I graduated from med school in 1993. The class took the WHO pledge, and it was printed in our Graduation Program. I recited the Hippocratic Oath during this.
Emanuel is a provocative thinker, but I think we cannot totally exclude a democratic element to the type of decision making he decries. If he is advocating that MD’s should think about every expenditure and deny some people care so the money can be spent with more “bang for the buck”, why not ask the people SUPPLYING these bucks how they want them spent? He acts as though scarce resources belong to everybody.
The market will never go away. Ask yourself the following question: Doctor A will treat me and conscientiously deny care to me if he thinks the money is better spent on someone else. Doctor B will move heaven & earth, through hell & high water, to take care of me no matter what. Which one will you choose?
By the way: I’m a Doctor B kind of doc....
But this leaves the door open for bureaucrats who are influenced by political coercion or beliefs to decide what constitutes the most 'bang for the buck'. If this doesn't appear that probable at first glance, just consider how the medical profession was corrupted and distorted under past socialist regimes such as Naziism and Communism.