Emanuel the doctor helping Obama deliver health care overhaul

White House Chief of Staff Rahm Emanuel once described his brother Zeke’s plan for health care overhaul in a single word: “wacko.”

President Barack Obama is more sanguine. He chose Zeke Emanuel as counselor to the budget director to help push for universal insurance coverage while lowering costs.

To advocate the president’s plan, Emanuel, a physician who treated patients at the Dana-Farber Cancer Institute and shaped policy at the National Institutes of Health, will have to keep some of his own ideas — notably a value-added tax to fund national health care — in check.

“I’m a very practical guy,” Emanuel, 51, said in an interview. “There are lots of ways you can achieve the same goal.”

Emanuel is the oldest of three brothers. The youngest is Ari, a Hollywood agent whose career was the inspiration for the HBO show “Entourage.”

Thursday, it will be Zeke, the lower-profile, higher- educated Emanuel, at the forefront when Obama convenes a White House summit on health care.

Emanuel wants everyone in the U.S. to be eligible for a voucher that could be exchanged for medical coverage, funded by the value-added tax. Insurers would be mandated to take all applicants, and people who wanted a more generous policy could pay extra.

His plan differs significantly from Obama’s. The president, in his budget last week, proposed setting aside $634 billion as a “down payment” toward universal coverage, building on the current system in part by expanding subsidies to make coverage more affordable.

After Harvard medical school, Emanuel had been an oncologist at Dana-Farber in Boston and found his ability to help only one patient at a time “incredibly frustrating.”

With his brother Rahm a key player in Bill Clinton’s White House, Dr. Emanuel arrived in the Washington area in 1996 to chair the newly created ethics department at the National Institutes of Health.

At the NIH in Bethesda, Emanuel focused on the ethics of conducting research and clinical trials as well as allocating medical resources — de facto rationing, he said.

Now his task is to help the Obama administration craft its national health care policy. But to that end, Emanuel promises to be flexible in his views.

“I’m not doctrinaire,” he said. Still, he doesn’t hesitate to offer candid advice to brother Rahm, 49.

“He bounces ideas off me and he can ask me questions and can trust the answers that he gets from me,” Zeke Emanuel said.

On the politics of health care reform, he defers to the kid brother.

“I’m related to an expert on it,” Zeke Emanuel said before bursting into laughter again. “And he’s said something about the political feasibility of his brother’s ideas — he thinks I’m wacko.”