[Emanuel (Rahm’s brother) is special advisor to the director of the White House Office of Management and Budget for health policy. The excerpt below explicitly spells-out his beliefs that budgetary considerations create a need to draw a line between those who merit life support and life-enhancing medical treatment and those who don’t. The determining criteria is political, those who can be made into functioning citizens, capable of adding to the political dialogue, and those who cannot. Dementia (Alzheimer’s is “senile dementia”) patients should not be guaranteed basic health care.]
Ezekiel J. Emanuel – Hastings Center Report
“a need for citizens who are independent and responsibile and for public forums that present citizens with opportunities to enter into public deliberations on social policies. ..
the need for public forums to deliberate about which health services should be considered basic and should be
socially guaranteed. Substantively, it suggests services that promote the continuation of the polity-those that ensure healthy future generations, ensure development of practical reasoning skills, and ensure full and active participation by citizens in public deliberations-are to be socially guaranteed as basic.
Conversely, services provided to individuals who are irreversibly prevented from being or becoming participating citizens are not basic and should not be guaranteed. An obvious example is not guaranteeing health services to patients with dementia. A less obvious example is guaranteeing neuropsycho-logical services to ensure children with learning disabilities can read and learn to reason.”