Brees List

An update .. just a question…

.. is this buried somewhere in the healthcare plan that is now law?  Just wondering…………….

The”complete lives” system that the brother of Rahm Emanuel, Dr. Ezekiel Emanuel.. also an advisor to Obama … is something your worst nightmare would not dream up.

Read the following excerpts from this “complete lives system”.  It is  for real .. and enough to make you wonder in what world we are living …

Consideration of the importance of complete lives also supports modifying the youngest-first principle by prioritising adolescents and young adults over infants. Adolescents have received substantial education and parental care, investments that will be wasted without a complete life. Infants, by contrast, have not yet received these investments. Similarly, adolescence brings with it a developed personality capable of forming and valuing long-term plans whose fulfilment requires a complete life. As the legal philosopher Ronald Dworkin argues, “It is terrible when an infant dies, but worse, most people think, when a three-year-old child dies and worse still when an adolescent does.” as supported by empirical surveys.

The complete lives system also considers prognosis, since its aim is to achieve complete lives. A young person with a poor prognosis has had few life-years but lacks the potential to live a complete life. Considering prognosis forestalls the concern that disproportionately large amounts of resources will be directed to young people with poor prognoses. When the worst-off can benefit only slightly while better-off people could benefit greatly, allocating to the better-off is often justifiable.  Some small benefits, such as a few weeks of life, might also be intrinsically insignificant when compared with large benefits.

….the complete lives system justifies preference to younger people because of priority to the worst-off rather than instrumental value. Additionally, the complete lives system assumes that, although life-years are equally valuable to all, justice requires the fair distribution of them. Conversely, DALY  (disability-adjusted life year) allocation treats life-years given to elderly or disabled people as objectively less valuable.

Finally, the complete lives system is least vulnerable to corruption. Age can be established quickly and accurately from identity documents. Prognosis allocation encourages physicians to improve patients’ health, unlike the perverse incentives to sicken patients or misrepresent health that the sickest-first allocation creates.

Accepting the complete lives system for health care as whole a would be premature. We must first reduce waste and increase spending. The complete lives system explicitly rejects waste and corruption, such as multiple listing for transplantation. Although it may be applicable more generally, the complete lives system has been developed to justly allocate persistently scarce life-saving interventions. Hearts for transplant and influenza vaccines, unlike money, cannot be replaced or diverted to non-health goals; denying a heart to one person makes it available to another. Ultimately, the complete lives system does not create “classes of Untermenschen whose lives and well being are deemed not worth spending money on”,but rather empowers us to decide fairly whom to save when genuine scarcity makes saving everyone impossible.

You can read the complete document  … Principles for allocation of scarce medical interventions for youself.