YouSaid · the spoken record

Ezekiel Emanuel

lines on the record: 82
first: 2019-05-22
most recent: 2019-05-22
sittings or episodes: 1
sources: podcast

Every line below is reproduced as it was said and linked to the record it came from. Nothing here is summarised or generated. Directory · Search · Corrections

“Well, so yeah, I am finishing a book. Hopefully it'll be done in the next 10 weeks. I would say that there are two things that I would really like to do. One is we're working with a lot of players in the healthcare system to try to transform various parts of the healthcare system to dramatically increase the quality. I'm super excited about that. We're trying to work on getting the drug choices.”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“No, I still don't have a car, and I ride a bike and take public transportation. I do now have a house. I love houses. I love renovating houses. I have one cell phone because I don't work for the government, don't need multiple personal. And it's a personal cell phone, so no one can complain. I'm using public or even university funds on other things. But I tend on a personal level to have an ascetic element. I don't have fancy clothes. I don't, you know, have a lot of fancy furniture and stuff. But I do splurge on experiences because I think having good experiences and interesting experiences are what create a rich life. They're more memorable. I like the experience of eating food. I like the experience of meeting people. So that's where I spend my money. So you will not find me with a lot of material items, but you will find me.”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“Yas it is true, I think all of us learn from my mother that and from my father that part of our role in life is to do good. Sometimes you do good on an individual basis. I think my father was very much that. He's not a guy who does big policy issues. He did good. A family that had the fourth child who came to him was free. Every kid after three was free because he knew it was a burden to charge them. But he did good on a local level. My mom tended to be more of a community organizer and interested in public policy. And I think that's rubbed off certainly on me. And, you know, part of the job in this world is to make it better. And the easiest way to make it better for more people is through public policy.”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“I'm sure it did, but I hated him. Although I can still do all the positions ironically enough, but it also may, I mean, look, what did it do? My parents were very good about raising us and having us know what was right and defend what was right, even if the majority of people were against us. And so we would be made fun of because we took ballet lessons, but we defended that and we defended ourselves. And I think that idea that you didn't have to go with the flow, if there's anything that characterizes my brothers and myself, we don't go with conventional wisdom. We make our own judgment and we defend that.”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“I think actually having brothers living with the brothers, we slept in the same room for the first 10 years of my life, really, really important. Lots of negotiation, lots of challenge, lots of competition, but also lots of friendship. I talked to my brothers three, four times a week. I talked to my middle brother, Ram, the day before, which we trade back book recommendations, we trade back, we spend some vacations together. We're planning a big vacation to Antarctica. Having brothers is probably the smartest choice they made.”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“I can now do. There are two key steps in the flavor of dark chocolate. One is the fermenting process that happens at the farm, and there's no substitute for going to the farms and seeing how they ferment and making sure that they ferment and dry the cacao beans well. And then it's all in the roasting, like coffee. Lighter roast rather than darker roast. someone advertises dark roast coffee, you know they've burnt it to hell and it's probably not great you know the the new I think recognition is a lot more volatiles volatile organics are critical for great taste and that's the same thing in chocolate so when I made my chocolate we roasted for about seven minutes seven minutes and 40 seconds and that really allowed a very bold start and a very long tail which is what I try to get in my chocolates”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“Of these are very small manufacturers, and what they do is they source their own beans or make sure that their beans are really good. So my next chocolate, which I'm going to make in May, we're sourcing out of Ecuador. We're getting only Crio-Yo beans should be a phenomenally good chocolate.”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“So the most important tip is you need to get something between 70 and the high 70s. I would not go into the 80s and above. It's typically too much chocolate. The second thing is make sure you have, try to make sure if you can to get Crio-Yo beans and then make sure you've got the beans from the right country. And I also think that there are a series of manufacturers, I won't name all the great ones, that really have phenomenal, consistently make phenomenal chocolate. The place, the guy I do my chocolate with, Sean Ashkenozi, Ashkenosi chocolate, I think is fantastic consistently, a fruition in the Hudson Valley husband and wife team make great chocolate rogue out of Massachusetts. I really love his chocolates. There's a guy named, why am I blinking on it? Dick, he's from Eureka, California. Dick Taylor, great chocolate.”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“I will go. I actually think that there are a lot of great homemade jams. It's funny this morning we were eating jam that we had brought back from San Francisco, from the ferry building farmers market. It was outrageously expensive jam, like $17 a jar, phenomenally good apricot jam. I like to make jams. This year we're sort of, I think our goal is to try to get apricots to make jam. We hope it's a good apricot season. And blackberries. I have not made blackberry jam yet. I have made a very good raspberry jam, and I like that a lot. But we're going to try Blackberries and apricots this year.”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“So I think it's always surprised me, I mean, Washington, D.C. is another place where the great ethnic restaurants are not in D.C. And you have to ask yourself.”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“Well, what I suspect is that it's the cost of rents and the cost of the fact that it's not 12 months a year. But I have often been surprised by the fact that there are various places in the country, high concentrations of wealth where there aren't great restaurants. Silicon Valley is a very good example. San Francisco's got great restaurants, but Silicon Valley itself, where there's gazillion dollars sitting there, not great restaurants.”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“I think it's got to be the supply side because it can't be the demand side because there's more money than God in Aspen, Colorado. And I suspect that the problem is...”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“So like you, Tyler, I like food and I like good restaurants and I am always surprised by the fact that Aspen, Colorado, which has the richest people in the world coming there. The restaurants are not the best in the country.”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“No, I don't know that we're quite well. I am surprised by how wise the people who've been doing this for a long time are, and we tend to have a longer investment horizon. 10 years is the length of our investment horizon typically. And so we do a lot of incubating of firms. And I do think once we've proven things, we've proven models can improve, bigger companies come in and want to adopt those and scale them. And I do think generating these new ideas, getting really smart people to come into this space has actually dramatically improved ideas, again, in what had traditionally been backwaters, but we're now recognizing are critical for improving the healthcare delivery system.”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“No, I'm not wildly optimistic about venture capital in the biotech space. I'm wildly optimistic about venture capital in the non-biotech non-device spent. Where, for instance? Well, I work for a venture capital firm, Oak HCFT, and we are investing, we've made lots of investment and actually I think catalyzed areas that have long been ignored by the healthcare system, primary care, mental health care, end-of-life care, social determinants of health. The medical system has long ignored those, and we have invested in small companies that we're hoping are going to transform these areas and develop solutions that are scalable beyond them. But are those rapidly?”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“I'm not an expert in the Singaporean healthcare system, but what you can do in Singapore with four million people in an authoritarian regime is not what you can do in the United States with 325 million people. They do lots of things differently than we do that we could never import. One of the things I like that they do that we could never get here is they pay their government officials a lot of money because they want the absolute best people in government. They don't denigrate their government the way we tend to denigrate our government and regulation. And that's one reason we probably will never get the Singaporean system. And I'm not even sure it's worth studying that carefully for how to import it here.”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“Just say you're sorry, identify problems, offer a standard payment back for identified problems that are admitted to be problems people can still sue, but it leads to much quicker resolution and much more focus on improving the quality of the system as opposed to hiding problems.”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“I think it's smaller than the doxay and smaller than a lot of conservatives say. We know that it's not going to lower healthcare costs, but it's important first, it doesn't serve anyone's interest except the plaintiff's lawyers. It doesn't serve the interests of patients. It doesn't serve the interests of doctors. It doesn't serve interests of the healthcare system. And it's too easy an excuse for doctors in the healthcare system to blame malpractice for not doing the right thing. And I think changing malpractice reform would be effective. I don't like the general conservative approach, which is limit the length of time people can file suits, limit the amount that people can get for non-economic damages, those turn out not to be good reforms. I do think moving to things like either safe harbors where if a doctor followed the protocols, they are presumed, it's a rebuttable presumption to not be guilty or have what they pioneered at the University of Michigan.”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“years you're going to see them do better and one major reason is that employers have said basically enough is enough now cost is at our limit and we want you to be better about cost control and I think that's risen to number one as opposed to just rhetorically number one I think actually it's risen pretty much to number one”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“Many reasons One reason is they typically make money on the percentage of transactions they do, so that's an incentive to actually increase costs. Second, they typically have a small market share in any particular region, and that undermines their bargaining power in that region. Third, a lot of employers want different kinds of benefit packages, and that actually, again, undermines their ability to negotiate hard. Most big employers want to satisfy their workers. You know, human resource departments, their number one obligation is typically not to keep health care costs down, but to keep fetching down, keep down the complaints of workers. The easiest way to do that is have a wide network of hospitals, wide network of doctors that drives costs up and handcuffs the insurer in terms of their negotiating power. Nonetheless, I think they could do better than they are doing. And I do think over the next few years,”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“Yeah, we need more antitrust enforcement. Absolutely. And if we're not going to get the antitrust enforcement, we need to put a cap on what hospitals can charge private insurance. Right now, if hospitals create local monopolies where local can be pretty big, they can take a lot of money from private insurers who have to negotiate with them and have to keep them in their network if they've got a local monopoly. And that drives up the cost for all of us. So capping that, how much they can charge if we cannot get effective antitrust is really important.”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“I don't think there's any drug I can think of where $3,000 would give you a guaranteed one year. I don't understand that calculation.”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“That's 1 over eighty, that's one point two percent of your life for 10% of your dollars. That's not a good ratio. Many other things you could spend it on”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“I don't know. Most students can't afford $3K a year, and I think that's a year of life. Remember, so there are two problems here. What's the right amount to spend on drugs? And that extra year of life when you're 80 going to 81, is that really that valuable to you? If I got that extra year, if I had, you know, instead of 10 years in my 30s, if I had 11 years in my 30s, that's a different story. And $3,000. So the average, I think you have to put it in context. Part of my thinking is you have to put in context into someone's entire life and how much money they have in their entire life. The average person American with a BA, average male with a BA, women make less, but the average male with a BA, their entire lifetime earnings about $2.2 million. Now, $3,000 a year for 70 years, about $200,000. So it's 10% of all their lifetime earnings for an extra year. That just doesn't seem to me to be a good ratio. So it's one extra year.”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“Not that I know. Oh, well, maybe Mash. I like Mash. I don't know if that's a truly good movie about healthcare. It's about a lot of things, but it's got a healthcare component. Let's put it that way.”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“Some like it hot. It's a fantastic movie from 59, black and white. It's great comedy. Got Marilyn Monroe in it. It's got this fantastic element of cross-dressing, transgender, homosexuality in it. 1959. Perfectly accepted. It's an amazing movie and it's so funny. It's fantastic. It's great. There are many other great movies, don't get me wrong. But if I had stranded on a desert island, a movie I could see over and over again, some like it hot.”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“My parents, which is what I tried to do, had a very good combination of free range. Let the kids out, but also very good limits. We knew what was right and what was wrong. We knew that we had to defend what was right and what was wrong. And we had a lot of restrictions on what we could do and could not do. But we were also given a lot of responsibility and allowed to explore and allowed to make mistakes. I wouldn't have called our raising free range, actually. So maybe I'm misunderstanding your notion. No, no, but I think limits, kids like limits. They like to know what the limits are. And I think having limits, you have freedom within limits. So I'll just give you an indication of what we did for my kids, which is your room, your castle. You want it piggy. You can have it piggy. That's fine by me. I'm not a common space. You have to keep it clean because it's common with everyone else and you're living with other people. I don't consider that.”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“I actually am not a big free-range children fan. I think it's overrated. I think children need limits. Children need restrictions. They do need certain kinds of freedom within limits to be creative. But I think the entire idea of free-range children probably overrated it.”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“No one knows who Spencer Waller is. Spencer Waller was my Bet Noir during school. He's a great friend during my first five grades of school at Anchay Emmett in Chicago. But he always, so if I got a B, Spencer got a B plus or an A minus. If I got an A, Spencer got an A plus and he kept me running. He was a great kid. He's now actually a health law professor at Lyola. So it's always good to have a Spencer Waller in your life.”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“Probably underrated ought to be overrated. I would say. So I grew up in the 60s, and my father, who grew up in Israel and then went to Switzerland for medical school, always thought travel was great. We were not very rich when we grew up. He was struggling newly immigrated doctor to the United States. But my father saved all sorts of money. We had holy pants. We used to go to school and holy pants before holy pants were fashionable, but he would save money for international travel in the 60s. Most of our rich friends, they went to Florida, but we would go and very cheap trips to Europe, very cheap trips to Israel because he always thought going and experiencing other cultures increases your empathy, increases your understanding of the complexity of the world, different cultures. It's very important to do. Not important to go to the heavily touristed Paris, London, but I think other places like Alison.”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“Probably overrated as an exotic place. Why is that? I went there. It's not that I was not impressed that beautiful. A lot of the lemurs is interesting to watch them, but you can see much better wildlife in many other parts of Africa. The infrastructure, I mean, just the life of people, they're very warm, but I've been to many other parts of Africa that I would rate way over it, places that are not necessarily highly recognized like Mali, I found one of the most amazing places. People are incredibly warm, mud mosques that you can see, the Dogon villages that are just truly amazing, lots of cultural residents that you just don't find in Madagascar.”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“Oh fantastic for kayaking. I've kayaked there. I love it. It is one of the great places, although not the best places in Norway for food.”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“Yes, so he was critical to the revolution. He's the guy who actually organized Paul Revere's ride. He's the guy who organized a lot of the revolt in Boston. Now, Sam Adams gets a lot of attention in Sam Adams as a rabble rouser, but Joseph Warden was the guy who organized it all, who made it coherent, who had an objective. He was president or head of almost every one of those committees that they established, the committee of correspondence, this and that. And he unfortunately was prematurely. He should not have done this. He ran to the Battle of Bunker Hill when it was in process.”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“Oh, totally underrated. You do know you've read a lot. So no one who's listening to this podcast knows who Joseph Warren is. I'm willing to bet that.”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“I do think it's probably plausibly possible. I think we're going to figure out what elements are for immortality. Now, whether that's good immortality in the sense that the body's going to be able to work well, you know, my brother, who is not a doctor, but a Hollywood agent, had a very insightful comment to me recently, is like, you know, we're going to be able to replace my heart, my lungs, everything. But damn it, that cartilage, you know, my back pain. Can't you doctors cure back pain at the common cold? You can't do any of this simple stuff. And so living a long time with a lot of back pain, that just doesn't seem like a great life.”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“They don't play very well. The ultimate excuse. What's wrong with drawing? Yeah, but why is that, Tyler? We revere Shakespeare. Not because of the just sitting there in the drama, because he makes us think about the bigger things in life and the kinds of characters we want to be and the kinds of characters we don't want to be. That's the point. But, you know, if you're at 80, there's no more character building. Your character's sack. You're not changing your character. At 80, who changes their character at 80?”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“People forgotten. You ask people, Richard Nixon, they have the vaguest memory tricky dick. They can't really tell you very much. Even Ronald Reagan, even Bill Clinton, much less you ask them, Bill Russell. No idea who Bill Russell is. Oscar Robertson. No idea who Oscar Robertson is. These were my heroes. I mean, these are like phenomenal basket. The people who made modern basketball. No idea. So this idea, you're absolutely right. We coneded down lower and lower the parts of what will make us satisfied. And we have to step back and realize those are pretty trivial. The NBA finals, the final four? Tyler, who was in the final four five years ago?”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“Can you talk to me out of that? Tyler, I think you're exactly right. That's why people do hang on. It's because, you know, so I talked to my father who, you know, he says, Zeke, you're absolutely right. I've become slower, physically slower, mentally slower. You know, my life, what ends up happening is your life cones down and you begin to overvalue certain small things like the NBA finals. Like what's in the Muller report? We all know from any cosmic standpoint, even not a cosmic standpoint, just a 2,000 foot standpoint. Most of those things are not irrelevant. It's really cool to know. You often ask, you know, this happens to me all the time. I teach undergraduates, pretty smart undergraduates, very smart undergraduates. MBA students, nurses, doctors, right? They have no understanding of history. So whoever finishes in the MBA final in five years.”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“Who do new things after 75 and really knew things, it's very small. And I think that there's a neurological reason for that. It's not just the physical body, it's also the brain and the ability to think new things, be creative, and not just be ho-hum. Even so I'm in the midst of doing a lot of reading about Benjamin Franklin. One of the probably the most creative person born on the North American continent in the 450 years we've been around, constantly new. And yet if you look past 75 slows down, yes, he does do his autobiography in his 80s and stuff. But even he recognizes that the mental abilities, the ability to focus in on science and make new discoveries went way down. So it's very hard for us. So I think, yes, we could do new things, have new experiences, but would we be new and creative? I doubt it.”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“I agree. The shadow value of more time. On the other hand, I do think we get, and I am a person who tries to do something pretty radically new every year, about four years ago, I made this play more than that, five years ago. I made this pledge that every year I tried to do something really out of the box for myself. So I was a chef. I've made chocolates. I've taken up pretty not terribly long distance, but very serious bicycle riding. But nonetheless, I do think our brains, and again, this is a general comment. There are some outliers, you know, there's natural selection among our neurons, the parts we use over and over again get very well done. The parts we don't use tend to die off, and it's very hard to keep that plasticity over time and to do new things and to be new and curious. If you look at the number of people who are creative after.”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“Tend to make a lot of mistakes. We're not necessarily the wise judge. I'll give you another good example. Just go to any airport, go any place where people collect with kids and watch the American Academy of Pediatrics. There's almost no one who thinks a lot of screen time, especially for young kids, is a good thing. What do you see throughout?”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“Another bit overemphasize IQ. They'll overemphasize physical prowess. We already have that. What's the biggest thing in kids' high school, right? Sports, right? Is that really the thing that ought to be the most important thing in a high school? No, we tend to celebrate in the United States sports. I remember going to Africa for the first time and happened to be in a country where the national exams, they had national exams were done. The whole first six pages of the paper were the people who did really well in national exams. Go and try to figure out some American town where that's, you know, they're going to list on page one the top 10 kids in all the local high schools. We don't do that. We do, you know, Friday night lights and football games instead. So that's what we emphasize is that what we really want with genetic engineering are going to be better football players. Seems to me we...”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“We've gotten here. We've gotten here over millions of years of evolution. Now we have been evolved for certain environments, which we don't necessarily have today, but I'm not sure we're wiser than evolution”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“Again, this goes back to, I think, emphasize, you know, typically it's a parental choice. We permit parents to have lots of choices over their kids. But having a few people make choices inevitably affects all the rest of us in all sorts of ways. And I don't think this is a way, I do think this is a very good place to draw a line. And I don't think we've had a very good national educated national discussion about what it would mean to enhance children or not enhance children. And I think we have to have that kind of discussion before we go forward. I'm no big fan of it in part because I don't think we're wise enough to figure out what's good and we are very likely to overemphasize the wrong thing. As I said, we tend to overemphasize certain values and ignore other values. We do this individually and we do this collectively. A big fan”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“You can't tell what's in those nutritional supplements, and they're often adulterated. And that's not a good place to be.”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“I guess you do have that right. But what's the difference? Because it's the possibly more violence. And in the case of drugs, that is a lot more violence and bad things that are going to happen. And we've seen that. And I do not want to go back to snake oil salesmen where everyone's got a concoction. And we have seen in the case of nutritional supplements that thank, and this is sarcastic, to the Utah delegation where a lot of nutritional supplements are made that they removed FDA oversight. There's been a lot of deaths on nutritional supplements when they don't regulate them. And I don't think that's a good thing.”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“Go to Tahiti. It's really not this institutional structure we want. And we know that because thalidomide, lots of drugs that have, unfortunately, I think the FDA has swung to approving drugs that have risks and either low or in some cases they've even approved drugs with no benefits. And I think that's a mistake. We have to get to better approval. We have created a process of compassionate use where people where if a drug's been proven relatively safe, not completely safe, relatively safe, patients can solicit to get it without, I think before it's been finally approved. I don't actually, I'm not a big fan of that.”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“You're already talking about we need a high trust society where we can really rely on things. And so we don't have to examine individually every time every item, even to make the informed consent process go well. And then you say, let's get the FDA out of here because I should be able to do whatever the hell I want with my body. We all need to rely on the fact that the medicines we take are proven safe and proven effective, and we have to have institutional structures to oversee that. Some individuals may be able to do it, but we have a society of 325 million people, and we have these institutional structures to oversee what we're taking as safe and effective for all of us, not just for the lone individual who's got a lot of money who says, I want to do it, damn you all. You want to do it, damn us all. You've got enough money, you know.”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“and certainly no responsibility for the IRB in terms of confidentiality. That's someone else's, you know, some other arrangement. I think that's very important. Also, we shouldn't have IRBs at each institution. I think the whole notion of IRB, institutional review board is a mistake. If there's a protocol that's being run at hundreds of institutions, which is quite common, we should not have each institution reviewing it. It's the same risk-benefit ratio. It's the same group of people one body can interview it, and that's much more efficient. And efficiency is also important because delaying protocols by a year wastes a lot of money, time, and for no benefit.”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source
“They should have different powers and they should emphasize different things. One of the problems is you go to an IRB and they, or their almost entire focus on what's in the informed consent document. That's wrong. And I've written extensively about there's an orderly process for thinking about the ethics of research and informed consent is at the bottom of the process. There are many things you need to consider, and I think the number one thing that needs to be considered is really risk-benefit ratio of a research protocol. It's the hardest thing for individuals to understand who aren't experts, and it's really where the focus should be. And if you put the focus on risks and benefits, some things that IRBs often object to may turn out not to be really that problematic, and some things that IRBs don't object to enough, they turn out to be really problematic. And so I think more emphasis on risk-benefit ratio and less emphasis on informed consent.”
2019-05-22 · Conversations with Tyler · Ezekiel Emanuel on the Practice of Medicine, Policy, and Life · IDENTIFIED FROM THE TRANSCRIPT · source