Healthcare and the Right-wing

I was having a conversation with a family member today and, unsurprising given the participants it went to politics and, specifically, to the healthcare debate.  Now, normally, I try to avoid talking too much to said person, because our political perspectives are quite opposite and I always feel like I am wasting my time and it gets me all emotional and flustered and angry.  And, I suppose, he's done it again, 'cause it's 1am and I can't sleep.

Contention: Rahm Emmanuel's brother said that old people are less valuable to society - he's advocating healthcare decisions based on people's value to society.

My response: I haven't heard that, but that sounds super fishey - I'm skeptical.

Counter-argument: well, he said it - you can read his words.

So, I wrestled with this the rest of the night.  It's certainly not something I would agree with, and certainly not something that anybody on the "loony-left" I've ever met would agree with.  I remain skeptical: it must be out of context, it has to be twisted around to misrepresent what he meant.  But then I feel compelled to figure it out: what is going on here?

So I hit the web (just now).  First I found this article in the Chicago Sun Times.  Okay - Emanuel defends himself; he's never advocated death panels; okay - but what got twisted?  So I searched some more . . .

And I found this message board with a link to his actual article that appears to have gotten everybody all up in arms.  If you read the posts to the message board, it is clear that either 1) the people claim to have read this article clearly, but have not; or 2) they have read the article carefully and still don't get it; or 3) they are just insane.

In the article, Emanuel is clearly dealing with very scarce medical interventions; organs, or vaccines in situations where there are way more people that need the intervention than organs or vaccines available.  It's kinda like the thought experiment we played in high school: You are in a boat with your mother, your significant other and your child.  The boat capsizes, all are knocked unconscious except for you.  You can swim to shore, but can only save one person, the others will drown.  Who do you save?  Emanuel is trying to do the same thing here.  The fact that we are saving some, means that others are going to be condemned to death.  What is the most ethical way of doing it?  Do you really propose condemning a thirty-year old person to death by refusing to give them an organ so that a 95 year-old can squeeze out another year?  Maybe I am cold-hearted.  Maybe it's because I am young.  But I'm sorry - I find Emanuel's argument compelling.

Okay - let's put aside the craziness of what is really an ad hominem attack on Rahm Emanuel's brother.  Let's say the argument is that people are not comfortable with letting the federal government make these decisions.  That it is too statist, too reminiscent of Joe Stalin's USSR.  What I notice is that Emanuel is presenting a nuanced, multi-faceted approach that is not one-size fits all, but that incorporates a number of different factors to increase the fairness of the system.  

Perhaps the biggest argument against the status quo in my book is that the decisions are still going to be made.  Somehow, someone is going to decide who lives and who dies, in this situation.  (And let's remember, it is a narrowly defined situation.)  Absent a methodical triage system, it is left up to money.  If you have the bucks, nothing else matters.  Of course, maybe that is the real fear of the radical right: perhaps they are afraid that under a different system it won't matter how much money they have, they'll actually get treated like everybody else.