The Other Emanuel

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THE SPINE FEBRUARY 17, 2009

The Other Emanuel

There are three Emanuel brothers. All of you know two of them. The first is Rahm, about whom I blogged even before the inauguration of Barack Obama, whom he serves as chief of staff. The second is Ari E. who you know not as the top man at Endeavor, the real Hollywood talent agency, but as the fictitious Ari Gold, the top man at the fictitious talent agency Entourage.

Both are friends of mine, and each is impressive in his own way. Very impressive.But the third brother, Exzekiel, really has gravitas. Zeke was an intern at TNR about a quarter century ago.  A graduate of Amherst College, he received a M.Sc, from Oxford. And then he was one of those scholarly legends who pursued two Harvard doctorates at once: A Ph.D. in political theory and an M.D., specializing in oncology.  Then he went on to teach in the faculty of arts and sciences (in the program that I used to run) and in the medical school, at once. No slouch, Zeke. Now, he is the chair of the department of bio-ethics at the National Institutes of Health. He has written for us from time to time recently.Just a few days ago he was dispatched to the White House to advise on new plans and proposals for comprehensive health care for all Americans, the big project interrupted by Tom Daschle's little tax transgressions. Zeke is an extraordinarily well-prepared for this task. Last year he published a book with Public Affairs press. It was called Healthcare, Guaranteed. I didn't read the book but I'd read some of the preparatory work for it. Last week it came out in paperback, and I spent last evening reading it.As when I first encountered Zeke's ideas, they are still illuminations. This is a proposal that has the virtue of comprehensibility and the attribute of being relevant and apt.  The key to it is a Value Added Tax (V.A.T.) of 10% on all goods and services (inevitable the big interests and small will try for exemptions) which would pay for it all.  There would be choice among health care providers, there would be standard--that is, mandatory--benefits, there would be dedicated funding. If you are rich or a medical care crank you can buy supplemental insurance. But basic health care would be available to all. It won't be cheap. About the same as it is now. The difference would be that fundamental medical care would not differ among the classes. Or, as Matthew Arnold said, "Choose equality and flee greed." Zeke's message. And Barack Obama's, too. 

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