Response to Gus

Since I like good discussions and Gus is the only one that I have such discussions with nowadays I am putting a long response to his post here:

You are gonna have to pity this fool then Gus.

Mr. Beck stated that he doesn’t believe Dr. Emanuel when he says he doesn’t believe in the ‘allocation’ system that he devised. You countered that with Dr. Emanuel saying that he doesn’t believe in his system. These two examples leave us with a ‘he said, he said’ situation and it is not clear that there is ‘outright deceit’ by any party, but we rather have a situation where we must deduce things.

Dr. Emanuel’s ‘complete lives system’ is an alternative to the ‘first come, first served’ waiting list system and also includes proposals for the rationing of medical care other than organs when ‘scarcity’ calls for it. The fact that the government will soon be bankrupt creates ‘scarcity’ and thus calls for ‘allocation’ if the government takes over health care. ‘Death Panel’ is just a cute name for the group of people who will decide where things get allocated. Mr. Beck stated that he didn’t believe Dr. Emanuel when he claimed that he doesn’t endorse his own ‘complete lives system’. Seems logical to not believe someone when they tell you they don’t like their own work. I think ‘first come, first served’ is fair enough rather than discrimination based on age or impairment status. There is no need to work up such a system unless you think it might actually be used. Unlike Dr. Emanuel’s thesis on “Puppy-punching”, that one was purely for fun.

The Doctor was not taken out of context as the entire context of his research was on deciding who gets treatment over others. There is no question of context because that was fully his topic, he set the context. The only question that would remain is whether it was just a waste of time for him and he doesn’t believe any of it should ever be used, or he believes it. He says he doesn’t, Beck doesn’t believe him. The Doctor is the ‘health-policy adviser at the White House’s Office of Management and Budget’, so his research and conclusions in previous works about health-policy ‘allocation’ aka ‘budgeting’, should be applicable. He states that he is against the ‘Right to Die’ when that is not the question. ‘Right to die’ people want to die. People who are concerned about a discriminatory system of allocation want to live. It is not assisted suicide if a person just lets someone die.

The doctor also claims that people are taking him out of context because they don’t have any solutions for health care costs. I have heard some real good alternate solutions. Tort reform is a huge one. I was sick a while back and the doctor misdiagnosed me and caused another problem. I told this to a friend of mine who was in law school at the time and he said I had a good solid case to sue. No permanent damage had been done but apparently I could have got some free money. I did not. If we could better protect doctors from worthless and dumb cases such as what mine would have been we could lower costs. Next we have a myriad of companies that are confined by state borders. If congress used it’s constitutional interstate commerce power in a better way and allowed interstate competition prices would go down.

The Doctor may very well actually not believe in the system he has devised, but the fact that he has plotted out the whole thing and that he has the ear of the powers-that-be can be concerning. He has clearly thought about it quite thoroughly. He even made a chart to demonstrate who will be less inclined to receive treatment.

Dr. Emanuel’s material is well thought out and has a lot of practical points, but it ignores some key principles. To kick off this point these are the decision methods he compares:

Treating People Equally

1. Lottery
2. First-come, first served

Prioritarianism

1. Sickest first
2. Youngest first

Utilitarianism

1. Saving the most lives
2. Saving the most life-years
3. Saving the most socially useful
4. Reciprocity (paying back people who have ‘contributed’, such as organ donors)

Now the biggest principle that I feel applies is equality. The government must treat the lives of all citizens with equal concern. A system which places people at different priority levels based on characteristics like age or mental capacity devalues the lives of those at lower priority levels. We have already had far too much unequal treatment in this country and we know it is horrible.

The next principle I feel has been overlooked is power. When there are people who make these decisions with the aforementioned criteria in mind these people are susceptible to corruption either from themselves or from others above them. Let’s go fictional and say that we have a president named Deorge W. Bush and he doesn’t like someone named Malerie Plame. Malerie gets very sick and needs a transplant. Well now that we have the ‘Complete Lives’ board and they are under the control of the government, it is very easy to manipulate things for political reasons and Malerie’s life is suddenly worth less, whereas before she would have had an equal chance on a waiting list or in a lottery. It is not hard to imagine a scenario where a leader would have it in for someone and if you don’t think it could happen in America then you trust government too much. The less power the government has, the better, to a certain point which is marked by the concept of ‘natural law’.

Now of course, I do not believe that Dr. Emanuel wants to kill people, I disagree with the method of allocation that he devised that he also does not agree with even though he devised it. I cannot speak for Mr. Beck, but it may be safe to say that he doesn’t think the Doctor wants old people and handicaps to die. But there are people around that do and a big concern is raised when government has any power over ones health and life decisions. The reason things seem Orwellian is because the government is involved in socialism, that was Orwell’s forte. The principles of Ingsoc are coming to fruition more subtly than set forth in fiction and obviously on a longer time line. The government should not be concerned with social things. The constitution should be adhered to and let society worry about social issues like health care. The more government is in our lives the more power they have and it should be known as a well established fact that power corrupts. This generation may not abuse that power but it will happen at some point.

The government has no place in health care. The constitution was a document set up to limit government and does not give the government the power to control health care or any other industry. Since it is not set forth in the constitution it is left to States or individuals to decide what to do. “Government is not reason; it is not eloquent; it is force. Like fire, it is a dangerous servant and a fearful master.” – George Washington. We should not let the fire out of the fireplace.