NCPA - National Center for Policy Analysis


July 24, 2009

The President's health care reform plan may result in denying care to a significant number of Americans, especially the elderly, says John C. Goodman, President, CEO and the Kellye Wright Fellow with the National Center for Policy Analysis (NCPA).

"Clearly the Administration does not consider doctors the best judges of the type of health care people need," says Goodman.  "The obvious end game: Washington will tell doctors how to practice medicine and dictate what kind of health care patients receive." 

Goodman cites two scholarly articles in which the President's health advisor, Ezekiel Emanuel, outlined how health care rationing could be carried out.  Emanuel, special advisor for health policy to the director for the White House Office of Management and Budget, says:

  • Young adults should be given preference over seniors because younger people have more years of life ahead of them.
  • And young adults should be given preferential care over very young children because society already has made an investment in their education.

In the medical journal, The Lancet, Emanuel writes:

  • If health care has to be rationed, he prefers the "complete lives system," which "discriminates against older people.
  • Unlike allocation by sex or race, allocation by age is not invidious discrimination; every person lives through different life stages rather than being a single age.
  • Even if 25-year-olds receive priority over 65-year-olds, everyone who is 65 years now was previously 25 years.

In a different article written more than 10 years ago for the Hastings Center Report, Emanuel said:

  • Health services should not be guaranteed to "individuals who are irreversibly prevented from being or becoming participating citizens."
  • An obvious example is not guaranteeing health services to patients with dementia.

Source: Press release, "White House Has Ideas on How to Ration Health Care," National Center for Policy Analysis, July 22, 2009.

For Lancet text:

For Hastings text:


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