Here’s a LinkedIn profile I’d like to see: In a fantasy world where everyone is obligated to tell the truth, Dr. Ezekiel Emanuel’s top-of-the-page summary would read, “Professional medical ethicist. Served two American presidents by crafting intellectual framework and persuasive moral arguments in service of world-changing health care policy. Will craft bioethical philosophy and matching rhetoric to suit your needs!”
Emanuel, who some might remember from 2009 as a chief salesman for President Barack Obama’s Affordable Care Act, is back in the spotlight again with tuned-up public health priorities and a new Democratic politician to serve. In this round of public service, he’s a member of Joe Biden’s public health advisory committee. With the pandemic ongoing, and health policy and virus restrictions front and center in this election, Emanuel’s position within Biden’s team matters.
Emanuel Wants Another Lockdown
Although there is a growing scientific consensus that extended lockdowns have caused more harm than good and that they don’t even contain virus spread particularly well (see Sweden’s bell curve, for instance, which looks just like every other country’s bell curve), Emanuel’s main recommendation is a new lockdown.
“Until case numbers recede to a level at which we have the capacity to effectively test and trace … nonessential businesses and interstate travel should be closed; restaurant service should be limited to takeout. People should stay home, going out only to get food and medicine or to exercise and get fresh air. … Then, and only then, we can try a little more opening,” Emanuel said in a recent interview.
He would also throw in a nationwide mask mandate, indoors and outdoors, because our mask mandates heretofore have been “a hodgepodge.” True masking will only occur after deep cultural change, when masking is “normalized to the point that it’s abnormal to not wear a mask out in public,” Emanuel told McKinsey consulting.
Haven’t most of us been slogging through some rather extended lockdowns? Not good enough! says the zealous doctor. We’ve “never sort of stuck it out nationwide.”
In a peevish letter, addressed “to America’s decision-makers” on Sept. 30, Emanuel and his co-signatories want to know why “in many states, people can drink in bars, get a haircut, eat inside a restaurant, get a tattoo, get a massage, and do myriad other normal, pleasant, but non-essential activities.” In his insistence that we just didn’t do lockdown right, Emanuel sounds a bit like the old communists who frequent the coffee shops of the Upper West Side of Manhattan muttering about the real communism that never got its fair test.
‘Why I Hope to Die at 75’
By now you might be feeling a twinge of cognitive dissonance as you listen to Emanuel prattle on in defense of lockdowns, a policy that essentially cossets a small proportion of the population, the frail elderly, at the expense of everybody else, especially those in the workforce and preparing to enter it. Your sense of dissonance is due to the fact that this is exactly the population that Emanuel, the author of a chirpy 2014 Atlantic magazine piece titled “Why I Hope to Die at 75,” ruled more worthy than the over-75s, who were not asking whether their “consumption was worth their contribution.”
The stats are in, and Emanuel knows them. The majority of COVID-19 fatalities have occurred among the over-80s, with a very large percentage coming from nursing homes, where life expectancy, according to many studies, doesn’t go much beyond five months.
Furthermore, another cold-eyed policy man, epidemiologist Neil Ferguson, who is largely credited with putting the U.K. in lockdown, has mused that “as much as half or two-thirds of the [COVID-19] deaths we see” might have occurred by the end of 2020 anyway “because these are people at the end of their lives or have underlying conditions.”
Given his balance sheet-obsessed Obama era statements, you’d think Emanuel would be popping champagne over this news. The Obama-era Emanuel had sermonized that the 75-and-overs should “stop getting any regular preventive tests, screenings, or interventions.” Even antibiotics would be out, as he wrote in his famous Atlantic article. “Death from these infections is quick and relatively painless. So, no to antibiotics.”
“I will die when whatever comes first takes me,” the then-57-year-old promised cheerfully.
Emanuel Is the ‘Rationer in Chief’
Times and presidents — or would-be presidents — change, however. During Obama’s first term, Emanuel was part of a general full-court press among the intelligentsia to sell a centrally run system more like U.K.’s National Health Service, famous for rationing care by age and generally encouraging a stiff-upper-lip, go-home-and-stop-whining approach to public health.
With Obamacare struggling for passage in the Senate, “persuasive arguments for rationing medical care via the theory of the necessary ‘rational allocation of finite health care resources’ were needed,” as one professor of neurosurgery, Miguel A. Faria Jr., put it in a National Institutes of Health publication. “It is in this context that the individual-based, patient-oriented ethics of Hippocrates, including his fundamental dictum, ‘First Do No Harm,’ have to be supplanted by the utilitarian approach.”
Emanuel earned his reputation as “rationer in chief” when he wrote, “Other things being equal, we should always save five lives rather than one, but things are rarely equal.” Accordingly, a system he proposed “produces a priority curve on which individuals aged roughly 15 and 40 years get the most substantial chance, whereas the youngest and oldest people get chances that are attenuated.”
Emanuel conceded that his plan appeared to discriminate against the elderly but explained: “Unlike allocation by sex or race, allocation by age is not invidious discrimination. … Treating 65-year-olds differently because of stereotypes or falsehoods would be ageist; treating them differently because they have already had more life-years is not.”
Keeping You on Lockdown Is a Lucrative Business
Get the difference? If you don’t, it’s probably because you miss subtleties apparent to people like Emanuel, who got degrees in philosophy from Harvard University. To me, it looks like a reversal straight out of “1984,” on the order of “Oceania had always been at war with Eastasia.”
Emanuel’s priorities clearly lie with the Democratic Party, wherever it may roam ideologically, and with himself. Another reason the doctor seems so committed to the lockdown is that he’s now in the business via a newly formed company called COVID-19 Recovery Consulting, which helps “business reopen safely, responsibly, efficiently, and in compliance with the law.” In other words, it makes money helping people emerge from lockdowns — the same lockdowns Emanuel pushes.
Given the bombastic warnings of the “coming second wave,” warnings he helps generate, Emanuel will have plenty of work for a long time to come.