The subject line of the AFA email actually gave me a little hope at first: "Healthcare reform moving toward euthanasia". If only that were true. Something in me, however, (probably my sense of logic and grasp of the current political climate) led me to believe this was just another gross misrepresentation.
Weird. I was right.
The AFA's fear fest starts off with their concern that "a government takeover of healthcare will allow Washington bureaucrats to use 'comparative effectiveness research' to dictate to doctors which treatments they should prescribe and how much those treatments should cost." Someone should let them know that the goverment already does that. (As a quick aside - someone once asked me why the hospital charged $120 for acetomeniphin. I responded "because the government won't let them charge more.")
The meat of the AFA article concerns a couple of technical papers. The first is a paper co-authored by Health Policy Advisor Ezekiel Emanuel (PDF) which they claim states that if healthcare is to be rationed, young adults should be given priority over the elderly.
Oddly enough, the AFA's assertation is a complete stawman. First of all, the article in question isn't a broad discussion on healthcare - but rather a very specific discussion on the allocation of "very scarce medical interventions such as organ transplants". As most of us know, these services are already rationed due to the simple fact that one rarely finds organs suitable for transplant just lying about in the street. Anyone in need of an organ transplant is evaluated using criteria specific to the organ needed. These criteria result in a score - the higher the score, the more likely you are to get a transplant. (Criteria for liver transplants, and lung transplants.) Secondly, the article is simply a synopsis of the general principals and underlying core values that societies might use in determining the allocation of scarce medical interventions.
The AFA article pulls another shifty tactic by taking two quotes from separate portions of the technical paper and combining them in such a way that the average reader will believe it to be a single quote - the AFA article states "Ezekiel Emanuel wrote that if healthcare has to be rationed, he prefers the 'complete lives system,' which 'discriminates against older people.'" Within the context of the technical paper, however, we find that the complete lives system is preferred only because it "combines four morally relevant principles: youngest-first, prognosis,
lottery, and saving the most lives." and that "To achieve a just allocation of scarce medical interventions, society must embrace the challenge of implementing a coherent multiprinciple
framework rather than relying on simple principles or retreating to the status quo." The second quotation used by the AFA was actually taken from a paragraph titled "Objections" and sites two papers written in 1989 and 1995. (Jecker NS, Pearlman RA and Rivlin MM respectively.)
They then move on to a paper authored entirely by Advisor Emanuel (PDF) through which the AFA claims he suggests that health care services should not be guaranteed to individuals who are not capable of participating as citizens, including dementia patients. In reality, the article is simply a discussion of the ethical issues raised by the possibility of universal health coverage including the definition and allocation of "basic" services and a call to begin discussing the "goods and goals of medicine". Basic services are not defined in the article, so the presumption made by the AFA is both completely meaningless and misleading. It seems they very much want us to believe that Advisor Emanuel would forcibly deny readily available services, such as pain management or diagnostics, right along with those services currently considered discretionary, like organ transplants or invasive surgeries that neither extend life expectancy nor improve quality of life.
Pity for the AFA that I'm a reader, eh?
They then string together a couple of Obama quotes, completely stripped of context, relating to the money sucking nature of the current Medicare and Medicaid programs and his desire to cut funding and subsidies from the Medicare Advantage program which has now been shown to provide no additional benefits over Medicare alone. I tried to understand how Medicare and Medicaid reform kills the elderly... I really did... but I just can't seem to figure it out.
All-in-all the email and linked article amount to nothing more than hyperbole wrapped in panic and based on a completely errant definition of euthanasia - nothing in their ridiculous argument bore even a vague resemblance to the act of granting someone a painless death.
The goal of the email was to rally the hordes of true believers into writing and calling their representatives and asking them to oppose the healthcare bill. Because I believe you all to be rational individuals, I'll leave it up to you as to whether or not you choose to support the healthcare bill rather than asking you to counter the AFA's call to action with your own calls and emails.
Should you be interested in learning more about the proposed healthcare reform, TrueMajority.org and Howard Dean will be hosting a live chat at 8:00pm Eastern, Monday, August 3rd.
