Everyone agrees the key to improving health care is to get control of unsustainable rising costs. This can be done either through greater market competition and more choices for consumers, or through restricting choice and imposing ever-tighter government controls. The thousands of pages of legislation now under consideration in Washington, D.C. show Congress and the Administration are opting for the second approach. A look at who is advising the White House on health care should cause all Americans to be very worried about our health care future.

Dr. Ezekiel Emanuel, a medical doctor and brother of White House Chief of Staff Rahm Emanuel, is a senior advisor to the Administration, health care policy advisor at the Office of Management and Budget, and a member of the Federal Council on Comparative Effectiveness Research. Dr. Emanuel believes that physicians take the Hippocratic Oath too seriously and use it as “an imperative to do everything for the patient regardless of cost or effects on others.” His view of social justice, not care of individual patients, is the top priority for him.

He admits cost cuts will be painful and that “vague promises of savings from cutting waste, enhancing prevention and wellness, installing electronic medical records and improving quality are merely “lipstick” cost control, more for show and public relations than for true change.” He bluntly supports health care rationing “…allocation by age is not… discrimination. Even if 25 year olds receive priority over 65 year olds, everyone who is 65 now was previously 25.” In effect he is telling older people they had their chance to be 25, now they must forego some disease treatments in favor of younger Americans. This convoluted and coldly indifferent logic does not bode well for people receiving Medicare – all of whom are over 65.

Dr. Emanuel also believes that people in this country expect too much. “Hospital rooms in the U.S. offer more privacy… physicians’ offices are typically more conveniently located and have parking nearby and more attractive waiting rooms” compared to other countries. In his view reform means Americans, like Europeans, should accept a lower standard of care — all for the greater good, of course.

David Blumenthal, M.D., is another key health care advisor to the Administration and is now the National Coordinator of Health Information Technology. His heartless plan for controlling costs is to slow the search for new cures. He fully understands that this will reduce “availability of new and expensive treatments and devices,” but he believes it is “debatable” whether these innovations and timely care are worth the costs. Of course, the millions of patients whose lives have been saved or made better by new medical technology would undoubtedly disagree with this approach to health care cost containment.

He also predicts many doctors would object to “embedded clinical decision support,” which are code words for government computer programs telling physicians what to do. Yet despite potential doctor objections, the currently proposed health reform legislation in Washington, D.C. includes language that will ultimately require them to follow government “best practices.”

Drs. Emanuel and Blumenthal are not politicians who have to run for re-election. Consequently, they can be blunt and tell us honestly what the federal government is really thinking and planning. So we now have a clear picture of the government’s plan to control costs by rationing based on age and by stifling the discovery of new cures for disease. This is a callous and unfeeling vision of the potential future of American health care, and helps to explain the rapidly rising public opposition to the current reform plans.