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Whose Medical Decisions? By: Thomas Sowell
FrontPageMagazine.com | Thursday, August 20, 2009


There was a time when rushing a thousand-page bill through Congress so fast that no one has time to read it would have provoked public outrage. But now, this has been attempted twice in the first 6 months of a new administration. 

The fact that they got away with it before, with the "stimulus" bill, may have led them to believe that they could get away with it again.

But the first bill simply spent hundreds of billions of dollars. The current "health care" bill threatens to take life-and-death decisions out of the hands of individuals and their doctors, transferring those decisions to Washington bureaucrats.

People are taking that personally— as they should. Your life and death, and that of your loved ones, is as personal as it gets.

The mainstream media are again circling the wagons to protect Barack Obama, but this time it may not work. One of those front-page editorials disguised as a news article in the New York Times begins: "The stubborn yet false rumor that President Obama's health care proposals would create government-sponsored 'death panels' to decide which patients were worthy of living seemed to arise from nowhere in recent weeks."

Nowhere? Dr. Ezekiel Emanuel is "Special Advisor for Health Policy" for the Obama administration. That's nowhere? He is also co-author of an article on Americans' "over-utilization" of medical care in the June 18, 2008 issue of the Journal of the American Medical Association. Is that nowhere?

Dr. Emanuel's article points out that Americans do not visit doctors or go into hospitals more than people in other industrialized countries. In fact we go to both places less often than people do in those other countries, which include countries with government-controlled medical care.

As the article points out, "It is more costly care, rather than high volume, that accounts for higher expenditures in the United States."

There are more Magnetic Resonance Imaging (MRI) devices per capita in the United States, more coronary bypass operations and Americans use more new pharmaceutical drugs created within the past 5 years.

Americans also have more of what the article calls "amenities" with their medical care.

"Hospital rooms in the United States offer more privacy, comfort and auxiliary services than do hospital rooms in most other countries."

In other words, it is not quantity but quality that is different— and more expensive— about American medical care. This is what Dr. Emanuel's "over-utilization" consists of.

At one time, it would have been none of Dr. Emanuel's business if your physician prescribed the latest medications for you, rather than the cheaper and obsolete medications they replaced. It would have been none of his business if you preferred to have a nice hospital room with "amenities" rather than being in an unsanitary ward with inadequate nursing care, as under the National Health Service in Britain.

The involvement of government gives Dr. Emanuel the leverage to condemn other Americans' choices— and a larger involvement of government will give him the power to force both doctors and patients to change their choices.

As for a "death panel," no politician would ever use that phrase when trying to get a piece of legislation passed. "End of life" care under the "guidance" of "some independent group" sounds so much nicer— and these are the terms President Obama used in an interview with the New York Times back on April 14th.

He said, "the chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health care bill out there." He added: "It is very difficult to imagine the country making those decisions just through the normal political channels. That is why you have to have some independent group that can give you guidance."

But when you select people like Dr. Ezekiel Emanuel to give "independent" guidance, you have already chosen a policy through your choice of advisors, who simply provide political cover. The net result can be exactly the same as if those providing that guidance were openly called "death panels."


Thomas Sowell is a senior fellow at the Hoover Institution.


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