, I was analyzing that perspective and what it might mean in practical terms. The rest of the text around that quote made it made it pretty clear I was trying to analyze it and understand it, not endorse it.”


But, from the text of Where Civic Republicanism And Deliberative Democracy Meet as published in a 1996 Hastings Center Report, we see the following:

Thus, it seems there is a growing agreement between liberals, communitarians, and others that many political matters, including matters of justice- and specifically, the just allocation of health care resources--can be addressed only by invoking a particular conception of the good.

...

Procedurally, it suggests the need for public forums to deliberate about which health services should be considered basic and should be socially guaranteed. Substantively, it suggests services that promote the continuation of the polity-those that ensure healthy future generations, ensure development of practical reasoning skills, and ensure full and active participation by citizens in public deliberations-are to be socially guaranteed as basic. Conversely, services provided to individuals who are irreversibly prevented from being or becoming participating citizens are not basic and should not be guaranteed. An obvious example is not guaranteeing health services to patients with dementia.


Nowhere did Dr. Emanuel say that his thinking was hypothetical. This last paragraph excerpt made it pretty clear what his stance on the issue is. His conception of "the good" is policies that "ensure healthy future generations, ensure development of practical reasoning skills, and ensure full and active participation by citizens in public deliberations-are to be socially guaranteed as basic." In layman's terms, that means that only those who are deemed "productive" should be getting medical coverage.

Tapper goes on to present another misleading explanation of the January 31, 2009 article published in The Lancet that Dr. Emanuel co-authored:

The oncologist suggests that his words are being twisted because opponents “don’t have a solution” to the health care reform debate. “Maybe the only tactic is to sow fear and use whatever means you have to attack whether that’s grounded in reality or not... If you don’t have good arguments you use whatever you got, I guess, to say things that are distortive and untrue.”

He says “there have been previous attempts to come after me and after some of my colleagues, but this is certainly on a completely different scale and magnitude. I’ve never been mentioned on Sunday shows in this light and certainly never on the floor of Congress. The distortions are much larger than I’ve ever seen or would have believed could happen.”


But, let's see what he wrote in that article and whether or not it jibes with his current claims:

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.

...

Strict youngest-first allocation directs scarce resources predominantly to infants. This approach seems incorrect.


No twisting there at all. Dr. Emanuel is clear and unambiguous as to what he believes. And the following graph shows where he believes resources should be rationed:



(Source: Principles for allocation of scarce medical interventions; Govind Persad, Alan Wertheimer, Ezekiel J Emanuel; The Lancet, January 31, 2009)

You can clearly see where Dr. Emanuel believes that the very young and the very old should fall in the priority curve. We can assume that such low priorities will also be held for Special Needs patients as well.

You can cross reference this with Sections 1162 and 1177 of HR3200. The parallels are undeniable.

When Gov. Palin voiced her concerns about Trig and her parents being denied medical care based on their "productivity," she was very justified.

Conculsion: Dr. Emanuel can spin and tap-dance all he wants. But he cannot run and hide from what he has written and published. And we should not allow him to even try.

People work hard their entire lives to ensure that their families are taken care of and to ensure that they themselves are taken care of in their twilight years. HR3200 would only serve to undo all that work and allow the government to come in and change the plans that people had made for themselves years before.

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