I’m loving following the war of words between Betsy McCaughey, the woman whose 1994 articles for the New Republic  nearly singlehandedly sunk Hillarycare, and the Washington Post’s  Obamacare-promoting editorial writers over Ezekiel Emanuel, the White House health-care advisor who thinks that babies, small children, and people over age 65 shouldn’t be “guaranteed” medical services once the government takes over health care.

That’s because McCaughey’s winning the debate!

Item No. #1: McCaughey (who also happens to be a former lieutenant governor of New York) in an Aug. 17 op-ed for the New York Post that quotes chapter and verse from Emanuel’s own articles for the Journal of American Medicine and the Lancet:

Emanuel wants doctors to look beyond the needs of their patients and consider social justice, such as whether the money could be better spent on somebody else.

Many doctors are horrified by this notion; they’ll tell you that a doctor’s job is to achieve social justice one patient at a time.

Emanuel, however, believes that “communitarianism” should guide decisions on who gets care. He says medical care should be reserved for the non-disabled, not given to those “who are irreversibly prevented from being or becoming participating citizens . . . An obvious example is not guaranteeing health services to patients with dementia” (JAMA, Feb. 27, 2008).

Translation: Don’t give much care to a grandmother with Parkinson’s or a child with cerebral palsy.

He explicitly defends discrimination against older patients: “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” (Lancet, Jan. 31).

Item No. #2: An unsigned Aug. 22 editorial in the Washington Post, pointing out that Emanuel is “a respected bioethicist who opposes euthanasia and physician-assisted suicide (the editorial also accuses McCaughey–and former Alaska Gov. Sarah Palin–of “cherry-picking” Emanuel’s writings to make him look unfeeling):

Dr. Emanuel struggled with the question of how to determine, in a system where everyone is guaranteed health coverage, what services patients are entitled to…In any event, Dr. Emanuel said he has since become convinced that there is enough waste in the health-care system that universal coveragecan be achieved without rationing….

Dr. Emanuel’s writings reveal him to be a thoughtful person grappling with difficult ethical issues. The same cannot be said of his critics, who seem less intent on discussing what is in the health reform proposal than in deploying scare tactics to defeat it.

Item No. #3: A second op-ed from McCaughey, this time for the Wall Street Journal on Aug. 26, that again uses Ezekiel’s own writings to refute the Washington Post’s breezy assertion that Ezekiel thinks that removing “waste” from the health care system will obviate the need for rationing:

As he wrote in the Feb. 27, 2008, issue of the Journal of the American Medical Association (JAMA): “Vague promises of savings from cutting waste, enhancing prevention and wellness, installing electronic medical records and improving quality of care are merely ‘lipstick’ cost control, more for show and public relations than for true change.”

True reform, he urges, must include redefining doctors’ ethical obligations. In the June 18, 2008, issue of JAMA, Dr. Emanuel blames the Hippocratic Oath for the “overuse” of medical care: “Medical school education and post graduate education emphasize thoroughness,” he writes. “This culture is further reinforced by a unique understanding of professional obligations, specifically the Hippocratic Oath’s admonition to ‘use my power to help the sick to the best of my ability and judgment’ as an imperative to do everything for the patient regardless of cost or effect on others.”

In numerous writings, Dr. Emanuel chastises physicians for thinking only about their own patient’s needs. He describes it as an intractable problem: “Patients were to receive whatever services they needed, regardless of its cost. Reasoning based on cost has been strenuously resisted; it violated the Hippocratic Oath, was associated with rationing, and derided as putting a price on life. . . . Indeed, many physicians were willing to lie to get patients what they needed from insurance companies that were trying to hold down costs.” (JAMA, May 16, 2007).

Of course, patients hope their doctors will have that single-minded devotion. But Dr. Emanuel believes doctors should serve two masters, the patient and society, and that medical students should be trained “to provide socially sustainable, cost-effective care.”…(JAMA, June 18, 2008).

Me, I’m rerelieved to learn from the Washington Post that Emanuel is against euthanasia–whew! I’m also happy to be assured that he’s a “thoughtful person” who really doesn’t hate kids and old folks all that much. But the idea of being treated by a doctor who thinks the Hippocratic Oath is archaic hooey and that his real patient isn’t me but, rather, “society” gives me the willies.

It’s also disturbing to know that Ezekiel sits on the Federal Panel on Comparative Effectiveness Research, a brand-new agency (its creation was sneaked into February’s stimulus bill) specifically designed to devise one-size-fits-all courses of medical treatment aimed at saving the government money once it takes over health care.

Remember that the backers of Obamacare expect to pay for it by cutting Medicare by $500 billion. As someone who’s not getting any younger, I’ll take Hippocrates over Dr. Ezekiel any day.