Michigan Christians
for Life
President
Obama, Health Care and Senior Americans
(Mandated
by the health care bill)
By Steven W. Mosher
Population Research
Institute
September 2, 2009
'The views of this
White House on the need to ration health care at the end of life to
contain costs are well known.'
How
this 'age-based priority' would work in practice is revealed by a graph
that Emmanuel helpfully includes in the article and which is reprinted
here.
Consider
Section 1233 of the bill, HR3200, currently under
consideration by the House of Representatives. This specifies that the
“advance care planning consultation “shall include … (1)(E) An
explanation by the practitioner of the continuum of end-of-life
services and supports available”, which “may include the formulation of
… an actionable medical order relating to the treatment of that
individual that …may include indications respecting …(iv) the use of
artificially administered nutrition and hydration.”
Proponents of
the new health care plan have fallen over themselves
to explain this away as simply familiarizing elderly Medicare
recipients with their options. We at PRI disagree. We hold that an
intrusive visit of this nature is intended to cut health care costs—by
cutting health care recipients. Why else would the option of
withholding food and water from the elderly even be on the table?
The views of
this White House on the need to ration health care at
the end of life to contain costs are well known. In fact, a senior
health policy advisor to the President, Ezekiel Emmanuel, this January
published a very revealing “how to” article on the subject in The Lancet. The article,
entitled Principles
for Allocation of Scarce Medical Interventions, argues for
something called the “complete lives system.” This system “prioritizes
younger people who have not yet
lived a complete life and will be unlikely to do so without aid.
Many thinkers
have accepted complete lives as the appropriate focus
of distributive justice: “individual human lives, rather than
individual experiences, [are] the units over which any distributive
principle should operate.”1, 75, 76 [italics added]. This “complete
lives system,” to put the matter in plain English, assigns a value to
human beings based almost exclusively on their age.
How this
“age-based priority” would work in practice is revealed by
a graph that Emmanuel helpfully includes in the article and which is
reprinted above. As the graph clearly shows, the best health care would
be reserved for twenty-some-things. From this peak, the quality and
quantity of care available would gradually taper down until about 55,
at which time it would plummet. By age 65, when Medicare starts, the
probability of receiving scarce medical care would have shrunk to a
mere 20%. Note that the chart ends at age 75, after which time the
probability of receiving adequate care in the event of a health crisis
is effectively nil. Goodbye, Grandma.
Those
concerned about the Culture of Life should also pay attention
to the other end of the chart. It shows that newborns would be
ineligible for all but the most basic care, and that even children
would have a significantly lower probability of receiving care adequate
to their needs than young adults. In short, those most in need of
health care, the very young and the very old, will have the least
probability of receiving it, while those in least need of care, the
twenty-some-things, will have the most chance of receiving it. Isn’t
this backwards?
Why do Ezekiel
Emmanuel views matter? Because he is widely
considered to have Obama’s ear on health matters, that’s why. He not
only works in the White House, but his brother, Rahm Emmanuel, serves
as Obama’s Chief of Staff. If the health care bill now before Congress
passes, and a government oversight boards is set up to determine who
receives medical care and who doesn’t, those appointed to serve on such
boards will hold these views. Ezekiel Emmanuel himself might very well
be appointed to chair such a board. Look at the above chart again and
ask yourself: Do you want him making life-or-death decisions for you?
In light of
all this, it is difficult to see any other purpose for
the end-of-life government visit than to evaluate the affected senior’s
health, and to pressure them to agree in advance to forgo medical
treatment in the event of a serious illness. For many seniors, this
will undoubtedly amount to a death sentence.
Obama has said
that he doesn't want to "pull the plug on Grandma,"
but that is exactly what his health advisors propose to do, and what
the health care bill before Congress would lead to. Make sure Grandma
knows this.
------
Steven W.
Mosher is the President of the Population Research
Institute and the author of Population Control: Real Costs and Illusory
Benefits (Transaction).