One reason your insurance premiums have skyrocketed during the past year is that Obamacare requires all health plans to provide “free” annual wellness visits and 15 associated preventive services for which they cannot charge the patient a copayment. According to a key architect of PPACA, however, “the annual physical exam is basically worthless.” Dr. Ezekiel Emanuel, last heard from claiming that he wants to die at 75 in order to avoid becoming a burden on society, writes in the New York Times that “screening healthy people who have no complaints is a pretty ineffective way to improve people’s health.”
The good doctor says he’ll forego his annual exam pursuant to a desire to “make the world a better place.” But, as with his professed willingness to depart this vale of tears after three-quarters of a century, he makes it clear that all men and women of good will should follow his example “to ensure there is no doctor shortage as more Americans get health insurance.” This is where the rubber glove hits the road. Emanuel wants you to voluntarily give up a much-ballyhooed feature of Obamacare for which the “reform” law itself compels you to pay via new taxes and inflated health insurance premiums.
This is entirely consistent with Dr. Emanuel’s unique code of ethics. He is, for example, a long-time proponent of medical rationing for the elderly. Consequently, he probably doesn’t experience much cognitive dissonance when suggesting that, in order to forestall the physician shortage caused by a program he helped design, right-minded people should forego a “benefit” they were coerced to purchase. For him, this call for you to restrict your consumption of medical care is just another expression of his passion for rationing. The only thing new here is the exhortation for you to impose it on yourself.
All of which raises a question: If annual physicals are worthless, why did Dr. Emanuel and his accomplices build them into PPACA? Their clinical limitations have long been known, and the President was called out as early as 2008 on his claim that such preventive care would reduce health care expenditures. Nine months before he was elected, the New England Journal of Medicine reported, “Barack Obama has argued that ‘too little is spent on prevention and public health.’… Our findings suggest that the broad generalizations [about preventive care] made by many presidential candidates can be misleading.”
There isn’t the slightest possibility that Dr. Emanuel was ignorant of this fact, yet he enthusiastically helped to create a “reform” law that literally made it illegal to sell a health insurance policy which fails to cover all manner of preventive screenings, including the annual exam that he now tells us is worthless. And even as he was working with the White House to cobble Obamacare together, he was silent as the tomb while the very publication that ran his column last week claimed, “[B]y increasing just five preventive services, clinicians could save more than 100,000 lives per year.”
But, now that Obamacare has become law, the Times and Dr. Emanuel sing a different tune. The good doctor’s op-ed puts it thus: “Regardless of which screenings and tests were administered studies of annual health exams dating from 1963 to 1999 show that the annual physicals did not reduce mortality overall or for specific causes of death from cancer or heart disease.” Why, then, has Dr. Emanuel been such a consistent and vocal promoter of Obamacare? If he is a genuine opponent of useless and expensive preventive care, shouldn’t he be a critic of the law rather than one of its highest profile supporters?
Even if he lacked the power to stop the preventive care illusion from becoming an integral component of “reform,” he doesn’t have to promote PPACA like a carnival barker. Yet he has been one of Obamacare’s most vociferous defenders. Indeed, during the comically inept rollout of Healthcare.gov, he blamed Fox News for the widespread perception that it was a disaster. His unrelenting support for the health care law is about his passion for rationing. Obamacare offers the best chance, through IPAB and other mechanisms, of realizing this vision of centrally controlled allocation of medical resources.
And this commitment to health care rationing is also what inspired Dr. Emanuel to write an op-ed encouraging you to skip your annual physical. Such effusions, his claims to the contrary notwithstanding, are not about his personal choices. They are meant to convince you to self-ration. The regrettable necessity of working through a democratically elected Congress to pass Obamacare has evidently left too much individual choice in the law for Emanuel’s taste, so he wants you to feel guilty about using too much health care. He claims he will make this sacrifice himself as well, but talk is cheap.
The final paragraph of Emanuel’s editorial guilt trip contains the following exhortation: “[J]oin me in my new resolution: My medical routine won’t include an annual exam. That will free up countless hours of doctors’ time for patients who really do have a medical problem.” But the looming physician shortage this will ostensibly forestall has nothing to do with your annual physical. It’s an artifact of the perverse incentives Ezekiel Emanuel, Jonathan Gruber, and their White House masters built into PPACA. If Emanuel really wants to prevent a doctor shortage, he should call for the repeal of Obamacare.
