Zeke Goes Off the Rails
Ezekiel Emanuel, Rahm’s brother and one of the key ObamaCare advisors, has been on quite a roll lately. Consider some of the headlines just from the past few weeks or so –
- “Insurance Companies as We Know Them Are About to Die” (New Republic)
- “In Health Care, Choice is Overrated” (The New York Times)
- “You Don’t Need a Doctor for Every Part of Your Health Care” (CNSNews write up of a Bill O’Reilly interview)
- “Inside the Making of ObamaCare” (Wall Street Journal)
- “Progress with Caveats: At least 12 million have received coverage directly through a provision of the law” (Wall Street Journal)
In every instance his message is that he knows better than you do what is good for you. He knows a better way to do insurance than you do, he knows that you don’t really need a choice of doctor or hospital, he knows that you don’t really need a doctor at all for most services, and he knows that “things are actually going well” for ObamaCare despite the fact that you and most Americans don’t like it.
One has to wonder what is going on with this guy. Why is he so confident in offending so many Americans? Either he is triumphant in the idea that what we think doesn’t matter anymore because Obama is firmly in control of our future, or he knows that ObamaCare is such a disaster that he can finally say any damned thing he wants because none of it will ever happen anyway.
In either case, he provides a fascinating window into the minds of the Leftist elite. What do we see in there?
Mostly we see an astonishing level of hubris and arrogance. We see an academic living in a world of dreams and “big ideas” divorced from both political realities and real-world practicalities. We also see an intellectual bubble of group think in which expressing a contrary opinion is seen as a betrayal, rather than a welcomed reality check.
In his telling of how ObamaCare came to be, he says he was pushing for bundled payments, at least for Medicare, as the panacea for controlling costs. We have written before about the limits of bundling but Zeke is not deterred. Unfortunately, he says he “hit a brick wall” because the people who actually run the Medicare program told him it wouldn’t work — “the Medicare bureaucracy wouldn’t budge.”
And this is how it goes in Zeke’s brain. The people who actually know what they are talking about irritate him by getting in the way of his pies-in-the-sky.
This hubris is evident in everything Zeke says or writes. He thinks existing insurance companies will be replaced by Accountable Care Organizations. Although these companies are “in their infancy,” in the next decade they will –
…succeed at integrating all the components of care and provide efficient, coordinated care. They will have the physician and hospital networks. They will have standardized, guideline-driven care plans for most major conditions and procedures to increase efficiency. They will have figured out how to harness their electronic medical records to better identify patients who will become sick and how to intervene early as well as how to care for the well-identified chronically ill so as to reduce costs.
How does he know this? Is there any evidence to support it? Well, no. What evidence is available shows quite the opposite, but Zeke won’t let that get in the way.
More recently, he pronounced that 12 million people have already gotten coverage due to ObamaCare. He cites the Gallup survey as showing that “the percentage of uninsured Americans declined from 18% in the middle of 2013 to 15.9% in the first quarter of 2014.” Yes, the Gallup survey does show that but what is curious about this survey is that the rate of uninsured soared from 16.3% in late 2012 to 18% in mid-2013. Either the survey is flawed or the anticipation of ObamaCare caused a whole lot of people to lose their coverage in 2013. In either case, the rate of uninsured has barely budged (from 16.3% to 15.9%) in a year.
More importantly, Zeke reports that 3.1 million young adults are now covered under their parent’s plan without mentioning that most of these were previously getting coverage from their employers, and that 4.5 million are newly eligible for Medicaid without mentioning how many actually enrolled and how many of those were previously covered, and the 5 million have selected a plan without mentioning how many have paid their premiums or how many of these got kicked out of their prior coverage thanks to ObamaCare.
So, now Zeke has gone well beyond just fantasizing to actually lying about the available data. And that is the ultimate lesson from the mind of Zeke Emmanuel and most other Leftists — when their dreams turn into garbage, they lie about the truth.
Or as Nancy Pelosi told us the other day –
It’s Affordable
It’s Affordable
It’s Affordable
It’s Affordable
It’s Affordable
It’s Affordable
It’s Affordable
As if repeating a lie enough times will make it true.
“In every instance his message is that he knows better than you do what is good for you.”
Zeke Emanuel: America’s nosy, know-it-all aunt.
Except my aunt makes me food
But she be in yo bizness.
Why does everyone keep using this 12 million number? I think it’s pretty obvious that it’s wrong, at this point.
12 million sounds better than 3 or 4 million and politics is all about appearances.
Still…you’d think the constant misrepresentation would make them uncomfortable at some point.
They’re politicians. It won’t.
As Jack Nicholson said:
“You can’t handle the truth.”
Who will actually investigate the truth? When the truth gets reported what percentage will change their mind.
Great blog post, Greg.A lot of good content.
I wrote about Zeke yesterday on my blog: http://www.thedisruptivedoctor.com. The article is titled, “All Zeke All the Time.
The media — both liberal and conservative — have given this guy way too much exposure, and he has not been challenged. Even Bill O’Reilly fumbled in his interview of Zeke.
Yes, the Wall Street Journal ran critical letters to his Review article, and again ran some critical letters today. But they should have run his original articles with accompanying critical articles to show that his views are challengeable as you and I have done. So, the mainstream national media are enabling Zeke, and he is grinning his way through every interview while patients and doctors are suffering from his ivory tower machinations.
Thanks Brant! I too have seen him on a lot of stuff, I look at it like Dr. Oz. Not much substance is being said, but people flock to the offbeat ideas he presents.
In his column Emanual admits: “I am neurotic.” He is a neurotic and a know-it-all that can’t see past his nose. If he actually believes the garbage he writes then he is borderline psychotic. Committed he is and one day when his fog clears he might need such commitment.
He just knows he’s getting paid
“More importantly, Zeke reports that 3.1 million young adults are now covered under their parent’s plan”
People are forced to! I am forced to be on my parents as well
Yeah that was a part of Obama’s first things in the white house, it’s like up to age 25
Trent – How are you forced to be on your parent’s insurance policy?
Do you mean you can not afford your own policy?
If that is the case then you are a beneficiary of Obamacare.
Most state laws for fully insured plans and self-insured ERISA plans already covered dependent children to age 26, depending upon state laws for the fully insured plans it could be 23-30. ObamaCare allowed coverage on parent’s plans even if they are married children who are no longer tax dependents or any other normal definition of dependent. They could be living in California, married and meditating in the middle of crystals, while parent is in Pennsylvania. Some call this the “slacker” feature. Most would agree with extending coverage to children up to 26 if a tax dependent (e.g. extended college due to student work program to pay for college) agree with this. The child should be a tax dependent…but Nooooo need to pass that test under ObamaCare.
This hubris is evident in everything Zeke says or writes.
Loved this. Can’t stand seeing him on TV.
I heard him in person on March 27, at a conference in DC. His new book is full of these utopian fantasies about co-ordinating care.
In his spoken remarks, he said (and I paraphrase): “I know, it did not work in the 1990s with managed care, even though everyone mouthed that it would. I mouthed it, too. But this time, we really mean it. This time, it will really work!”
About 89% of health care is paid for by third-parties; and half of all health care spending is paid for by government. That is primarily why we worry about how much health care is consumed and whether care is wasted through lack of coordination.
Regardless of political affiliation, nobody wants medical services to be wasted through redundant care. However, it is rather naïve to believe that if only we could get seniors’ doctors to talk to each other the world would be a better place. Most of wasted care that is paid for by Medicare is probably aggressive treatments either because physicians and hospitals want to boost revenue; or because seniors themselves want it. Moreover, patients themselves probably cause more unnecessary medical spending through non-adherence and poor lifestyles.
Ideas like care coordination and medical homes are well-meaning and good ideas. However, we should not reply for too much of our health care reform on them. Most things we do in medicine tend to cost money rather than save money. Managed care didn’t fail in the 1990s because is was bad. It failed only because patients didn’t like being told they couldn’t have care when they wanted it. If your goal is to ration care and only provide care that has higher efficacy, then managed are worked pretty well. It just wasn’t politically feasible given the expectations of the public.
“Ideas like care coordination and medical homes are well-meaning and good ideas. However…”
However, they are also almost 50 years old. Are you going to force everyone into HMOs this time?
@ Devon: While I agree with much of what you say, I strongly disagree that managed care failed in the 1990s because petulant patients and doctors didn’t like being told what to do. Having been an expert witness in several Kaiser death cases in Dallas, I saw first hand what happened to patients in managed care. You can see what happened in some of the cases in the ABC TV Nightline transcript from 2/13/98. And I was recruited by one of the staunchest conservatives in Texas who was upset that one of his closest friends died while under the care of Kaiser. Then, I saw first hand the results of a one year undercover investigation of the HMO industry that was never aired. Too bad you and the American people couldn’t see the difference between how a sick patient was treated by HMO doctors vs. fee-for-service doctors. And then my trial partner and I litigated the Smelik case against Humana and others to a multimillion dollar verdict in state district court in San Antonio in 2005. Please look at that trial transcript and all of the exhibits and see how benign managed care is. Managed care failed in the 1990s because it was bad. And it is still bad and now even richer and more powerful. This does not bode well for the American people.
“And he shall be called Emanuel”… or Zeke the Policy Geek. So much wishful thinking, while ignoring the evidence, sometimes distorting it. Not quite rigorous analyses.
Having said that, a challenge of sorts to Greg and Grace Marie Turner of the Galen Institute:
Grace seems to have turned into a one-lady campaign to repeal Obamacare. But that ain’t gonna happen. Greg consistently has pointed out the weaknesses and land mines in Obamacare and cited evidence of same, including the dreaded unintended consequences.
But since the ACA has been confirmed by the Supreme Court as the (health) law of the land, why not focus on how it can be modified to confirm to workable insurance concepts and meet legitimate needs? The Administration seems to TRY to do this on a daily basis. Why can’t those who claim to have better ideas do the same?
Let’s think real reform, using what’s available — not just a futile attempt at repealing an improvable law. It’s nice to stand on principle. But people will continue to become ill or injured and need to be treated, and providers will expect to be compensated… and yes, others will go uninsured and the cost of their care will be passed on.
As much as some critics decried Medicare and Medicaid upon their passage, we have managed to live with them…and some of those critics have been their major beneficiaries. Moreover, some hospitals have confided that some of Medicare’s regulations actually helped them to be more accountable, in the strict sense of the word.
Finally, the slam against managed care seems more mean spirited than than reasoned. Some HMOs have performed poorly but I wouldn’t characterize the whole movement as a failure. There are two many enrollees to justify that criticism. My family and I belong to Kaiser and we appreciate the physicians’ abilities to have immediate consultations, cross check medications,
have x ray and lab work done in the same building on the same day, etc. At the very least, managed care offers a competitive alternative to fee for service care.
Was Obamacare partially ill conceived, hastily prepared, rammed through Congress, passed “so you know what’s in it”? Absolutely, but you can’t undo history. Let’s work on the present and future.
Isn’t it interesting that the liberals didn’t take the same approach of modifying the previous system problems with reforms like: HSAs, high risk pools, cross state selling, and tort reform. Instead they decided to put government controls on 100% of the population when 85-90% of the population were happy with what they had. Solving the health access and affordability problems for 15% of the population didn’t require a 2700 page $3 trillion bill. The actual uninsured was closer to 3-5%, but when 3-5% lost their insurance under ObamaCare, the libs said it was a minor glitch.
Come on, it was NEVER about healthcare reform, it was always about redistribution of wealth and political power & control over voters. As the old saying goes, “You cannot change a sows ear into a purse.”
“1. Let’s think real reform, using what’s available — not just a futile attempt at repealing an improvable law.”
There are so many problems with PPACA that whether you fix them one at a time or all together, you are repealing it. We took the one-at-a-time approach to repeal here in Massachusetts with Romneycare and it was Chinese water torture (and is still not finished after 8 years).
2. “… some critics decried Medicare and Medicaid upon their passage, we have managed to live with them…”
As a 50-year Medicare contributor and 2-year Medicare user, having to depend on something that “we have managed to live with” is the problem. Most (over 80%) Medicare beneficiaries have multiple additional private or semi-private policies because you are happy with a system “we have managed to live with.” (Do you have some cushy retiree insurance you are counting on? Don’t!)
3. “… the slam against managed care seems more mean spirited than than reasoned.”
I assume you mean the attack on public Part C Medicare Advantage health plans by the Obama administration for the last five years and by the Democratic Party over the past 12 years. I’m confused. Your defense of Medicare Advantage does not seem to fit with the rest of your post.