Wednesday, June 15, 2011

Orwellian Arguments in Favor of Government-Rationed Care

Given the provisions in Obamacare that will give a board of “experts” broad power over Medicare, it’s worth examining what some liberal “experts” want to do with that authority.  In an article for the New Republic, Hastings Center bioethical researchers Daniel Callahan and Sherwin Nuland argue American health care is a “quagmire…destroying itself” because of Americans’ desire for new technological innovations – i.e., treatments that save lives.  The authors argue for a “conversion experience” favoring a “more affordable” type of health care:

The traditional open-ended model of medical research, with the war against death as the highest priority, should give way to a new goal: aiming to bring everyone’s life expectancy up to an average age of 80 years (already being approached), reducing early death, and shifting the emphasis in the direction of improving the quality of life of those in every age group.  The highest priority should be given to children, the next-highest to those in their adult years (the age group responsible for managing society), and the lowest to those over 80.

This concept of prioritizing medical spending sounds similar to the infamous chart offered by former Obama Administration official Zeke Emanuel, in a journal article in which Emanuel admitted that his system for dedicating resources “discriminates against older people….[However,] age, like income, is a ‘non-medical criterion’ inappropriate for allocation of medical resources.”  Like Emanuel, Callahan and Nuland agree that their proposal will not be without consequences for seniors:

  • “Unhappily, however, some rationing and limit-setting will be necessary.”
  • “Modern technology has brought us many benefits that enhance the prestige and social power of medicine.  But the public must be persuaded to lower its expectations.”
  • Some people may die earlier than now, but they will die better deaths.”

Recall that in his famous 2009 New York Times interview, President Obama said he would consult with ethicists as part of a “difficult democratic conversation” about what he perceived as too much spending on end-of-life care.  It’s therefore worth asking whether President Obama and Democrats agree with these two ethicists’ “modest proposal” – and whether any “experts” like these will be included on Obamacare’s treatment denial board.