Michael Scherer's Time Magazine hatchet job is nothing groundbreaking. It is unfortunately exactly the sort of thing Americans have come to expect from the media, and particularly from Time Magazine. It has the same blend of oozing sympathy for anyone associated with Obama and contemptuous disdain for anyone who disagrees with Obama. It is heavy on first person journalism, and spends more time discussing Ezekiel Emanuel's reaction to hearing that there are allegations against him, than actually stating the allegations. And of course it lies blatantly in defense of Ezekiel Emanuel, but that's a given these days, isn't it?
We get the tragically beleaguered Dr. Emanuel's reaction to the allegations;
Time: "You have the quality of your work and the integrity with which you do it," he said by phone from the Italian Alps. "If it requires canceling a week's long vacation, what's the big deal?"
Naturally most Americans will sympathize with Ezekiel Emanuel's great sacrifice in selflessly giving up his taxpayer funded vacation in the Italian Alps because he got caught with his eugenics down. At least most Americans who are highly paid writers for Time Magazine.
Time: Within days, the Post article, with selective and misleading quotes from Emanuel's 200 or so published academic papers, went viral.
The quotes are actually based primarily on three of Emanuel's articles, not 200. But here are the article's repeated statements that Ezekiel Emanuel's quotes are somehow distorted or taken out of context. Yet oddly enough Michael Scherer's article does not find time in between discussing such vital facts as Ezekiel Emanuel's favorite vacation spots, his feelings on the internet or putting scare quotes around any statement critical of Emanuel... to actually cite one of those Emanuel quotes verbatim. Which if those statements are as innocent as Scherer and Ezekiel claim they are, is a no brainer.
Michael Scherer does not bother interviewing a single critic of Ezekiel for balance. Instead he puts scare quotes while citing a few dramatic adjectives. He describes Mike Sola, the father of a son with cerebral palsy, who stood up at a Town Hall meeting as the product of hysteria.
Time: By Aug. 10, hysteria had begun to take over in places. Mike Sola, whose son has cerebral palsy, turned up at a Michigan town-hall meeting to shout out concerns about what he regarded as Obama and Emanuel's plans to deny treatment to their family. Later, in an interview on Fox News, Sola held up the Post article. "Every American needs to read this," he declared.
Scherer is cynically careful enough to avoid literally calling Sola hysterical, instead he formulates the phrasing in a way that gives that exact impression instead, piling cowardice on the already ugly act of smearing the parent of a disabled child whose one crime was to voice opposition to Obama's health care plan.
Then completely devoid of irony, Michael Scherer flashes back 8 years, completely ignoring everything Time Magazine had been writing during the Bush Administration to claim that;
Time: The attacks on Emanuel are a reminder that there is a narrow slice of Americans who not only don't trust government, but also have come to regard it as a dark conspirator in their lives.
Naturally Scherer is not referring to Code Pink or the ACLU or Paul Krugman, or the legion of liberal columnists and pundits who distrusted the Bush Administration and regarded it as a "dark conspirator".
For example there's the following bit of "paranoia" by a narrow slice of one American who viewed government as a dark conspirator.
The Next Worst Thing
Is the federal government's expansion of biodefense research paving the way for the bioweapons of the future?
The paranoid fellow who wrote that was Michael Scherer, of course that was back during the Bush Administration, when making up conspiracy theories about secret government conspiracies was cool. Now of course that the Dems are in power it means you're a dangerous extremist.
But maybe Michael Scherer could use the reminder that his "narrow slice" is not so narrow as he would like to pretend. It's something his former colleagues at Mother Jones magazine could tell him something about.
Finally though near the bottom of the article, Scherer gets around to addressing any of the specifics of the allegations against Ezekiel Emanuel.
Time: In her Post article, McCaughey paints the worst possible image of Emanuel, quoting him, for instance, endorsing age discrimination for health-care distribution, without mentioning that he was only addressing extreme cases like organ donation, where there is an absolute scarcity of resources.
Emanuel does use organ donation and flu pandemics as examples, but he is not speaking only of extreme cases. He also lists beds in intensive care units in his article introduction as an example. He is speaking of how to address medical resource shortages, which would be a reality under a national health care plan.
Emanuel also mentions dialysis machines and penicillin as other examples. He is clearly not discussing only organ donations or absolute scarcities. In fact based on Emanuel's own introductory words, he is saying that any number of medical resources may be considered scarce, even if they are available, because their cost would be better utilized somewhere else.
For some interventions, demand exceeds supply. For others, an increased supply would necessitate redirection of important resources, and allocation decisions would still be necessary
So ironically it is Michael Scherer who deliberately misrepresents Ezekiel Emanuel's views, in order to pretend that Emanuel is speaking about organ donations and only the most extreme situations in which there is no alternative but to ration. In fact Emanuel views even some available treatments as not worthwhile if they do not meet his criteria.
Time: She quotes him discussing the denial of care for people with dementia without revealing that Emanuel only mentioned dementia in a discussion of theoretical approaches, not an endorsement of a particular policy.
In fact the denial of care for dementia is mentioned in the conclusion of Ezekiel Emanuel's article. It is not treated as hypothetical in the sense that Emanuel mentions it without recommending it, instead he quite clearly treats it as one of those substantive practices that serve as an example of what we should be doing.
"This civic republican or deliberative democratic conception of the good provides both procedural and substantive insights for developing a just allocation of health care resources. Procedurally, it suggests 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."
Ezekiel Emanuel is clearly not citing this example as something he disagrees with. It is an approach he is recommending. For Michael Scherer to claim otherwise is a blatant lie.
Time: She notes that he has criticized medical culture for trying to do everything for a patient, "regardless of the cost or effects on others," without making clear that he was not speaking of lifesaving care but of treatments with little demonstrated value.
In fact that is not clear at all. In the JAMA article, "The Perfect Storm of Overutilization", Ezekiel Emanuel cites a number of factors in the high cost of US medical care. These include,
"the abundance of amenities. Hospital rooms in the United States offer more privacy, comfort, and auxiliary services than do hospital rooms in most other countries. US physicians' offices are typically more conveniently located and have parking nearby and more attractive waiting rooms."
... as well as overutilization itself. Ezekiel Emanuel defines overutilization as;
higher volumes, such as more office visits, hospitalizations, tests, procedures, and prescriptions than are appropriate or more costly specialists, tests, procedures, and prescriptions than are appropriate.
One of the causes he blames for this is physician culture;
Medical school education and postgraduate training emphasize thoroughness. When evaluating a patient, students, interns, and residents are trained to identify and praised for and graded on enumerating all possible diagnoses and tests that would confirm or exclude them... This mentality carries over into practice. Peer recognition goes to the most thorough and aggressive physicians. The prudent physician is not deemed particularly competent, but rather inadequate. This culture is further reinforced by a unique understanding of professional obligations, specifically, the Hippocratic Oath's admonition to "use my power to help the sick to the best of my ability and judgment" as an imperative to do everything for the patient regardless of cost or effect on others.
This paragraph above is the source of the quote. The discussion is not about treatments of limited value as Michael Scherer wrongly contends, but what Ezekiel Emanuel feels is doctors being too thorough in excluding possibly more serious but less likely conditions, rather than simply treating the patient in the most "prudent" and efficient" way.
For example then a patient who comes to see a doctor with blood in her urine, would be treated with antibiotics for an infection, and given an ultrasound. Ezekiel Emanuel would consider this a waste of medical resources from a too aggressive physician who is trying to rule out more dangerous conditions that the patient might have.
In thes sole paragraph in Michael Scherer's article dedicated to actually listing specific criticisms of Emanuel based loosely on his words, Scherer gets all 3 statements wrong. Which suggests that he either did not read Emanuel's articles, did not understand them, or deliberately misrepresented them. Either way it's a level of incompetence or deceit that a major publication would not have tolerated once upon a time.
Scherer concludes by giving us the heroic image of Ezekiel Emanuel passing up on a return trip to the Italian Alps, surely an image right up there with a crowd of slaves rising to proclaim, "I Am Spartacus".
Emanuel, for his part, plans to continue his work, which is focused on finding the most equitable and ethical way for this reform to be carried out, even if he has opted against returning from the Italian Alps. "I am an Emanuel," he says. "We are pretty thick-skinned. I am not going to change my colors. I am not going to crawl under a rock."
Yes it's hard to crawl under a rock, when the rock has been lifted up and you've been exposed to the light. It'll take a lot more than articles like Scherer's to pull that rock back over him again.