Pt. 2 The formation of the plan and it's advisers

The fiscal and philosophical group

The most successful leaders in history have surrounded themselves with the best and brightest they could find to fill in the gaps in their own knowledge base. This is necessary to have any kind of success in business. If you have the best, you can expect the best. The same holds true in government as well. Throughout history, presidents have chosen the top minds from business, industry and academia to fill key roles in cabinet posts. These men and women have shaped the direction of the decisions of many presidents and some have even stood as examples of what our country stands for--Henry Kissinger, Colon Powell and Robert McNamara to name just a few.

In order to better understand the current plan the President has in place for overhauling the health care system, it's important to know the people he has chosen to advise him on such an important issue. He chose the best and brightest he could find to insure he would come up with the best plan possible. Let's meet just a couple:

Cass Sunstein - Sunstein is a legal scholar and the next head of the Office of Information and Regulatory affairs (OIRA). This position puts him in place to make decisions on budgetary items regarding the cost of a government run health care plan. Let's leave aside his radical views on animal rights, he actually believes that animals have a right to sue for grievances, and delve deeper into his thoughts on how government plays a role in our lives. He has written in the past his belief in the celebration of tax day this way,

"In what sense is the money in our pockets and bank accounts fully ‘ours’? Did we earn it by our own autonomous efforts? Could we have inherited it without the assistance of probate courts? Do we save it without the support of bank regulators? Could we spend it if there were no public officials to coordinate the efforts and pool the resources of the community in which we live?... Without taxes there would be no liberty. Without taxes there would be no property. Without taxes, few of us would have any assets worth defending. [It is] a dim fiction that some people enjoy and exercise their rights without placing any burden whatsoever on the public fisc. … There is no liberty without dependency."

This line of thinking presupposes that every thing we have is the result of a generous gift from government. The money in our pockets, the cars we drive and the very lives we lead are all extensions of the government. Now, I may not be a thinker at any level near Mr. Sunstein's but the idea that I owe my very existence to the government scares me more than just a little. This is just a taste of the philosophy he believes and we've barely scratched the surface so far. Let's hear Mr. Sunstein in his own words on the subject of "life years", a controversial idea in which he proposes that some humans are inherently more valuable simply because of their age,

"I urge that the government should indeed focus on life-years rather than lives. A program that saves young people produces more welfare than one that saves old people."

Gone are the days where we used to honor the elderly in our society for their past contributions if Mr. Sunstein has his way. All that matters to him are future contributions. I wonder if he could be so callous, so unfeeling if it were his own mother or father suffering needlessly because a government bureaucrat decided that a life extending treatment has been deemed "not in the best interest of the collective". One last bit of information about Professor Sunstein is his admiration for the noted philosopher, Peter Singer, a bio-ethicist. Singer, a far left wing animal rights activist, has said that a border collie has more intrinsic value to the collective than does a child with developmental disabilities.

As I write this, I feel a chill at the thought of a man like Singer having sway over the opinion of someone who may decide one day that I am of no further value to the collective and should be "put down".

Next in line to meet is,

Dr. Ezekiel Emanuel - brother of White House Chief of Staff Rahm Emanuel and also a noted bio-ethicist. Dr. Emanuel has formulated what many in academia consider to be a brilliant work on the concept of the "complete life". In Dr. Emanuel's own words he describes how a child is not truly "human" until it has been socialized. This lesser stature leaves an infant in the precarious position of being considered not "viable" to society,

"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 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."

"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."

"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" (emphasis added)

So anyone who doesn't fall into the age range of 15-40 deserves less care? Less attention? I am horrified by these remarks but Dr. Emanuel takes it even a step further,

"Doctors take the Hippocratic Oath too seriously, as an imperative to do everything for the patient regardless of the cost or effects on others"

"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." (emphasis added)

"Drawing on data from the Netherlands on the use of euthanasia and physician-assisted suicide and on available U.S. data on costs at the end of life, this analysis explores the degree to which the legalization of physician-assisted suicide might reduce health care costs. The most reasonable estimate is a savings of $627 million, less than 0.07 percent of total health care expenditures." (emphasis added)

In those statements, we all cease to be individuals and become only numbers on a balance sheet. I find it comforting that doctors take their Hippocratic oath seriously. I want them to, in fact. That oath is, "First, do no harm." According to Dr. Emanuel it should read, "First, consider the cost and the benefit to the collective."

The President has more advisers helping him form his health care reform bill but these two alone should give us all pause to wonder at his good sense. In the weeks to come the views of these two men would shape what would be written into the bill the president hopes to pass in his first term.