The Tale of Two Obama Minions: Donald Berwick and Ezekiel Emanuel

As regular readers are well aware, I’ve spent a great deal of time covering the death and abuse that are part of the British NHS.  We’ve covered that over 20,000 cancer victims die each year because the NHS won’t cover their medications.  We’ve covered the terrible conditions at some NHS facilities, and we’ve covered the lack of care and waiting periods that are part and parcel to any socialized medical system.  Needless to say, the NHS should be viewed as a cautionary warning against a single payer system.

Here are some of the posts here that discuss the carnage that is the NHS.

Does Single Payer Kill? Why Yes, Yes it Does

Does Single Payer Kill?

The Results of Socialized Medicine: Do we Really Want What Obama, Pelosi, and Reid are Selling?

Rationing Your Life Away

Not everyone see’s it that way.  One person, in particular, is Obama nominee Donald Berwick.  Berwick has been nominated to run the Centers for Medicare and Medicaid Services.  Like so many other nominees, Berwick seems to have the typical “progressive” elitism, as well as a health portion of reality denial.  Redstate has a great post on the situation, and I will be using the material that they dug up on Berwick.

“I am romantic about the NHS; I love it. All I need to do to rediscover the romance is to look at health care in my own country.”

Not enough people dying here?

“Berwick complained the American health system runs in the ‘darkness of private enterprise,’ unlike Britain’s ‘politically accountable system.’ The NHS is ‘universal, accessible, excellent, and free at the point of care – a health system that is, at its core, like the world we wish we had: generous, hopeful, confident, joyous, and just’; America’s health system is ‘toxic,’ ‘fragmented,’ because of its dependence on consumer choice. He told his UK audience: ‘I cannot believe that the individual health care consumer can enforce through choice the proper configurations of a system as massive and complex as health care. That is for leaders to do.’”

Source: American Spectator

Wow, this guy is actually bold enough to openly state that he believes we’re too dumb to manage our own health care.

Also, Berwick is an admitted advocated of a single payer system.

“If we could ever find the political nerve, we strongly suspect that financing and competitive dynamics such as the following, purveyed by governments and payers, would accelerate interest in [our policy ideal] and progress toward it: (1) global budget caps on total health care spending for designated populations, (2) measurement of and fixed accountability for the health status and health needs of designated populations, (3) improved standardized measures of care and per capita costs across sites and through time that are transparent, (4) changes in payment such that the financial gains from reduction of per capita costs are shared among those who pay for care and those who can and should invest in further improvements, and (5) changes in professional education accreditation to ensure that clinicians are capable of changing and improving their processes of care. With some risk, we note that the simplest way to establish many of these environmental conditions is a single-payer system, hiring integrators with prospective, global budgets to take care of the health needs of a defined population, without permission to exclude any member of the population.”

Source: Health Affairs

Rationing?  Yes we can!

“NICE is extremely effective and a conscientious, valuable, and — importantly — knowledge-building system [which has] developed very good and very disciplined, scientifically grounded, policy-connected models for the evaluation of medical treatments from which we ought to learn.”

Source: In an interview on Comparative Effectiveness Research

Now, we’ve covered NICE before.  NICE is the rationing body in the UK that determines that life saving treatments are not “cost effective.”  As a result, tens of thousands of British citizens die each year from treatable conditions, such as cancer.

The Redstate article also shows that Berwick publicly embraces rationing.

The interviewer pointed out: “Critics of CER have said that it will lead to the rationing of health care.” To which Berwick replied: “The decision is not whether or not we will ration care. The decision is whether we will ration with our eyes open.”

OK, here’s the twist; we’ve heard some very similar things before.  Ezekiel Emanuel, Rahm’s brother, is a government adviser on health care.  Here are some quotes from Emanuel.

“Strict youngest-first allocation directs scarce resources predominantly to infants. This approach seems incorrect. The death of a 20-year-old woman is intuitively worse than that of a 2-month-old girl, even though the baby has had less life. The 20-year-old has a much more developed personality than the infant, and has drawn upon the investment of others to begin as-yet-unfulfilled projects…. Adolescents have received substantial substantial education and parental care, investments that will be wasted without a complete life. Infants, by contrast, have not yet received these investments…. It is terrible when an infant dies, but worse, most people think, when a three-year-old child dies, and worse still when an adolescent does.”

Source:  First Things

“Ultimately, the complete lives system does not create ‘classes of Untermenschen whose lives and well being are deemed not worth spending money on,’ but rather empowers us to decide fairly whom to save when genuine scarcity makes saving everyone impossible.”

“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”

So, they will use rationing per population, just like Berwick suggests.  Here’s some more.

“There is a widespread perception that the United States spends an excessive amount on high-technology health care for dying patients. Many commentators note that 27 to 30 percent of the Medicare budget is spent on the 5 percent of Medicare patients who die each year. They also note that the expenditures increase exponentially as death approaches, so that the last month of life accounts for 30 to 40 percent of the medical care expenditures in the last year of life. To many, savings from reduced use of expensive technological interventions at the end of life are both necessary and desirable.”

“Many have linked the effort to reduce the high cost of death with the legalization of physician-assisted suicide. One commentator observed: “Managed care and managed death [through physician-assisted suicide] are less expensive than fee-for-service care and extended survival. Less expensive is better.” Some of the amicus curiae briefs submitted to the Supreme Court expressed the same logic: “Decreasing availability and increasing expense in health care and the uncertain impact of managed care may intensify pressure to choose physician-assisted suicide” and “the cost effectiveness of hastened death is as undeniable as gravity. The earlier a patient dies, the less costly is his or her care.”

Source: What Are the Potential Cost Savings from Legalizing Physician-Assisted Suicide? New England Journal of Medicine, July 1998

So, as Glen Beck would suggest, we need to judge Obama by with whom he associates.  He has Emanuel as an adviser, and now, he nominates Berwick.  Both men seem to mirror very similar ideas when it comes to rationing care, and doing so by “population.”  I think it is safe to assume that both men reflect Obama’s beliefs regarding health care.  If they didn’t, why would he appoint or nominate them?

Actually, this is something that Obama does quite often.  He says he’s against censorship, yet he appointed Cass Sunstein and Mark Lloyd, both of whom DO advocate censorship.  His latest nominee to the SCOTUS also seems to think that the state can squelch free speech.  He claims not to be a gun grabber, but his AG is.  He still tries to portray his position as more moderate, and the MSM helps, but his appointees and nominees clearly reflect his true intent.  Basically, his rhetoric goes one way, but his appointees tell the true story.

Note: Don has a great post on this subject over at his place, Present Discontent.