Dienstag, August 11, 2009

History Repeats Once Again...

If you are aware of history, especially social history, you know that one of the more sinister developments of the 20th century was eugenics.

Simply put, this is the idea that you should breed people like pets, and winnow out the defectives. The Germans loved eugenics in their racial politics, but there was a significant eugenics movement in the US as well, which led, in part, to such horrible acts as forced sterilization of undesirables (at least 64 000 documented cases). The Swedes even maintained eugenics programs well into the 1970s. It was supported by Woodrow Wilson, amongst other prominent folks.

The most barbaric eugenics program, of course, was that of Germany. Here cost-benefit analysis was widely used and thousands of "deficients" were killed ("Aktion T4") because they cost too much to maintain, and between 1934 and 1937, 400 000 were forcibly sterilized as they were deemed unsuitable to have children. These eugenics programs led directly to the Holocaust, as the Germans saw this as the cleansing of Germany and Europe from the plague of the Jews and other "inferiors".

There were similar programs in China and Japan, as well as most industrialized countries.

After WW2, Eugenics was disgraced for what it is, racist "science", science based on the idea that the scientist is independent and capable of to determining, objectively, who was desirable and who wasn't. Put bluntly, no one is, especially not scientists.

So what happened to the eugenicists?

Basically, they went into hiding, as social biologists, situational ethicists and those advocating population control, including the environmentalists, and some of those promoting human bioengineering.

And now, of course, in the Obama health care reforms. History repeats itself.

Don't think so?

Look at this and tell me different. This is nothing less than the use of cost-benefit analysis to determine who gets medical care and who doesn't. Done by the main adviser to President Obama, the brother of his chief-of-staff.

Ezekiel. J. Emanuel. To quote from the Wikipedia page on him:

Ezekiel Emanuel wrote an article for The Hastings Center Report in 1996, in which he suggested that public deliberative forums should decide which health services should be socially guaranteed, and that those services "that ensure healthy future generations, ensure development of practical reasoning skills, and ensure full and active participation by citizens in public deliberations" might be considered by this deliberative body as "basic", while "services provided to individuals who are irreversibly prevented from being or becoming participating citizens are not basic and should not be guaranteed". He goes on to give examples illustrating these two concepts: "not guaranteeing health services to patients with dementia", while "guaranteeing neuropsychological services to ensure children with learning disabilities can read and learn to reason"

I've highlighted the two phrases which, for me, are thoroughly chilling. This opens the door to the determination, for instance, that a certain political thought is not "a practical reasoning skill", and that opposition to a program means that those who oppose such a plan are not participating citizens. We've seen enough examples of these kinds of thought processes in recent days, of political opponents being called un-American.

Further, there is something called "Complete Lives" which purports to use a prognosis - aka forecast - to determine how cost-effective care would be, not for the here and now, but rather for a possible future: those of the ages 15-40 will get the most care, those younger and older will not. It is rationing health care based on societal worth, nothing more, nothing less.

This is what we are getting, if the Obama Health Care reforms are rammed through Congress.

Lovely. History repeats itself once again. The bright shining light of reason, taken once again to the brink of madness, rationalized and well-argued the entire way, totally devoid of ethics (situational ethics aren't ethics: they're an intellectual excuse to do anything you damn well please to "because of the circumstances"), a return to the 1920s and 1930s complete with visions of racial purity and the ruthless repression of those who dare to think differently.

This time instead of killing the undesirable directly, the government will simply deny them medical care. Nicely deniable, that one: no one was killed by government decisions, instead they simply died. Of course, we do have the most nuanced President around...

Hat tip to both James Taranto and via him to William Jacobson of Legal Insurrection.

And as an aside: do those insisting that health care is a moral mandate realize, based on the above, that they will be cutting off health care to some of the homeless, namely those few individuals whose behavior - as drunks, as drug addicts, as psychologically challenged (aka "wackos") - cause a fair amount of non-paid expenses for hospitals and the like? It was found in Denver that a handful of people were the major drivers of hospital costs: homeless folks whose life styles brought them to the brink of death time and time again, whose hospital stays with hypothermia, collapsed lungs, serious pneumonia and the like cost, literally, tens of thousands of dollars with no hope of recompensation? That repeated every month or two, costing local hospitals literally millions? Or do emergency rooms no longer automatically treat anyone who comes in regardless of ability to pay, just on the need for emergency health care?

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