August 19, 2009
Hello ObamaCare, Goodbye GrandmaBy Stuart Schwartz
Oh, look! See Ezekiel. See Ezekiel Emanuel. Zeke is in charge of health care policy for the Obama administration. Policies are the official thoughts that guide the relationship of government and health care. Zeke thinks health care thoughts for the president and congressional leaders. Hello, health care policy.
Oh, look. See Zeke think. Zeke has not run a hospital. He has not run an insurance company. He has not run a medical practice. He has not worked in the pharmaceutical industry. Zeke has spent more than twenty years in education and government... thinking.
See Zeke think. Zeke specializes in thinking about "social policy" and medicine. Social policy is government management of services. Zeke heads a government department that thinks about who gets what health care treatments and when. He is the White House health care czar. And he has a medical degree and doctorate in social policy from Harvard, where brilliant people think. Think, Zeke, think.
President Obama, a Harvard Law graduate, shares Zeke's thoughts. Congressional Democrats praise Zeke's thoughts. Mainstream journalists and commentators praise his thoughts. Zeke's thoughts are their thoughts. Zeke thinks great thoughts. Hello, great thoughts.
Think, Zeke, think. Think and write. See Zeke write. His resume packs more than a fifty page list of articles, speeches and books. Read the articles, know Zeke. His writing provides the foundation for Zeke's "complete lives" approach to health services. Hello, complete lives.
Zeke created the "complete lives" approach to health care. A complete life is one that contributes in thought and action to the "instrumental value principles" of the greater community. Complete lives "prioritizes younger people" and lifestyles that are likely to contribute to the "common good." Hello, instrumental values. Hello, government.
Zeke thinks health care should contribute to the common good. The community, led by the government, determines the common good. Zeke thinks about community. Zeke is an active "communitarian." Communitarianism is a cross between communism, socialism, atheism and new age. Hello, communitarianism. Hello, Marx, both Groucho and Karl.
Zeke the communitarian believes that health care should promote the public good, and develop "reasoning skills" that contribute to a "just society." In "A Communitarian Health-Care Package," Zeke asserts that "community-minded" leadership must make medical decisions for "more passive individuals." Communities should have the "power of exclusion" from health services over those who do not share their view of the common good. Think, Zeke, think.
See Zeke think. Community good must influence medical treatment. Some groups "whose notions of the good are rooted in the denigration of others" should be excluded from some medical resources. Government may deny medical services to an individual who is a "hostile adversary" of community good and groups that are "noxious weeds which gain their strength" by vehemently opposing community goals. Hello, government priorities.
Think, Zeke, think. Medical care is a means to encourage "healthy participation." Healthy participation means acceptance of community goals, structure, and policies. Hello, acceptance. Hello, healthy participation.
Health care is to be provided through "a process of interpretation and judgment" by state and federal "Health Oversight Boards." A fundamentalist Christian, for example, who believes "certain sexual orientations" are wrong is "a noxious weed" in the green fields of community, and may be denied certain health services under certain circumstances. Hello, health oversight boards.
See Zeke think. Zeke thinks the ideal "instrumental values" of a community determine the "level of justice" that health care must provide for society. Zeke thinks medical services should provide incentive for individuals to fit in with the community. Zeke thinks individuals must be conformed to "shared conceptions of the good." Hello, shared conceptions of the good.
Think, Zeke, think. Zeke thinks individuals and doctors often use "irrelevant values" when making decisions. Irrelevant values include physician notions of responsibility to the patient, the Hippocratic Oath, and individual and family concerns. Such concerns may not "affirm common conceptions of the good." Hello, affirmations of public good.
Zeke thinks spirituality is not an "instrumental value." Zeke has thought long and hard about religion. As a result, he describes himself as a "practicing atheist." He thinks religious communities that put God ahead of the larger community do not contribute to the greater good. Hello, atheism.
Thus, Zeke concludes, patient and physician values and behavior must be changed. Government, on behalf of the community, must remake them as individuals. And, as he asked at the "2004 Communitarian Summit" at George Washington University, "What Is Wrong with Remaking Human Nature?" Hello, remaking physicians. Hello, remaking citizens.
Think, Zeke, think. Too many physicians and citizens do not understand the priorities inherent in a complete life. Therefore, Zeke thinks, we need universal, compulsory government-run health care. He thinks "more taxes" must "be required." He thinks only government can provide "just allocation of health care resources." He thinks government should make choices for physicians and individuals. Think, think, think.
See Zeke think. Zeke thinks your health care choices are selfish. Therefore, government, on behalf of "community," must force "involuntary" "outcomes" on those whose values and behavior conflict with the principles underlying government health care policies. Hello, involuntary outcomes. Hello, government force.
Zeke thinks universal, government-run healthcare must allocate medical services so as to exclude from some treatments those who do not contribute value to the community. Zeke proposes that smart people in government who understand the way your lifestyle and medical treatments "promote the continuation of the polity" should decide who gets what medical treatments, and when. He calls these "principles of allocations." Hello, principles of allocations.
Zeke thinks government must assure "distributive justice" You think you are just eating cheesecake. However, to Zeke, eating cheesecake is an act that either does or does not contribute to the "communitarian" good. He links individual health choices to community goals and government. Link, Zeke, link.
See Zeke link. He links medical treatment of those who are unable to live "complete lives" to government health care decisions. Zeke thinks those less able to live complete lives include the mentally and physically handicapped, the elderly, those with crippling illnesses, and those with "noxious" thoughts. They contribute less to community. Link and think, Zeke, link and think.
Zeke thinks health care must be rationed according to the value of the community to which an individual belongs. Valued communities include those with appropriate "instrumental" values, community activists, young and healthy persons, and favored racial and gender groups. Those of less value may not have the potential to "be or become" a "participating citizen." This group includes those with crippling medical problems, the elderly, the disabled of all ages, and infants too young to have received substantial "community investment."
See Zeke think. Think, think, think. Hello, Obama health care. Hello, social usefulness. Hello, government allocation of health services.
Goodbye, noxious weeds.
Hello, brave new world.
Stuart H. Schwartz, Ph.D., is a former newspaper and retail executive. He is on the faculty at Liberty University in Lynchburg, Virginia.