Chicago Sun-Times
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Dr. Ezekiel Emanuel, Rahm's brother, tapped for White House health care policy advisor spot.

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WASHINGTON--While the Obama White House is searching for a replacement for health czar Tom Daschle, policy work on health care reform--a priority for the administration--Is ongoing with one key advisor especially well connected.

The brother of White House Chief of Staff Rahm Emanuel, Dr. Ezekiel J. Emanuel, a noted bioethicist, is advising the Obama administration on health care reform.

Dr. Emanuel is the Chair of the Department of Bioethics at The Clinical Center of the National Institutes of Health and a breast oncologist.

Dr. Emanuel is a special advisor to the director of the White House Office of Management and Budget for health policy. He told me he is "working on (the) health care reform effort." He is "detailed" to the OMB spot and is still officially an employee of the NIH.

Until last August, Dr. Emanuel was commuting between his Chicago home in West Rogers Park and Washington. He moved to Washington last August after his youngest daughter graduated from Northside College Prep at Bryn Mawr and Kedzie.

One of three wildly successful Emanuel brothers (Ari is a Hollywood superagent) Dr. Emanuel also advised the Clinton White House on health care issues. He is a graduate of Amherst College, receiving his masters of science from Oxford University in Biochemistry. His M.D. is from Harvard Medical School. He holds a Ph.D. in political philosophy from Harvard University. In addition, in 1987-88, he was a fellow in the Program in Ethics and the Professions at the Kennedy School of Government at Harvard.

According to his NIH bio, Dr. Emanuel is "widely published on the ethics of clinical research, advance care directives, end-of-life issues, euthanasia, the ethics of managed care, and the physician-patient relationship, Dr. Emanuel's articles have appeared in The New England Journal of Medicine, Lancet, Journal of American Medical Association, and many other medical and ethics journals. His book, The Ends of Human Life, has been widely praised and received the Rosenhaupt Memorial Book Award by the Woodrow Wilson Foundation.

"Dr. Emanuel served on the ethics section of former President Clinton's Health Task Force, the National Bioethics Advisory Commission, and the International Advisory Board on Bioethics of the Pan American Health Organization. He has been a visiting professor at the University of Pittsburgh School of Medicine, UCLA, and Brin Professor at Johns Hopkins Medical School."

53 Comments

As part of his effort to assist President Obama plan a reform of the U.S. health care system, I invite Dr. Emanuel to visit France. As a public health professional who has worked on several continents, my judgement is that the USA has a lot to learn from what the French have accomplished in terms of access, cost and quality of care.

Whether Dr Emanuel has a talented brother with influence over appointments to senior roles in US Public Health Policy is probably about as important in the scheme of things as whether Dr Castro has influence over who governs Cuba.
I'm a complete outsider, but I watched while attempts (partially successful, sadly) were made in my country to implement a variation of the US managed care model.
The only thing that has a prayer in hell of fixing your health system is to abandon the "insurance" model and get yourselves into a pay-as-you-go paradigm. You have what we call a buggers' muddle of perverse incentives from one end of your health system to the other, with massive and harmful over-intervention for the rich, and massive, equally harmful, under-intervention for the poor. Each of these effects is tearing at the fabric of your society, and it is not too fanciful to say, damaging your gene pool. In the same way that war is too important to be left in the hands of generals, health care is far too critical to be left in the hands of doctors. Dr Emanuel appears to have the necessary extra-medical perspective to challenge some of the conventional wisdom. You'd better hope he does.

What is position on medical marijuana ? I am living proof of it's miracle, any Dr. can't deny that so the DEA shouldn't either.

He seems like the "good" brother. His other siblings are not known for their ethics or their temperament. Good luck to him (and our country).

As a Registered Nurse in clinical practice for over 40 years, in almost every practice setting, finishing up in April with 3 years in Hospice, I find the credentials of this man very reassuring and appropriate for the role with which he is tasked.

This is someone with whom I would love to be professionally associated with.

I saw him speak on the economics of our health care system, and think he is an excellent choice.

Dr. Ezekiel J. Emanuel should also be considered for the post of health czar for the United States, as he would be an outstanding choice for this post as well.

Dr. Ezekiel J. Emanuel should also be considered for the post of health czar for the United States, as he would be an outstanding choice for this post as well.

We need a cure for health care in America. It's horrifying to think Governor Phil Bredesen is under consideration for HHS. See what is deemed, defended and supported as "THE ACCEPTABLE STANDARDS OF HEALTH CARE" in Tennessee. A three day procedure turned out to be a ten month long nightmare and they are patting themselves on the back for what they are doing to our communities and spreading MRSA. Profit care comes ahead of Patient Care in East Tennessee.

www.wisecountyissues.com

this would not be a good idea for Obama's administration. It would look like favorism/nepotism.

I don't care about this position but the best person for HHS secretary is Governor Howard Dean. He's a doctor and came up with the winning strategy for Dems in 06 and 08, the 50 state strategy.

It seems, however, that Rahm Emanuel has a feud with Dr. Dean. Well, my advice is to GET OVER IT. Forget about the petty fighting; let's get on to the country's business.

As I look over the list of his published works, it appears to me that anyone over 65 or anyone with a serious illness better "run for the hills". Euthanasia, End of Human Life, fits right in with Obama's desire to cut back on Medicare. Better say bye bye to your parents and grandparents if they get sick.

Anxiously awaiting the "onslaught" by the Repubs on "nepotism and wonder if how they will find fault with his qualifications ?? Somehow , they will plant some phony allegations somewhere and pound away, and of course , our co-operative media will happily go along .Still hoping that Obama sees the light and appoints Gov. Howard Dean to be the head of HHS,thanks for the article it was right to the point and explicit in its details

He's brilliant. A great choice.

The ethical thing to do is remove profit from our healthcare system. Medicare for all (single payer) is the most cost efficient way to get all our people heathcare as a human right.

Enough cronyism. There's surely someone equally qualified in this country that won't project the image that Democrats are as susceptible to nepotism as Republicans are. For that reason alone, we should have someone else.

Why isn't former OR governor Kitzhaber (sp?) being considered for HHS?

Emanuel has published a book detailing his views on heatlh care reform: Guaranteed Access Health Care (or something close to that). The book is a a polemic for his preferred solutions, which puts me off, but on relection it's loaded with good - if radical - ideas. He rejects all the current major reform themes - like incremental change, or single-payer, or patch-work reforms to major programs like SCHIP amd Medicare, and simply extending Medicare-like program to every one - opting instead for: universal coverage, no precondition exceptions, everyone pays for it via a dedicated VAT tax, everyone gets a standard basic package of coverage like what congress-persons now get, decoupling health insurance from employers, a solid role for insurance companies in developing networks of healthcare providers that compete on the basis of the quality of healthcare they deliver, and free choice for anyone who wants to add (and pay for) coverage beyond the basic package.

Individuals would be entirely free to choose which network to affiliate with - and they could not be rejected.

He advocates a Health Care Institute that would measure and report on benefits vs costs of drugs, treatments, providers, and insurance networks - and make the results public.

His book is available in paperback from Amazon and others.

I would advise Dr. Emmanuel to review the success of the health care systems in Germany and Austria. These employ competitively private health care funds (note, not "insurance companies") which are a) non-profit, b) must accept people with pre-exisiting conditions and c) compete with each other for patients and keeping premiums and health-care costs as competitive as possible. The hospitals and doctors are also private, but again must be cost-effective. This system still gives patients "choice", as is beloved in America. I have lived in Germany, Austria and the UK and have found the German and Austrian systems to delvier excellent standards of care. The UK system is "signle provider" i.e. the government, and while good for critical and emergency care, you can end up waiting for things like hip replacements, which is not the case in Germany or Austria.

This man is in the hands of the private health care community and has campaigned against public health care (especially single-payer versions) for at least six years. He is the very worst appointment Obama could make and stay within the ranks of the Democratic Party.

It's time to write off the efforts many of us made to get Obama elected. We wasted our time. This appointment shows our new President to be either a fraud or a dupe. Either way, healthcare is lost.

sc

Wow! This is REAL CHANGE!

We went from Dick Cheney's Cronyism, Corruption and hand outs to bankers to Rahm Israel Emanuel's Cronyism, Corruption and hand outs to Bankers.

Did they expect us to treat them with any respect?

Howard Dean for either HHS sec. or Health Czar. I agree with toosinbeymen 100 percent. To not pick Dean would be insulting to him and to us, because he is singularly qualified.

Also, why is Obama so eager to reach out to the right but not the left? How about 1 or 2 real progressives, like Dean, for a change.

Well, isn't that just keen? We get someone who promotes "the ethics" of ending human life? Clearly this would be the "solution" to the high cost of health care, the Social Security shortfall and Medicaid cost overruns, now wouldn't it?

Anyone up to speed on the "elite" and their desire to cut the world population down to a more manageable size?

What a gruesome choice.

"Better say bye bye to your parents and grandparents if they get sick."

Got that right, Elena.

Only if they don't have a bundle to care for themselves...like "some" people...

As a Boomer, I can only say, thanks but no thanks.

Dr. Emanuel spoke at the university where I teach & do medical research, and I was fortunate to have the opportunity to pick his brain about healthcare reform over lunch. I came away hoping that he would find a prominent position within the Obama administration. There is truly no one better for the job.

Dr. Emanuel is eminently qualified for any position within the Administration related to health care. So is Dr. Howard Dean. It is time to bring on universal health care - what is needed is an imaginative writer-adman to come up with the magic words to use instead of "universal" and "socialized" to make it palatable to the media and the country.
While working on it, this person should also come up with a magic word instead of "nationalized" for the banking rescue.

A. Howard Dean has been a practicing physician.
B.Howard Dean has experience in medical and hospital politics
C. Howard Dean LED the DNC brilliantly in 2004 and 2008 advocating the opposite strategy from what Raum Emmanuel advocated.
D. Howard Dean is NOT the brother of Raum Emmanuel

I am disappointed.

Poor Elena, please don't start with the scare tactics before understanding the whole picture. It appears to me that choice at all levels of medical care is an anathema to many.

I saw my dear friend's mother die with tubes in her throat, and viens in a very noisy hospital bed. Dieing this way is not my vision. My wishes are known to my family and I have signed legal papers rejecting heroic efforts to keep me alive. Why shouldn't I have the ability to decide?

So on the one hand we have doctors who don't want to provide pain pills to the elderly for fear of them becoming addicted, but we want to do everything to prolong their agony? This seems irrational and cruel to me.

We don't want to provide birth control, and we don't want to provide insurance once the children arrive into our world? This is cruel.


The Governor of Tennessee is a lousy candidate for HHS. He has allowed the healthcare companies to run roughshod over the citizens of this state.

The state laws are so screwy that a policy termed individual by a health insurance company is classified as group by the state and exempt from state review.

Dr. Emanuel is an execellent choice. His views on end of life care are SHARED by millions of elderly and terminally ill who simply want to be able to die with dignity with a minimum of medical intervention.

As a nation we spend more of our healthcare dollars in the final year of life then all the decades preceeding it. Million of dollars are wasted with no postive impact on the patient or outcome.

It's always struck me odd that our society seems more concern with the not yet born and the dying than with the living who need help.

having dealt with the Vermont Department of Health during Dean's Vt tenure, I suggest the Dean supporter look at his health history & policies rather than his Democratic Party history policies.

I've read Emmanuel's work, and approve.

I'm not fond of his brother, but he can't chose his siblings...

Howard Dean should have Sec. of HHS. This will need huge work, getting universal health care up and working, and workaholic Dean suits the task. I am so afraid we'll have another spineless Dem or ineffective bureaucrat who'll use up precious time, and we'll still not have universal health care. That kind of person will throw up her/his hands and say, "I tried!" and return to her/his other life. Unacceptable.

This would look like favoritism for Obama's administration.

We could certainly use some ethics in the process of healthcare reform.

The health insurance companies have played a major role in our current healthcare crisis. These companies make huge profits and their CEOs make millions, while the rest of us, workers and employers alike, face skyrocketing healthcare costs, impossible bureaucracy, and life-threatening insurance denials.

THE FACTS: HEALTH INSURANCE COMPANY PROFITS IN 2007:

1. UnitedHealth Group -- $ 4.654 BILLION. UnitedHealth Group owns Oxford, PacifiCare, IBA, AmeriChoice, Evercare, Ovations, MAMSI and Ingenix, a healthcare data company

2. WellPoint -- $ 3.345 BILLION. Wellpoint owns BLUES across the US, including Anthem Blue Cross Blue Shield, Blue Cross Blue Shield of Georgia, Blue Cross Blue Shield of Wisconsin, Empire HealthChoice Assurance, Healthy Alliance, and many others

3. Aetna Inc. -- $ 1.831 BILLION

4. CIGNA Corp -- $ 1.115 BILLION

5. Humana Inc. -- $ 834 million

6. Coventry Health Care -- $626 million. Coventry owns Altius, Carelink, Group Health Plan, HealthAmerica, OmniCare, WellPath, others

7. Health Net -- $ 194 million

The huge insurance company profits—BILLIONS EACH YEAR—could be used to provide quality healthcare for millions of people. We need to get the insurance companies OUT of healthcare, so patients can receive the care they need and physicians can be paid adequately for their work.

The only way that we all will have affordable, quality care is to get the insurance companies OUT of healthcare! We can no longer tolerate a healthcare system where those without medical expertise or genuine interest in our patients' health have absolute control, and where profits are made by denying care.

FOR MORE INFORMATION, SEE:
http://www.insurancecompanyrules.org/learn_more/the_roster/

As an Obama supporter and former federal government professional, I am disturbed to see all the new bureaucratic positions that the Obama administration has added. The stimulus bill creates two new health agencies with entire staffs that duplicate what already exists, and has existed for years, in HHS. Emanuel's post is a health care advisor to the OMB person in the White House? They already created a whole new Office of Healthcare Reform in the White House. Dupication and extra layers of bureaucracy aren't what we need right now.


ARE YOU KIDDING? SURELY THE OBAMA ADMINISTRATION HAVE HEARD OF THE PRACTICE LABELED NEPOTISM. I THINK OUR NEW PRESIDENT MUST HAVE LOST HIS MIND!!!


Solving the Health Care Problem

Principles-
1. Do not throw out the baby with the bathwater- we have a good system for most people
2. Put responsibility for healthcare with the individual.
3. The more people covered, the more efficient and lower the costs for the insurance and healthcare industries, and ultimately the cost to consumers.
4. Let the private sector and free markets determine the optimal solution
5. Eliminate the tax and price bias against small business and the self employed vs. big business.
6. The program must be easy and low cost to administer.


Proposal
1. Separate healthcare insurance from employment- it is a legacy of wage and price controls during WW2. It is impossible for a small group to obtain a policy that is optimal for all employees- some are underinsured and some are overinsured, both of which are inefficient. It will also free up business owners to concentrate on their business, rather than purchasing and administering health insurance for employees. It also gets the employer out of the personal business of the employee, and reduces selection against employees with health issues in the family.
2. Create a voucher to purchase health insurance in the model of the earned income tax credit. Based on estimated earnings, an individual could apply for and get a voucher to use in the purchase of health insurance from a private carrier. Each individual could find the policy that best meets their needs. Based on annual income, a credit on the income tax return, less the value of the voucher, would be provided. If income increased during the year and the credit was less than the voucher value, you would pay the difference in tax. If income decreased (i.e. loss of job), you could apply for the voucher in mid-year, or wait until you file a tax return and get a tax credit with no offset for a voucher. This automatically subsidizes lower incomes and excludes higher incomes from the voucher/credit based on actual annual income. It also protects individuals who lose employment from losing health insurance. Social Security could issue the vouchers with reporting to the IRS as with any other SS benefit.
3. Government and insurance companies would work to develop a basic coverage policy, which insurance companies could offer in the HMO, POS,MSA/HSA or Reimbursement models. Insurance companies could provide additional or enhanced coverage, reduced or higher deductibles, etc.. for additional or lower premiums. The premiums would be set by the insurance companies, (NOT THE GOVERNMENT) with competition keeping prices down. All prices would be published and available to consumers to make an informed choice, based on price, coverage, networks, and personal needs. An individual could use the services of an agent, or purchase it directly (think auto insurance). Associations or employers could partner with insurance companies to provide health insurance or seminars about coverages and options and the costs, but all policies would be purchased by the individual.
4. Insurance companies could sell nationwide, thereby increasing capacity in underserved areas, but they must prove they can manage and support the network or clients in the area.
5. It may be necessary to adjust the voucher based on region due to differences in costs. Since in general higher health insurance costs are related to higher wage areas, the higher voucher will be offset by higher earnings and taxes paid. Such adjustments must be kept to a minimum to reduce complexity and selection against regions, and the problem of individuals moving between regions.

I do not know the man and his work, but we sure know his brother that has and will bring loads of problems. Rohm is a real political animal and I say that not in a flattering way. My point is that his brother would do well to pass on the offer and keep his life separate and contribute in a less direct method.

I am suggesting that everyone read some of this man's writings before deciding that you want him to be advising our president on ANYTHING!

I am much encouraged by Dr. Ezekiel Emanuel's comments regarding health care reform and his philosophy of human life. Also I am more impressed with his view on tort reform on medical malpractice. I share his view that we human are all mortal beings, our presence here on this planet is a brief and fleeting experience.

Medical mistakes happen and victims should be compensated properly but current medical malpractice trial system escalates medical costs and too much unnecessary burden on physicians.
With tort reform health care costs will be reduced substantially.

Good luck to your sincere effort. I am very happy to see a person like you in medical profession.

Kenneth J. Wooh, M.D.
retired

646 852 6255

Every American should read what this man has written about health care since he is the mastermind behind the government takeover of healthcare. He believes that the elderly should be denied healthcare because the money can be spent elsewhere. He believes that doctors should not follow the hyppocratic oath but should determine the worth of a person and evaluate whether or not they should get treatment. He also believes people with dementia or alzheimers should not be given medical care. These are not his direct quotes but paraphrases of what he has published. You had better read his writings now before the Obama administration hides all the evidence as is their standard practice. This man's beliefs are dangerous. WAKE UP AMERICA!

This guy is from hell. If any of you think that communist healthcare is the answer, wake your stupid self up. It does not work anywhere, France included. I know many people who have had to deal with nationalized healthcare in Canada and in Europe. NONE of them are impressed. Obama and Ezekiel are two of a kind. Rotten through and through. I don't care how "educated" Ezekiel is, it doesn't mean he has any common sense. And obviously he has very little. He and Rahm must have had demons for parents.

Oh, sure...

And Dr. Josef Mengele' of Nazi Concentration Camp fame was also a "MOST WONDERFUL and COMPASSIONATE DOCTOR" according to the hundreds of thousands of Jews on whom Dr. Mengele ordered and performed all kinds of experiments and "miracle works", just before signing their death warrants for Stockade 25.


Folks better WAKE UP to THE COLD HARD FACT that Dr. Zeke (Dr. Ezekiel Emanuel) HAS NOT REFUTED BEING QUOTED his effectively stating that in his role as what will be effectively be 'one of making the decisions' (the "DECIDER") when it comes to cutting costs (aka "RATIONING CARE"), that we ... should consider withholding medicines that no longer prolong life to seniors unable to make a contribution to society'... (aka "EXTERMINATE THOSE UNABLE TO GENERATE TAXATION REVENUE FOR THE POLITBURO STATIST MACHINE").

So, Zeke, what you're recommending is that we "exterminate" seniors in their last year or so of life, simply because they don't provide a taxable revenue base for you and your commrades-in-hammer-and-swastica to usurp from their bank accounts through the new legislative bill's provisions for having electronic access to every American citizen's bank account (pg. 59 of House Bill #3200). This is kind of like Obama himself saying we should "...think about just giving 'em a pain pill...", huh?


Have we got that about right, Zeke?

I just love having a COOL president, don't you? I mean, isn't Obama cool?

Yes, he's cool alright.
Downright chilling...!

Hippocratic Oath


Dr's take this oath to save lives . Yet this Dr is in agreement with this health care that on page 425 actually instructs people who are terminally ill . disabled , handicapped or just getting old. Their definition of old BTW is age 65 or older , on how to END their lives .

This DR who took the Hippocratic Oath to become a DR is in agreement with DEATH to the people mentioned above ! Not to help save a life but END it !

So when you reach age 65 or you become disabled or you become handicapped or you become terminally ill.

The gov, will counsel you on the best way to END your life !

Oh BTW if your not willing to END your life they meaning the GOV will end it for you by denying you heal care period !


OH yes we sure did vote in a great president and congress didn't we !


Time to CLEAN HOUSE !

By Ronald A. Schwarz, Ph.D.

Why wouldn't you go get treatment in france, see how that works out for you. It will likely result in Survival of the fittest and less wasted bandwidth on the internet

I am a Nurse & office manager in a medical practice. I am not in love with the Private Insurance Companies. There is a lot of room for improvement, but I think that a government takeover in our healthcare & business is dangerous. I have worked in government run healthcare facilities and the quality of care is so poor and facilities are often not maintained in the best conditions and the quality of the physician's leave a lot to be desired. Also, supplies were often short or lacking, especially at the end of the fiscal year.
Medicare is rapidly changing also. They are denying payments for care that has already been rendered to patient's more than ever and are simply taking money back because they say the physician over-coded the visit. Physican offices must spend hours appealing decisions.

The paper is "Principles of Allocation of Scarce Medical Interventions", his name is on it as a co-writer.

Read it and be scared. Obama is a liar when he says there will be no allocation of healthcare, when this guy is an health advisor to him.

Why a "Czar" and not a cabinet positon. Isn't that what the Russian dictators were called?

The word is "insidious" meaning "operating or proceeding in an inconspicuous or seemingly harmless way but actually with grave effect: an insidious disease." This is how the current administration operates. A bill's language appears inoccuous but when interpreted by this man becomes insidious and in application downright evil. Get used to it or work to get rid of it. This guy is not a medical doctor he is a spin doctor.

This is nepotism.

This isn't about healthcare. It is about the government funneling 1/6 of the economy to Washington so that it can be given to their supporters like General Electric (electronic records) and AARP(plan clearinghouse) who will make billions in taxpayer dollars and then give millions in turn back to Washington. Dr. Emanuel's job is to find an effective way to deny care to millions to achieve this goal.

Others ideas of end of life care should not be forced on anyone. First of all, this is not about healthcare, it is about power.

If you want to choose to end your life rather than fight what is deemed a terminal illness, fine. You go ahead and do that.

I prefer to fight....my life may not be valuable to you....but it is to my children.

I will never be silent on anything that puts the government in the middle of my medical treatment or that of my family.

This man is nothing but pure evil.

O.K. So your the better of the brother??? Well, if you are so good then how come you haven't developed a anesthesia that doesn't make a person sick to their stomach post op??? Oh yes,
I wish you would be a little kinder to the folks with cancer, back in 1989 a group of students from the JHH group got a agar dish put an e-coli plug on it and did chemotaxis??? You know the same medicine in chemotherapy; used in oncology, well, given chemotaxis it caused the e-coli plug to tumble and roll; but, given glucose it caused the e-coli plug to expand. So, if e-coli is a bacteria and cancer is a virus, what makes you think that chemotherapy would reduce a cancer??? It's not hard, another thing why can't we get better cancer treating drugs like interferon?? because of the wonderful "End of Life Book?????"""" Maybe you are just another name for Dr. Death???? Michigan is north of Illinois???? I don't get it???? And you are the advisor under Health Care???? I don't care about the nepotism, what about the practice of medicine. Get with the program...life is better than death...healing on a virus takes anti-viral drugs, and what about when it doubt cut it out???? Oh well, look back at the study in 1980's you will be pleasantly supprised to see that patients don't have to loose their hair, skin, teeth, and life under chemo-not to mention the blood pressure issue. Good Luck,

it appears to me that this author and 90% of those writing comments have been drinking too much kool-aid. why don't you move somewhere that already has his greatest of all medical care systems? then, when you get really sick you could come to america and get the treatment you need. if you destroy this system you will not have that second chance.

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Lynn Sweet

Lynn Sweet is a columnist and the Washington Bureau Chief for the Chicago Sun-Times.

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This page contains a single entry by Lynn Sweet published on February 14, 2009 6:41 AM.

Rahm Emanuel retaining his $1.7 million political warchest. Keeping his options open. was the previous entry in this blog.

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