Wednesday, January 7, 2009

'Serious' Emanuel Brother Aims To Fix Health Care

When Esquire named the three Emanuel brothers as (collectively) one of the 75 most influential people of the 21st century, they called Rahm, president-elect Obama's chief of staff, "the mouthy middle boy" and portrayed younger brother Ari as a petulant change-of-pace character mixed with a little of Rahm's bombastic intensity. The oldest Emanuel, Zeke, is different. He is the low-key, serious brother attempting to fix the nation's foundering health-care system.

Zeke Emanuel's ideas run somewhat off the beaten path, if not controversial. In an appearance of PBS's public affairs program, "NOW," his plan to fix health care involves using vouchers of similar value to what most Americans pay for basic coverage (Watch the clip here).

There is one catch. To pay for the program, a "value added" sales tax of 10 percent, excluding food and other items that disportionately affect the poor, would be added. In California, for example, consumers would be paying more than 18-percent sales tax, something many people might find exorbitant. In the interview, Emanuel points out that the savings in health care and a theoretical jump in earnings would offset the tax.

In a piece for The Huffington Post, Emanuel states his belief that the recent economic downturn may actually help push through health-care legislation that would have otherwise languished in the halls of Congress.

This financial crisis also means Americans may be more willing to forgo gold-plated comprehensive insurance that covers everything with few restrictions. Under the threat of losing everything, Americans may feel content with the guarantee of a decent plan that covers cost-effective treatments with some restrictions on choice and services to save money. This should enhance the chances for a bipartisan deal on health care.

Emanuel, as the chair of the bioethics department at the National Institutes of Health, will likely have some of his ideas within earshot of the new administration working under Tom Daschle at the Department of Health and Human Services.

As one of the leading opponents of doctor-assisted suicide, Emanuel wrote in a 1997 article for The Atlantic that from an ethical view it both violates the Hippocratic Oath and could possibly be used without consent in the future – refuting studies done in the Netherlands.

The Netherlands studies fail to demonstrate that permitting physician-assisted suicide and euthanasia will not lead to the nonvoluntary euthanasia of children, the demented, the mentally ill, the old, and others. Indeed, the persistence of abuse and the violation of safeguards, despite publicity and condemnation, suggest that the feared consequences of legalization are exactly its inherent consequences.

Zeke may be the Emanuel you have never heard about, but The Atlantic's Andrew Sullivan says he's just like the others.

Emanuel will discuss his ideas for fixing health care in America this Thursday night at The Commonwealth Club at 6 p.m.


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