August 20, 2009
The chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health care bill out here....There is going to have to be a conversation that is guided by doctors, scientists, ethicists. And then there is going to have to be a very difficult democratic conversation that takes place."
- President Obama, interview with The New York Times
In his April interview, President Obama announced the need for a "difficult democratic conversation" surrounding federal health spending on end-of-life care. However, one of President Obama's senior health care advisors, Ezekiel Emanuel, has already reached the conclusion that some individuals are more worthy of medical care than others:
- An article Dr. Emanuel co-wrote this January proposed a "complete lives" system for purposes of determining the "appropriate" allocation of scarce health care resources. The article notes that under this system, "Individuals aged between roughly 15 and 40 years get the most substantial chance [of receiving care], whereas the youngest and oldest people get chances that are attenuated."
- The model includes reasoning why adolescents should receive priority over infants: "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."
Figure: Age-based priority for receiving scarce medical interventions under the complete lives system.
- As the chart shows, and the article admits, "the complete lives system discriminates against older people....[However,] age, like income, is a ‘non-medical criterion' inappropriate for allocation of medical resources."
- Dr. Emanuel's other writings show an inclination to direct health care resources away from individuals deemed "unworthy." In 1996, he wrote that, "[Health care] 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."
Given that President Obama's self-appointed "ethicist" supports allocating resources in a way that discriminates against the most vulnerable citizens in our society-infants, the elderly, and citizens with disabilities-who can state with certainty that the federal government will not end up denying treatments to those deemed "unworthy" as a result of Democrats' government takeover of health care?
For additional information, contact:
The House Republican Conference Policy Office