Complete Lives System

Dr. Ezekiel EmanuelPresident Obama’s White House Health Care policy adviser and brother of Obama’s Chief of Staff and “attack dog,” Rahm Emanuel, has some very disturbing plans for healthcare “reform.” Dr. Emanuel advocates a collectivist system of “merit-based” healthcare services.

In an example of Orwellian TrueSpeak he calls his plan the Complete Lives System.

Dr. Emanuel first published his ideas of merit-based healthcare in the 1996 Hastings Center Report (Volume 26, No. 6) where he declaimed:

This civic republican or deliberative democratic conception of the good provides both procedural and substantive insights for developing a just allocation of health care resources. 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. A less obvious example is guaranteeing neuropsychological services to ensure children with learning disabilities can read and learn to reason.

You can download the article in PDF format here.

Over the ensuing years Dr. Emanuel fleshed out his plan over the following years and published it in the January, 2009 issue (Volume 373, Issue 9661) of The Lancet. Some excerpts from the article follow:

Some people wrongly suggest that allocation can be based purely on scientific or clinical facts, often using the term “medical need”. There are no value-free medical criteria for allocation.

~*~

Consideration of the importance of complete lives also supports modifying the youngest-first principle by prioritizing adolescents and young adults 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. Similarly, adolescence brings with it a developed personality capable of forming and valuing long-term plans whose fulfillment requires a complete life.

~*~

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.

~*~

Unlike allocation by sex or race, allocation by age is not invidious discrimination; every person lives through different life stages rather than being a single age. Even if 25-year-olds receive priority over 65-year-olds, everyone who is 65 years now was previously 25 years.  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.

~*~

Accepting the complete lives system for health care as a whole would be premature. We must first reduce waste and increase spending.

The complete article in PDF format, entitled, Principles for allocation of scarce medical interventions, can be downloaded here.

Dr. Emanuel’s Complete Lives methodology of applying his interpretation of both allocative and distributive justice to healthcare is put forth in the context of having scarce medical resources available. That’s an important consideration when reviewing his Complete Lives proposal; it is not meant to address the allocation and distribution of readily available and plentiful medical resources, only scarce ones. It is a two-tiered system divided between basic (guaranteed) and discretionary (not guaranteed) medical services.  Some citizens will receive only basic services while others will receive both basic and some discretionary health services.

So we have to take Dr. Emanuel’s ideas in the context in which they were set, which makes them somewhat less monstrous and horrific than some of the commentary on the subject would have you believe.

That being said, one of the oft-stated goals of President Obama’s healthcare “reform” was to reduce costs and the amount of America’s GDP being spent on healthcare. That certainly implies that money – tax dollars or deficit dollars – will essentially be a medical resource. This could very easily create the sort scarcity that would call Dr. Emanuel’s bio-ethical philosophies into play. Dr Emanuel is, after all, a special advisor to the Director of the White House Office of Management and Budget for health policy. He would definitely be consulted on streamlining expenditures.

How does that you feel? It definitely makes my skin crawl more than a little bit. There are just too many ways that Dr. Emanuel’s particular twist on eugenics could be quietly and on-legislatively introduced into any government ran healthcare system for me to be comfortable with the idea.

Related Reading:

The Oxford Textbook of Clinical Research Ethics
Socialism: A Very Short Introduction
The How Can It Be Gluten Free Cookbook
Collectivism in 20th-Century Japanese Art (Positions Art Critique)
The New Freedom: Individualism and Collectivism in the Social Lives of Americans

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70 Responses to “Complete Lives System”

  1. Dana Says:

    Well, think about it. Say you’ve got a large family with a wide range of ages, from infant on up into the 80s. All of a sudden three people in the family get sick: a baby, a 15-year-old, and the 80-year-old matriarch. All three of them caught a weird disease and now they all need a liver transplant. But you can only afford one transplant. Who do you save?

    Before we had all this wonderful healthcare technology, families made decisions like this all the time, and although they didn’t have transplants to look forward to, they understood that you don’t prioritize an infant who might not live to adulthood over a teenager who already has. And you don’t insist on letting your great-grandson die when you’ve already lived a full life.

    People could become creeped out by this only through selfishness. The elderly in this country already expect to get their share of the pie whether it starves their children and grandchildren or not. Literally, our politicians make their decisions around the whims of the elderly far more than around the needs of young parents or teenagers or children. I don’t know how we have gotten to this point, but it is despicable.

    Look, I didn’t vote for Obama, let’s get that straight right now. I favor the Green Party, and the Democrats really disgusted me in this last election with their pitting of a white woman against a black man, guaranteeing an intra-party civil war. But I’m sick and tired of younger people being considered expendable. I understand that the relationship between the generations has broken down, perhaps irreparably. Our propensity for sticking the grandparents in a nursing home rather than taking care of them ourselves is a big part of that, I feel. But that’s no excuse for starving the younger adult generations of resources just to extend lives that are already sickly and miserable. Because it’s not the healthy elderly who are worried about this. It’s the ones on thirty pills a day.

  2. Dana Says:

    Also, technically this is not eugenics because even if you could argue that someone is deliberately killing old people, killing old people is not going to stop young people from getting old. The point of eugenics, monstrous as it was, was to weed certain characteristics out of a gene pool. It is impossible to weed aging out of the gene pool. I suspect we’d *all* die if we did that.

    Way to invoke the Nazis and provoke hysteria, though.

  3. jonolan Says:

    Dana,

    Two things that you said in your comment truly strike me:

    People could become creeped out by this only through selfishness.

    ~*~

    But that’s no excuse for starving the younger adult generations of resources just to extend lives that are already sickly and miserable

    You complain of people’s selfishness? Try looking the mirror and realizing that your purely materialist utilitarian approach, with all of it’s age and health based biases, is the absolute nadir of selfishness.

    Tell me, what about care for the chronically ill? The mentally infirm? How about poor people from savage and nihilistic neighborhoods? They’re a drain on your resources as well.

    As for eugenics – I think anyone with both a brain and a sense of ethics would understand Dr. Emanuel’s views of not expending resources on the those – including children – who “are irreversibly prevented from being or becoming participating citizens” is a finely worded example of eugenics since it would weed them out of gene pool.

    If you’re representative of the ideals of the Green party, then I’m glad that they’re politically insignificant.

  4. Zombywolf Says:

    Dana frightened me so bad with this: “People could become creeped out by this only through selfishness. The elderly in this country already expect to get their share of the pie whether it starves their children and grandchildren or not. Literally, our politicians make their decisions around the whims of the elderly far more than around the needs of young parents or teenagers or children. I don’t know how we have gotten to this point, but it is despicable.” That I lost my train of thought. How is it selfish to want people over 40 to have the right to health care as good as a 20 year old’s. I thought that was part of the issue with Socialized medicine they keep throwing in our faces–people in the UK and Canada have longer life expectancies–really because they don’t count certain preemies. Who gets to be wise if we kill off every one over 40. I have a cousin–healthy as could be till 17 when he developed a brain tumor–Saint Jude’s cured him and manage his care almost 10 years later–but he had dozens of strokes toward the end of his chemo and can’t talk plain or walk very well and may never. A lot of diseases tend to strike people in their 20s and 30s. Another cousin is married to this girl who just got her Master’s in psychology or was it a PhD–well point is she is 26 and was diagnosed with breast cancer–the fast spreading kind. Another third cousin was diagnosed and dead of tongue cancer at 32 (his father’s family is a genetic mess of diseases –he played the horn high school and college –but never smoked)–his sister was dead at 50 of diabetic complications. Life’s a crap shoot sometimes—some 80 year olds are very productive citizens and some 20 years will never amount to a thing. A friend who’s mother-in-law is Irish and in her 80s is on her 5th PhD because she wanted something to do.

    I said on another blog what is the point of gaining affordable health care at the cost of losing our collective soul because we sold the older generation out–sacrificed on the altar of the collective good–or something like that.

  5. Phil Says:

    Valuable post jonolan. I hope we can avoid this doomsday triage (in some circumstances -e.g. organ transplants it’s already here) by addressing the scarcity issue. This past year I had need of the services of the “home health care” industry- another ripoff (I sank $50K in it before I woke up). Some of these kids who worked for me were working part-time and going to nursing school. Tuition here was easily $20K per year. They got no help from their work agency and in fact the agency didn’t have health insurance and a lot of them were uninsured (part of the problem with the system here- the young healthy uninsured). Unless we remove these barriers to entry to the health-care field (docs with $200K student loan bills) and ease up on our precious Adam Smith-Ayn Rand-Alan Greenspan free market bushwa we’ll never make any progress. Thanks for hipping me to the Emanuel dystopian vision. This might be fodder for the Town Hall disrupters and the Birthers.

  6. Phil Says:

    Actually, on reading Dr Emanuel’s Lancet article, it looks like a review of some principle’s that are already considered in the medical community for some resources that are necessarily scarce. There will always be such. I couldn’t see any personal opinion statements. That said however, this will most likely be picked at by the “just say no” crowd the way they took that piece about Medicare-funded end-of-life planning sessions as euthanasia.

  7. Ex-Democrat Says:

    Hey Dana, Ezekiel Emanuel is a Josef Mengele eugenicist. If you’re okay with that just say so.

    Not only did you vote for pResident Soetoro/”Obama” I’m sure you offered Larry Sinclairs to him and any other willing O-drones.

    America is a-rising and we’re taking out you Nazis. We will NOT be Germany, circa 1932.

    It’s on.

  8. Sam Says:

    oh, look – a communist! apparently I have to do good works to get into the hospital with this guy (like being related to a us Administration official?). Good thing its not required for getting into Heaven – the only great communal society we’ll ever have.

  9. ichabod Says:

    Hi jonolan;

    The way the Doctor presents it is reasonable enough. If I am seriously ill, like my friend who died from Lou Gehrig’s disease, which cost more than a million dollars to treat to no avail, I would rather take a few pain killers to make it comfortable and leave the money to treat a young person in need.

    However, I would not desire to have the people in Congress or anyone else make that decision for me. I’ll make it myself.

    If the government can’t afford or doesn’t want to pay to keep me going, that is fine as I don’t depend on the government for any of my needs anyway.

    Some people do depend and that is ok

  10. Greg Says:

    There is no cake

  11. charlie Says:

    does the murderer TED KENNEDY go along with this?

  12. jonolan Says:

    Ex-Democrat & Sam,

    Well said, well said indeed. I do not think this is a direction that Americans should allow the Liberals to drag us down. That road leads, with very few and hard-won exceptions, to Hell – either here in America or in death, or in both.

    ~*~

    ichabod,

    Yes, Dr. Emanuel presents his Complete Lives System very reasonably; all people of his sort do so. He, like so many others, is not a raving, immoral beast. He’s a dystopian pragmatist who seems to lack the ability to see patients as people.

    My issue, like yours it seems, is that Dr. Emanuel is one of the people that will shape US healthcare policies and those policies will be forced – by circumstance, if not by design – upon all or most of America if the Liberals have their way.

    ~*~

    charlie,

    Yes, Sen. Kennedy fully supports this plan. He’s one of the staunchest proponents of ObamaCare, just as he was one of the staunchest supporters of the earlier HillaryCare.

  13. Health care bill, a few scarry concepts to consider? - Page 3 - Christian Guitar Forum Says:

    [...] System" – by Dr. Emmanuel – Advisor to Prez – News & Current Events – Comcast.net Community Complete Lives System | Reflections From a Murky Pond this one qoutes him from Jan. 2009 Make no mistake about if and when the govt. gets control of an [...]

  14. James Says:

    First of all, I appreciate vocalizations of various opinions because that is one of the greatest rights we are guaranteed. We are blessed with the ability to dissent and disagree.

    I find it very interesting that the points that are targeted here as being the atrocious machinations of the liberals via the infamous Emanuel brothers (specifically Dr. Emanuel in this case) are actually indicative of the system that we currently have through private health insurance providers. Who is considered by health insurance companies to be the ideal clients? Healthy 15 to 40 year olds that are unlikely to need their services thereby making huge profits for these private firms by paying in over the longterm while rarely taking out funds for services. In many cases, if the “ideal client” becomes not so ideal by developing an expensive illness or condition, the insurance provider responds by refusing to pay or even dropping the individual.

    As for the infants and elderly that need care or procedures, not only is the private provider resitant to covering such care but is also less likely to insure individuals in these age groups in the first place. All of this is taken to an even greater extreme if the individual (regardless of age group) is indigent. Those individuals have no chance of receiving health care or needed procedures from the private insurers and are relegated to either going without or getting sporadic care through emergency room visits that they can never hope to reimburse and that do not really address their health issues over the longterm. By most logical reasoning would this not be considered “eugenics” especially considering that the groups most affected by this weeding out due to indigence fall into the category of minorities.

    I think that all of this is shameful and frightening if you put any stock in the addage that we judge our society by how we treat the “least” among us.

  15. Sue Says:

    The article in question first of all is highly academic in nature. It is not a public policy paper. It is not part of any legislation. Dr. Emanuel is not in Congress. His paper has nothing to do with the health insurance reform proposals on the table. Second, the paper clearly states in the opening paragraph that it is specifically addressing a narrow situation, i.e., how to allow a very scarce medical resource, such as organ transplants. Academic articles of this type are designed to explore ideas and stimulate debate among academics. That is all this article is. Other academics no doubt disagree, and likely there are additional articles that will carry on this highly academic debate. You are all free to disagree with his ideas about how to decide who gets the few organs that are available for a transplant. But please remember that the article has NOTHING TO DO WITH THE LEGISLATION BEING CONSIDERED IN CONGRESS!! It would be so refreshing if just for once we could have a rational, intelligent discussion about a policy issue in this country, instead of all lining up on opposite sides and lobbing verbal grenades.

  16. jonolan Says:

    James,

    You should probably read this if you’re going to discuss the evils of the health insurance market. It might surprise you.

    Also, try to consider that, while private insurance is flawed, the proposed government “solution” will solve few, if any, of the problems and will cost America trillions of dollars that we don’t have.

    ~*~

    Sue,

    There were two articles by Dr. Emanuel cited in this post. Both showed the same underlying dystopian, materialist pragmatism – and, despite your partisan, Liberal rantings, it has a great deal to do with the legislation being “considered” by Congress.

    Have you read the bill in question? I have and it is written largely in sweeping statements that the details and implementation thereof will have to worked out by Obama’s “czars,” bureaucrats and advisors such as Dr. Emanuel.

    And there will be shortages due to issues with funding; anything funded through tax dollars has funding issues. Do you really want someone like Dr. Emanuel advising Obama Health Czar on what the money should be spent on? You might, but I certainly don’t.

  17. Your Hell-th Care Future: The Scarcity System of Dr. Emanuel’s “Complete Lives” - ausonius’s Diary - RedState Says:

    [...] See: http://blog.jonolan.net/wp-content/uploads/2009/08/complete-lives.pdf [...]

  18. James Says:

    Jonolan,

    While I did not specifically address the self-funded plans in my previous discussion (and I had already read your blog that you linked), my point still stands on several merits. First, these self-funded plans are not much different than the traditional insurance plans in that the provider (the employer in this case) still constructs a plan that excludes many of the people that I discussed before. In many cases these plans only cover the employee, not the family, and still is designed to exclude payment or coverage of many illnesses and conditions. Additionally, as the KFF study even points out this coverage is primarily of “nonelderly people in America.” After all the bulk of the workforce in our country falls into the 16 to 50 age group. The indigent, mostly unemployed or employed in temp jobs with no health plans offered, are also still not helped by such plans.

    The focus of my discussion was not primarily to demonize the private insurance industry but to point out that the outrage about an Obama-Emanuel plan which selectively excludes certain groups to the point that it is equated with eugenics seems to ignore that such exclusion currently exist on a broad scale under our current system. Where is the outrage about this? Self-funded plans certainly do not solve this problem.

    As for advocating an Obama plan, I cannot do so because there is not an actual plan before us. However, I realistically beleive that no single plan, whether government or private, provides a panacea to the problem.

    On a separate note, I am not sure how Sue’s comments, whether you agree or disagree, can be construed as “partisan, Liberal rantings.”

  19. jonolan Says:

    James,

    OK, you do bring up some valid points. I’m the last one to say that our health insurance system is without flaw.

    However, there is more choice under the free market than there would be under a government run or mandated plan. You or your employer can change carriers, or change coverages. I know; I’ve done it in order to get the coverage I desired.

    Such choice is far less feasible or likely under a government run health insurance plan where all the carriers have to offer essentially the same plans, which makes Dr. Emanuel’s predilections worrisome to me and many others.

  20. Linda Says:

    Dana,

    You made a couple of comments that I would like to respond to. First, your comment “Our propensity for sticking the grandparents in a nursing home rather than taking care of them ourselves is a big part of that, I feel.” I totally agree with that, however I would go in a different direction that you are. I believe that one of the worst things we have done in our society is to allow the government to take over the “welfare” of a large portion of our society, specifically the elderly, with Social Security and Medicare. It’s hard for us to even imagine life before these programs, but has it really improved the quality of our lives? Before Social Security, who took care of the elderly? It was FAMILY. Once we allowed the government to come in and say “we will take care of Grandma, so you families don’t have to do that anymore”, well that’s exactly what happened. The mindset of people shifted away from the idea that families have a responsibility to take care of their seniors. We didn’t have to do that anymore. Slowly over the years, we have abandoned our seniors to the government. Families decades ago took their seniors into their homes and took care of them. And if you were to ask any senior if they would prefer government programs for their support, or do they prefer that their family take care of them — even if it means not living as long — undoubtedly they would choose being cared for and loved by family over the financial support of the govt and abandonment by the family. Granted, the seniors didn’t live as long then either, but they were not abandoned and separated from their families either. Our greatest fear of growing old is being abandoned, and putting our seniors into the hands of govt has allowed us to do that.

    Your other comment: “But that’s no excuse for starving the younger adult generations of resources just to extend lives that are already sickly and miserable.” I am baffled at that comment. I see NO “starving the younger adult generations”. Where are you seeing this ?? Do you live in a third world country? You better report that to someone.

  21. Mike Murray Says:

    Emanuel claims it is preferable to favor a 25-year-old over a senior citizen because, after all, the senior was once himself or herself 25. The flaw in that thinking is this: It presumes that the current senior has already been favored (during his or her youth).

    But, if medical care has been disproportionately allocated to the elderly in the past (as is historically the case), then current seniors — and even more so those fast-approaching that status — will have been disfavored all their lives. Earlier, when they were young, and now — when Emanuel and his ilk send them to the rear of the allocation line.

  22. ex-Democrat Says:

    “First of all, I appreciate vocalizations of various opinions because that is one of the greatest rights we are guaranteed. We are blessed with the ability to dissent and disagree.”

    —————-
    When you hear fascists (like Soetoro and James) start off like this you can be SURE that the last thing on their minds is discourse … and right on cue, James rolls into the Soetoro Party Line (stalinist party that is) about the EEVIL insurance companies.

    Insurance companies and big pharma helped s-elect Soetoro! It’s all a game you drone. Your never-done-anything-in-his/her-pathetic-life professor has led you into the gas chamber …. baaaa baaaa …. it’s not left vs. right; it’s right vs. wrong.

    It’s a rising ruling class vs. the rest of us…and believe me James, if you’re posting on here you ain’t one of the former; probably an Axelhole astroturfer collecting your $7/hour for CHANGE! Not.

    Wake up brother or enjoy your FEMA camp.

  23. Samuel Kostoski Says:

    Let me say, if I had two grandchildren, one a young girl age 2, healthy & beautiful; and one grandson age 11, who had some health issues, such as asthma and a heart murmur, who should be accounted the extra “expense” of medical treatment. I would hope the girl would be choosen as she has the best chance of survival. Her genes are pure and she should live a long life. If she decided have a child, that child would, if the mother chose a pure partner, also grow into a healthy adult. Therefore the good genes would carry on. If the world was eventually inhabited by only healthy people, our healthcare costs would be minimal.

  24. jonolan Says:

    Samuel,

    Please tell me that you physically reside far outside of America’s borders. You certainly mentally, spiritually, and morally do so.

    Her genes are pure and she should live a long life. If she decided have a child, that child would, if the mother chose a pure partner, also grow into a healthy adult. Therefore the good genes would carry on.

    Tell me, are you an active devotee of Dr. Mengele? Or does the eugenics of the Nazis just resonate with you in general?

    I lot of very brave men died exterminating vermin such as you. Don’t tell me we’re going to have to do it again.

  25. Twitted by fleckman Says:

    [...] This post was Twitted by fleckman [...]

  26. Thomas Says:

    As I read many of these statements, I was appalled at the basic disregard for human life expressed in the comments and I begin to understand how someone like Obama could be elected to the highest office in the land. It is a sobering, yet very sad, realization that many people in this country do not believe in the sanctity of human life. The current Health Care Reform Bill (HR3200) is shocking and unconscionable for anyone who loves their children, parents, and grandparents; regardless of their “health.” Those of you who are buying into this deception on health care reform should remember that you, too, will grow old and that your children or other loved ones could be denied health care because they do not meet the “requirements.” This entire bill is shocking and morally reprehensible.

  27. jonolan Says:

    Thomas,

    Disillusionment and disgust is the natural result of interacting a great number of the people in America today. We used to teach right from wrong; that changed after the Liberals essentially took control of the education system.

    That being said, the entirety of HR 3200 is shocking and morally reprehensible, just a large part of it. There are some good ideas in amongst the filth.

  28. Leo Says:

    I think it’s all rather Silly, I mean look at this:

    “Even if 25-year-olds receive priority over 65-year-olds, everyone who is 65 years now was previously 25 years. “

    Folks aged 25-40 are usually healthy and much more unlikely to actually have to use healthcare services…. so if we took all the other folks off of HC, then how much business are HC providers, aka docs and treatment facilities, are they losing out on? A lot… entire fields of medical practice could be eliminated utilizing that mindset. So lookie here this means:

    * Less medical fields means less doctors
    * Less Doctors because there’s now less business for them to do
    * Less medical fields to be educated and certified in
    * Meaning less fields to be taught in medical schools–less OPTIONS for
    medical students
    * Meaning Less teaching jobs for those certified in those fields.
    * Less medical study and Research, i.e. fewer medical advances…

    That’s gonna add to the unemployed level right there…. and I thought all of this was about stimulating the economy and providing more choices?
    To be honest, I don’t think any of this is really being done in the interest of helping any problems, because nothing they’re doing even approaches an understanding of the “problems”, let alone a realistic solution… It all about power to the government…

    “Consideration of the importance of complete lives also supports modifying the youngest-first principle by prioritizing adolescents and young adults over infants. Adolescents have received substantial education and parental care, investments that will be wasted without a complete life.”

    This is disgusting, revolting, immoral and illegal. People like this don’t need to be walking the streets, they need to be in some kind of mental rehabilitation facility… coming up with suggestions like that….

    “Say you’ve got a large family with a wide range of ages, from infant on up into the 80s. All of a sudden three people in the family get sick: a baby, a 15-year-old, and the 80-year-old matriarch. All three of them caught a weird disease and now they all need a liver transplant. But you can only afford one transplant. Who do you save?

    Firstly: This is subversive of common morality and human dignity.
    Secondly: It is highly unrealistic, and therefore has no relation to realities that are faced in today’s medical/insurance environment.
    Thirdly: IF you have insurance this should not be too much of a problem…
    Fourthly: coverage for things like this are not limited to the big three Health Insurance companies…. there are such things as critical, chronic, and terminal illness supplemental health insurance programs which are often very affordable [typically less than $60 per month, depending on the amount of coverage, per person, contingent on health and age of the individual].
    Fifthly: Families may be able to raise sufficient funds in a variety of ways
    Sixthly: Seek help from a charity or Church group
    Among many other options…. so this premise does not necessitate your “solution”, Dana.

    James Said: “Who is considered by health insurance companies to be the ideal clients? Healthy 15 to 40 year olds that are unlikely to need their services thereby making huge profits for these private firms by paying in over the longterm while rarely taking out funds for services. In many cases, if the “ideal client” becomes not so ideal by developing an expensive illness or condition, the insurance provider responds by refusing to pay or even dropping the individual.

    As for the infants and elderly that need care or procedures, not only is the private provider resitant to covering such care but is also less likely to insure individuals in these age groups in the first place. All of this is taken to an even greater extreme if the individual (regardless of age group) is indigent. Those individuals have no chance of receiving health care or needed procedures from the private insurers and are relegated to either going without or getting sporadic care through emergency room visits that they can never hope to reimburse and that do not really address their health issues over the longterm. By most logical reasoning would this not be considered “eugenics” especially considering that the groups most affected by this weeding out due to indigence fall into the category of minorities.

    I find a lot of folks don’t seem to understand the insurance industry when they start off on ramblings about who gets covered.
    Firstly: Someone should not wait until they’re old or have medical conditions to apply for coverage, that’s what’s known as being irresponsible. And of course there is a price to pay for that irresponsibility….
    Secondly: They fail to consider just what insurance is, consider this: If you are the company, when you agree to take on a policy, you assume the risk that you might have to pay out a lot of money for that person’s healthcare, and of course the higher risks are going to cost more because there is a higher risk level for them than for someone who is currently healthy. If companies just accepted everybody, they face the possibility of becoming an AIG by taking on more obligations than they can fiscally fulfill.
    Same thing with a loan, as a bank: when you loan someone money, you expect them to pay that loan back, but if they have a history of defaulting on their financial debts and obligations, are you sure you want to take the risk of paying them thousands of dollars just so they can default on you, causing you to lose a lot of money….???
    Thus, any solution that would be crafted in solving the healthcare crisis is going to have to take into consideration both business and personal realities…. As it stands, the government is assuming a side of the minority consumer, so to speak, in launching its ad hominem attack on the HC system as a whole… the fact of the matter is that you can’t please everybody, so no matter what the gov does, it ain’t gonna solve the problem by ignoring the obvious truth and addressing fallacies…
    Now of course there are problems with the system as it stands, but the “solutions” thus far proposed do not provide a realistic solution. I think a major problem is that the system is monopolized… if certain regulations were drafted and enacted to help new insurance companies become involved, there’s more competition and more choices, and more variety of HC options. IF anyone is to blame, right now, it is the government’s involvement in areas that it does not belong in, and its decision to not become involved where it should have been: PROTECTING choices and varieties in our HC and insurance industry through its antitrust and monopoly laws, protecting the capitalist system by preventing the big boys from taking over the little guys… thus protecting choice and variety…

  29. Leo Says:

    Thomas Said: “As I read many of these statements, I was appalled at the basic disregard for human life expressed in the comments and I begin to understand how someone like Obama could be elected to the highest office in the land. It is a sobering, yet very sad, realization that many people in this country do not believe in the sanctity of human life. The current Health Care Reform Bill (HR3200) is shocking and unconscionable for anyone who loves their children, parents, and grandparents; regardless of their “health.” Those of you who are buying into this deception on health care reform should remember that you, too, will grow old and that your children or other loved ones could be denied health care because they do not meet the “requirements.” This entire bill is shocking and morally reprehensible.

    Thomas, I have to agree with you whole-heartedly… it truly is reprehensible the beliefs that people have regarding human life nowadays… it is sickening, to me, I just can’t understand them, because to me human life is more sacred than any other life on this planet, but thanks to the irreligion, immorality and general lack of social values of our current society, it is no surprise….
    The fact of the matter is that once upon a time, we had charities, which were much more numerous, often religious, who were devoted to doing charitable work. We have fundraising options and operations that can help… and then of course the isolationism in our current society is also a factor: Families are not as close as they used to be…. once upon a time when times were tough, they would band together and compile resources and efforts to get through, but nowadays we don’t have much of that anymore, people have such a general lack of charity in their hearts….

  30. Leo Says:

    Samuel Said: “Let me say, if I had two grandchildren, one a young girl age 2, healthy & beautiful; and one grandson age 11, who had some health issues, such as asthma and a heart murmur, who should be accounted the extra “expense” of medical treatment. I would hope the girl would be choosen as she has the best chance of survival. Her genes are pure and she should live a long life. If she decided have a child, that child would, if the mother chose a pure partner, also grow into a healthy adult. Therefore the good genes would carry on. If the world was eventually inhabited by only healthy people, our healthcare costs would be minimal.”

    The fact of the matter is that we are not like other animals, we as humans have a special dignity, and we deserve to be treated with dignity and respect…
    Now someone’s health is largely contingent upon the life they lead…. age is not everything, one can be 65 and perfectly healthy and productive as a citizen, and one can be 25 and be either unhealthy or unproductive because of their lifestyle…. I think the best solution is to cultivate a culture of responsibility, inviting people to lead a more responsible lifestyle, by being healthy and engaging in an active and productive activity, getting insurance when they’re young, instead of waiting, and by not living fast and loose…

    Our problem with poor minorities to an extent lies with a bad culture… there are irresponsible gang cultures out there teaching youth to be like gangsters and crooks, and with our young adults with materialism and many of bad living practices that they are encouraged to live through popular culture and pure sloth… and our elderly are being forced into idleness, which helps them do absolutely nothing. Look at the pharmaceutical industry: it’s huge because folks don’t want to be responsible, they just want to do things however they want and grab a fast-med solution, like fast-food…. the fact is that if people were more responsible then a large percentage of our problem could be abated to some extent or another….

    It’s not about choosing who lives and who dies, as if that was anybody’s place to decide….

  31. anonymous Says:

    What we have right now is rationing based on ability to pay. What Emanuel is describing is rationing based on the benefit of a given medical intervention to society. So given the choice between treating a young person and an old person–if you only have enough resources to treat one or the other–such a view would opt to treat the young person, as they have the potential to add more to society when cured than the old person. In a pure free market system with the same resource restriction, the decision is made based on ability to pay without regard to the benefit to society.

    So the question is not between rationing and not rationing. The question is between rationing based on ability to pay and rationing based on benefit to society.

  32. jonolan Says:

    Leo,

    Much of what you said was very well-said indeed, but much of it was somewhat repetitive; the same lack of responsibility that leads to poor health also led to the deprecation of charitable organizations in favor of government intervention.

    ~*~

    anonymous,

    America currently does not ration health care, despite the lies of Liberals. We have a mostly free market system where people can get whatever care that they can afford – with various safety nets in place, both governmental and private, to aid those who cannot easily do so.

    Saying that America has rationed healthcare is like saying that we have rationed housing, food, automobiles, etc… It is a lie perpetrated by the enemies of America, the Liberals with their non-merit-based egalitarian dreams.

  33. Kat Says:

    Great post! Thank you for the links to Ezekiel Emanuel’s articles, jonolan. I’ve been looking for those off & on. This is my first time to your blog. I linked over from http://www.physiciansforreform.org/ .

    I have 3 additional comments –

    1) Dana said: “Say you’ve got a large family with a wide range of ages, from infant on up into the 80s. All of a sudden three people in the family get sick: a baby, a 15-year-old, and the 80-year-old matriarch. All three of them caught a weird disease and now they all need a liver transplant. But you can only afford one transplant. Who do you save?”

    In your senario, you’ve made this a family decision. That is fine. What is not fine is the government stepping in & dictating to us which of those 3 will have the liver transplant — based on the “complete lives” theory, or any other.

    2) Sue said: “Dr. Emanuel is not in Congress. His paper has nothing to do with the health insurance reform proposals on the table.”

    Dr. Ezekiel Emanuel is a health policy adviser to Obama. With Ezekiel Emanuel & John Holdren, science czar, who has written about forced sterility & Barack Obama’s hatred for the American people — there’s not much telling what plans they truly have for us. I’m sure in their socialist/marxist ways of thinking, they’ve documented it well — you just have to read between the lines.

    3) Here’s something else from Ezekiel J. Emanuel – A Time to Die: The Place for Physician Assistance — regarding physician assisted suicide.
    Journal of Health Politics, Policy and Law – Volume 25, Number 2, April 2000, pp. 382-387

  34. michael Says:

    We are fighting over crumbs (a diversion). There is enough $ for health care for all.
    We need to protect American wealth. We must protect American jobs from the neo-liberal globalists.
    Trade protections NOW!

  35. Douglas Roy Says:

    If one is unable to see the immorality of government guided health care instead of family or personal guided, then you have yet to fully grasp our Republican form of government and its foundation in Christian principles.

  36. Tom Jones Says:

    “When the government tells us when to sow and when to reap, we will soon be wanting for bread” Thomas Jefferson. I am also vectoring here from http://www.physiciansforreform.org/ and I am pretty shocked at the number of comments here that to some degree seem to sympathize with Dr. Emanual. His views would do honor to the Nazi Dr. Mengele,and to Eugenics. If people like him and the Green “Czar” of the Umwelt are advising President Obama on health care we should be very afraid. Mind you, if we were talking about a triage situation at the end of civilization after an EMP attack had wiped out all but a handful of humanity left to starve, his views might be necessary in the emergency, they are reasonable in that kind of last choice situation perhaps.

  37. Ron Says:

    After reading about the Complete Lives System, with its emphasis on medical expenditures on the 15-40 year old group, at the expense of our elders, it suddenly occurred to me that the “savings” envisioned by healthcare reform was not going to come from electronic medical records, or stamping out fraud; but from shifting the money from elder care to the younger, healthier group. I’m surprised that the Obama administration is not trying to sell HR3200 as a way to reduce the budget deficit!

  38. jonolan Says:

    Ron,

    There are two reasons why Obama has not marketed the abomination that is ObamaCare as a deficit reducing measure.

    1) Dr. Emanuel’s sick views are not actually part of HR 3200; they wouldn’t come into play until the specifics of implementing the bill were determined by Dr. Emanuel and other non-elected bureaucrats.

    2) Irrespective of any future saving that reducing healthcare access to young children, the disabled, and the elderly might generate, ObamaCare is expected to cost TRILLIONS of dollars over the next 10 years. All of those trillions of dollars would, due to our current situation, be deficit spending.

  39. m. sanger Says:

    “attenuation”, means thinning ? ” practical reasoning skills”, by whose definition ?, “full and active participation”, in what ?, and why are “gays” being discriminated against, since “valuing long term plans” is a criteria that they unfortunately don’t participate in, as the have no “actual” stake in the future. should they be looked at as unable to be one of those “whose fulfillment requires a complete life”?, as in most things it is always better to take a 2nd, or a third look

  40. jonolan Says:

    m. sanger,

    To reach the point you’re describing would take a lot of extrapolation of Dr. Emanuel’s desires. In all of his writings he has said that the only valid criteria for such determination of “full and active participation” was age and chronic infirmity.

    Of course, once a system is established and entrenched, such extrapolation is quite possible – even probable some would say – though it might take decades, even a generation or two, to reach the point you fear.

  41. Karen Says:

    It would depend. Once the govt. is out of money like they are now Emanuel’s system could be implicated fast. You would not be able to trust your doctors. During the Russian contrived revolution many doctors murdered their patients.The powers that be would like to reduce the population to 350million or so. This would be a start. Only the fit would survive which is straight out of the eugenics handbook. Well his plan is not just at the expense of the elders. It is at the expense of those under 15 years of age too. It would be at the expense of those classified as scoring low on an IQ test and we know IQ’s can change and IQ test are notoriously invalid. Why should the govt. be involved at all in making such a decision? The elderly aren’t the major cost to our health care system. The addicts,the uninsured and illegals who use our emergency rooms for minor illnesses such as a cold are. Age doesn’t determine what a person will likely contribute to society. Would you treat a 70 year old scientist or give the treatment to a heroin addict? Who is more valuable, the child molestor, the street person or a 60 year old gardener? BESIDES. IT ISN’T ABOUT THE STATE! We are the only country I know of that will accept foreigners w/out insurance. Many countries advance payment is required even when it is a life or death emergency. I have never had treatment denied by an insurance company. NEVER! I have never had them say you have used more than your $45,000 as they do in England. I do have a friend whose father was denied surgery in Holland for prostate cancer. he was told, well you know you are 75. She brought him over here> he got his treatment. His grandchildren will know him and he will add a lot to their lives. Most countries that have govt. insurance the citizens have to pay for supplemental insurance in addition to paying for govt. insurance.
    Life has become so cheap here. I’d hate to run into some of you cold hearted bastards. I can tell you one thing if I knew you our acquaintance would be short lived.

  42. Karen Says:

    This is all a moot point anyway. The vote has been delayed until at least December if ever. There are not enough DEMS. who will vote for it.
    Obama has changed the subject which indicates he knows he has lost this one. Now the subject is the CIA. He wants the light taken off of him. Good idea! Probably won’t work.

  43. The Unwanted Blog » Blog Archive » All the Presidents Men Says:

    [...] Ezekiel Emmanuel, health care adviser — proponent of the Complete Lives System, which puts values on lives based mostly by [...]

  44. loupgarous Says:

    I’m very much of two minds about all of this. I have a rare cancer that is being held at bay with medication that costs several thousand dollars a month. My wife’s employers are not happy about this, understandably – and as a result have begun trumping up bulls–t complaints about her work and accusing her falsely of illicit drug abuse. So ObamaCare on the face of it looks attractive because it would give my wife’s employers a break from high health insurance costs (it won’t give them souls, but that’s a whole other issue).

    But let’s look at what happens when all of the “unnecessary” healthcare expenses – such as our current prevalence and good supply of CT scanners and other medical equipment – are trimmed away by the usual gang of idiots on the Hill. Medical care we used to take for granted now will have to be approved by at least one, possibly several “gatekeepers,” all guided by the Thoughts of Rahm Emmanuel’s Brother.

    As a 52-year old man, most of my life is behind me. Now that my cancer care has become a scarce commodity, it can be denied me on purely “ethical” grounds. That five or six thousand dollars a month for my life-sustaining care could be used to provide methadone (for example) for a much larger number of 25 year-old heroin addicts, so in a resource conflict between them and me, I might be told by Dr. Emmanuel and his think-alikes to go home and die.

    If I’m good and don’t create a fuss, they might let me keep my pain meds.

  45. jonolan Says:

    That’s an odd and disturbing story, loupgarous. You also have a very interesting perspective on the matter at hand and a realistic view of the results of the possibilities arrayed before you.

    Thanks for stopping by and sharing it.

  46. Complete Lives System | Reflections From a Murky Pond | Better Life For The Elderly Says:

    [...] A nice web master created an interesting post today on Complete Lives System | Reflections From a Murky PondHere’s a short outline [...]

  47. Joe Says:

    1) let me start with we do not have a healthcare crisis here. Anyone wishing treatment need only go to the hospital and get treated they can not and will not turn you away.

    2) It racks up a big bill and people go bankrupt and don’t pay the bills. Then we the American tax payers bail out the hospitals with billions of dollars in funding each year.

    3) Unlike socialist medicine countries like Britain. France, Australia, Germany, Switzerland and Canada. Americans do not suffer from lack of available medical care. EVERYONE is treated and care is plentiful. We suffer from 8-10% of the population not being able to afford healthcare. Or do we?

    46 million
    9.2 million (20% uninsured by choice)
    11.5 million (25% qualify but don’t use existing federal programs)
    12 million (25% are illegals covered by tax payer bailouts to hospitals)
    70% of your 46 million can already have insurance or are already covered by
    tax payers dollars
    32.7 million
    ————
    13.3 million Americans need coverage (the problem is not as bad as some have demonstrated then is it?)

    13 million reduces the number to 2-3% of the population.

    4) If you poll the countries Britain, Germany, Australia, France, Canada they want to overwhelmingly abandon their current healthcare system in favor of a model like we have.

    5) In the 1990s Canadians even sued and won the right to purchase individual healthcare and abandon the government plan. The people in Canada with private insurance have more access because of less limitations by governments for cost savings. They are healthier with private insurance and get treatments faster and without rationing….hmmmmm

    Do your homework people. This is basics here. We have the BEST medical system in the world second to nothing. most Pulitzers for medicine go to US based achievements 15 of 22 winners in the past 10 years were Americans! Of the 7 remaining 3 of those were working IN THE USA and on government sponsored (tax payor) money. That means 18 of 22 were from the good old USofA where our system is so backwards why is the rest of the world combined only receiving 4 Pulitzers? Why when you look over recent life changing medical break throughs only the CAT Scan was not invented here?

    Yup our system is SO broken we benefit the entire world and are the model they wish to become!.

  48. jonolan Says:

    Valid points, Joe, with the exception of how the people in socialist feel about the American free-market based health insurance / healthcare model. Most of the people in socialist countries don’t like our model – though they’re more than happy to benefit from our innovations.

  49. Joe Says:

    OK i believe the point taken. What i re-read was the 70% ant to completely dismantle thier own system in favor of a new system. I presume there are only 2 government and free market.

    Our free market system honestly has not cost as much as say Canada to our north or Briton when you factor in the value of a life saved because they recieved treatment and it wasn’t rationed. Other points are look at tax burdens in socialized countries. I am in the top 5% of earners and pay only about 20% compared to Briton where they pay 80%. When you add in my families healthcare costs in total including insurance premiums i pay 26% which is still a far cry less than socialized nations.

    Canada has moved toward our system and only after the advent of free market insurance did thier healthcare improve. Those who can afford private insurance have no lines, no rationing and better access.

    Helping those without insurance is a noble endeavour. But dismantling the free market system we have will stiffle innovation, drive up costs world wide, reduce options for everyone worldwide. Where will they go when the US also begins rationing care and turning away non-US citizens?

  50. Meat For The State | Reflections From a Murky Pond Says:

    [...] Cass Sunstein’s views on who owns your body and its organs with Dr. Ezekiel Emanuel’s Complete Lives System, which details a merit-based approach to healthcare rationing, and you can begin to put together a [...]

  51. Cancer Health Center : : Berwick – Another Radical - Cancer Health Center Says:

    [...] Complete Lives System by Ezekial Emanuel [...]

  52. dj nicco Says:

    This “complete lives systems”works for people like Dr. Emmanuel because he is exempt from this healthcare system. If Dr. Emmanuel gets sick when he’s 60 yrs old, he’s not going to be sitting next to you at the same “clinic”getting the same “merit-based” healthcare that the private sector American in the government healthcare program will get.

  53. jonolan Says:

    I’m not sure if it is so much that he expects to be exempt from such a system as it is that his sort always feels that they would “merit” the very best.

  54. zig Says:

    Okay, so let me get this straight. Because I am over 50, I am going to be FORCED to pay for healthcare that won’t cover me……………………….WTF???

    Obama and his cronies are elitist, Fabian Socialists. If you don’t know what that is, I suggest you look it up. They helped “design” Britains healthcare system that I’m sure is working out for ALL of the British people.

    Can anyone say Weimar Republic??

    God, I hope Jesus is coming soon!

  55. Bill Gates Confirms Population Reduction Through Vaccination on CNN | askmarion Says:

    [...] Wealth, and Happiness), Don Berwick, and Ezekiel Emanuel (Rahm’s brother) and promoter of his Complete Lives System just to begin with and there is always Jay Rockefeller. [...]

  56. Seniors Left Behind? | Brain and Head Health Says:

    [...] Complete Lives System by Ezekial Emanuel [...]

  57. Eugenics Started in America in 1907 and Spread To the World – Segment One of Five | Brain and Head Health Says:

    [...] Complete Lives System by Ezekiel Emanuel [...]

  58. RFID Chip for all Americans in 2013 as Part of ObamaCare… See Biden Telling Fed Judge He Will Have to Rule on Implanted Microchips | askmarion Says:

    [...] Complete Lives System by Ezekial Emanuel [...]

  59. Bob Casey’s poor record will help Mr. Smith go to Washington, Part I Says:

    [...] not save any lives but they will save lots and lots of money for the country. Ezekiel Emanuel’s complete lives system will make sure that old farts do not receive any “unnecessary treatment.” There will be no [...]

  60. On the Road to Death Panels | askmarion Says:

    [...] Complete Lives System by Ezekial Emanuel Technorati Tags: ObamaCare Mandate Committee,rationing for seniors,rationing,death panels,ObamaCare,repeal and replace ObamaCare,wake-up America,Star Parker,rationing for the disabled,Rationed healtcare,Ezekial Emanuel,Sarah Palin,John Holdren,watch the other hand,ObamaCare mandates,stand-up America. Complete Lives System,Sarah Palin was right,birth rate,U.S. declining birth rate,entitlement programs,social issues,Steven Rattner,Social Security,Medicare,Medicaid Like this:LikeBe the first to like this. [...]

  61. President Declares War On Seniors With ObamaCare Ploys And Medicare Plans | We The People Shall Speak Says:

    [...] Dr. Emanuel has advocated a “complete lives system” in which scarce resources can be allocated.  In this system, patients  between age 15 and 40 get [...]

  62. Death Panels are HERE | askmarion Says:

    [...] Complete Lives System by Ezekial Emanuel [...]

  63. AGENDA 21 AND DEPOPULATION ACCORDING TO JOHN HOLDREN, OBAMA’S SCIENCE CZAR « How Did We Get Here Says:

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  64. Will Sick Babies Be Starved to Death Under Obamacare? | askmarion Says:

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  65. Doctors Quitting Over ObamaCare – Lindsey Williams – Doctors Quitting Over ObamaCare | askmarion Says:

    [...] read the bill. Rationing, mandate committees & rationing panels, death panels and the Complete Lives System are all part of this bill as well as higher taxes and fees, less healthcare and treatment choices, [...]

  66. SamAdams1776 Says:

    Look, it’s simple; they deny care once your past your working life and save on paying out Social Security. Of course they will continue to collect Social Security. and Healthcare will not be dined the elite “ruling class”

    I rather prefer the poor lose out, not the successful older.
    the poor made lousy choices which is why they are poor. Let the free market reign and those who can afford healthcare get it. It is a better way of rationing healthcare resources. It is not the place of government to pick the winners and losers. Let the real winners and losers do that themselves.

    ;)

  67. jonolan Says:

    That’s the inevitable outcome of these things.

  68. UK Targets Disabled for Euthanasia as a Cost-Saving Measure - Page 2 - US Message Board - Political Discussion Forum Says:

    [...] You're all wrong including Noomi. It is about a plan that was implimented some time ago called "Complete Lives Systems". According to Obamacare it isn't a matter of whether or not you'll recover. It is a matter of whether or not you are entitled to keep on living – if you are age 15 -45 and can produce for the USSA – you will get the care – if you are over the age of 15 ( as the woman with the dying 14 yr old who doesn't qualify yet..) or under 45 you will get good medical care and if you fall lower or higher on that bell curve? You won't. Why? Because between age 15 – 45 you can produce for the State – they need you. Before or after that you are expendable. Click link for some info on complete lives systems. Complete Lives System [...]

  69. Bachmann, Gohmert, & Steve King Appeal Directly To Glenn Beck And Audience: ‘We’re Losing Badly…’ | askmarion Says:

    [...] Obama’s friend, now Mayor of Chicago and first Chief of Staff, brother) and promoter of his Complete Lives System just to begin with and there is always Jay Rockefeller. [...]

  70. Ezekial Emanuel Is Really Looking Forward To The Demise of Insurance Companies | askmarion Says:

    […] also did not mention his creepy ‘Complete Lives System’. In 2009 Betsy McCaughey warned about Obama’s Health Rationer-in-Chief and now we are standing at […]

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