Posted by
David Wood, M.D. on Friday, October 09, 2009 12:00:00 AM
ON THE VALUE AND MEANING OF LIFE
During this 2009 congressional summer vacation, traditional Representative and Senator Townhall meetings have witnessed large numbers of anxious, worried older (and many younger) citizens attending to express their grave concerns regarding the many sections of the proposed ObamaCare nationalized medical plan. Of greatest concern are the sections of the H.R. 3200 Bill concerning the “end-of-life” counseling and panels, the poorly-concealed descriptions of rationing, and the bureaucratic, non-professional committees deciding what care and medications can be given by doctors. This projected total disregard of personal decision-making by patients with their physician’s advice is projected to be superseded by non-medical personnel based only on pre-programmed cost structures.
The basic reason these anxious, older citizens are worried is that each respects his (her) own life and each wants that life to be as healthy and long as possible. Individual insurance assumes the individual risks potentially faced by that person (or family), so that no group or government must assume payments. “Cost” is not the prime factor of medical decisions; it is “need.” The bureaucratic threat to deprive these folks of their personal importance and decisions and have those decisions overridden by the bold and liberal concepts that would happen if this preposterous bill were passed, is enough to inspire and move these people to their self-preservation action.
It is interesting to observe the late Senator Edward Kennedy, in his last year of life with a brain tumor, expend every effort to obtain all medications and the best treatments available (regardless of cost) to attempt to prolong his life. For decades he audaciously had worked to procure a universal medical plan for all (except for himself and his fellow elites) that would restrict the availability of those entities based solely on cost as determined by some unknown, totally disinterested and non-medical hirelings. Such bureaucratic hirelings would follow guidelines developed to discriminate the value of individuals based on arbitrary evaluations of age and an arbitrary philosophical assignment of “value” (again by age) to the collective society.
Placing “cost” above “the value of life” is a collectivist justification for rationing of medical care. Who but a liberal-‘progressive’ could think that way? Everyday citizens do not think that way. To each the value of life is important, and when it comes to preserving that life, all measures become important just like with Edward Kennedy. Solving how to do that devolves upon the individual, and the insurance mechanism is the best means available for those who understand to think ahead and provide it.
Understanding today’s high costs of insurance and medical care, requires one to understand the role of government’s Medicare underpayments and the decades-long attempts by doctors and hospitals to make up for the bureaucratic underpayments by shifting charges more to private insurance companies and patients. It is an unfortunate but understandable circumstance and not a good one. The reported near-bankrupt condition of Medicare proves the impossibility of providing necessary (and wanted) medical care to all people, including those in the country illegally.
This great country was founded upon the worth of the individual and his (her) basic God-given rights delineated by the Bill of Rights. To be besieged by those who believe in the subservience of the individual to the “state” is next to unbelievable, but it is real that a whole cadre of public-education-indoctrinated people in this country adheres to that anti-incentive philosophy on the mistaken belief that everyone should possess the same amount of property and wealth as everyone else. To achieve that condition, wealth from “the rich” must be transferred coercively to “the poor.” In a short run, this can be done forcibly, but in all instances in history that this has been instituted, that system has failed. The simple, observed reason for it is that it goes against human nature and moral action.
Dr. Ezekiel Emanuel, the brother of Rahm Emanuel, has been appointed health-policy advisor at the Office of Management and Budget. Shockingly, he has stated that doctors take the Hippocratic Oath “too seriously,” “as an imperative to do everything for the patient regardless of the cost or effects on others.” He believes that doctors must alter their outlook beyond the needs of patients and consider “social justice.” I took the Hippocratic Oath at my graduation from medical school, but there was nothing in it about “regardless of the cost or effect on others,” nor was there any mention of “social justice.” That is distinctly born of Dr. E. Emanuel’s philosophical belief, not the humanitarian purpose of the original oath. He writes that “Savings will change how doctors think about their patients.” That fits right in with the ObamaCare plan where “cost” will reign as the impetus for all future nationalized medical payments. Such a distortion of Hippocrates’ purpose is odious and loathsome and can be born only of a mind that intends to develop external and despotic control over people.
The best alternative and possibly the best solution is magnificently simple: get out of the way, back off, and remove the imposed barriers and mandates. The millions of individual decisions will add up to solving the situation. Nonetheless, there are children and incapacitated adults who will need assistance, yet unencumbered charities plus careful government assistance programs have been adequate in the past and enormously less expensive.
It would appear that the actions of today’s politicians show determination to force controls over the population with the implication of avaricious intent on power. Well, couldn’t it be just as plausible that the political leaders of the left-wing thinking truly believe that their manner of management is the most efficient and sincerely hold that their philosophical approach is the best? Such a benign explanation would eliminate the accusations of malice of forethought and intent. Nevertheless, the outcome is the same; the respect for the composite of individual decisions is lost in the fervor of advancing left-wing convictions. Noble reasons cannot justify coercive management.
I wish to explain more of the misguided belief system of Ezekiel Emanuel. Here are a few of his quotations:
“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.”
“Allocation by age is not invidious discrimination.” “Treating 65-year olds differently
because they have already had more life-years is not ageist.”
“The ‘complete lives system’ (authored by E. Emanuel) produces a priority curve on
which individuals aged between roughly 15 and 40 years get the most substantial
chance, whereas the youngest and the oldest people get chances that are attenuated
(reduced).” “. . . (it) empowers us to decide fairly whom to save when genuine
scarcity makes saving everyone impossible." [This can only prevail when government
pays.]
“Procedurally, the civic republican and deliberative democratic conception of good
provides both procedural and substantive insights for developing a just allocation of
health care resources. (This conception) . . . suggests the need for public forums to
deliberate about which health services should be considered basic and should be
socially guaranteed.” “ Conversely, services provided to individuals who are
irreversibly prevented from being or becoming participating citizens are not basic and
should not be guaranteed,” . . . such as “patients with dementia.” [Such managing
thinking is applicable to pets but not humans.]
Merely to place cost assessment upon age is indefensible and unjustifiable. Some of the greatest contributions to civilization have come from people in upper age. Look at Winston Churchill who at 66 inspired his British nation to stand up against almost insuperable odds and defend itself against the WW II German Forces. My cardiologist close friend is still actively in practice, contributing much to his hospital, his patients, and his community. He is in his eighties, and one of his prominent patients, who is a very successful inventor, is 96 years-old and is still managing his company successfully. Examples like these are all over this country, and they totally belie the disingenuous notion that younger age is more important than experienced older age. In the United States, individuals are important, not groups.
The actual history of this nation demonstrates the superiority of individual endeavor and innovation. Unencumbered by mandated requirements of behavior, wealth, and religion the growth and advancement of the standard of living in the US has never been equaled in all recorded history. Individual success has been demonstrated to be related to individual resolve, education, and hard work. For those who believe that stories of failure indicate the weakness of the free-exchange capitalistic system, then a proper comparison with the many examples of socialist, coercive societal systems of the past and present should unequivocally demonstrate the dismay, the destruction of personal freedom, and the loss of desire for individual improvement caused by those regimentations.
Most of what capitalism’s critics decry as faults of the capitalistic system is the result of the government restrictions heaped upon enterprises. A full, unencumbered capitalism is not operating freely now because of the gradually increasing bureaucratic interference and controls which impair its correct functions.
An aside thought; the huge spending programs of the last and present US regimes represent calculated but erroneous thinking. Correct economic principles of proper wealth creation have been disregarded. It calls to my mind an observation of Andrew J, Galambos, one of my significant teachers who contributed to my philosophy and economics. He observed, “The greater the development and accumulation of wealth, the greater will be the attack upon it.” The lack of frugality for the wealth of our country by the government attests to that observation. Certainly the mere printing of money to increase the amount of it is diametrically opposed to the legitimate creation of wealth. Enormous spending of it is in no form a production of assets.
The importance of life is inextricably connected to conditions of liberty and freedom and is not bestowed by government bureaucrats.
David L. Wood, M.D., Long Beach, CA, August 30, 2009.