I think it's a bit crass to call Dr. Emanuel's position raving. While his ideas may seem a bit Nietzschean, it does make sense. Where I 70 years old, I would much rather medical dollars be spent saving my grandchildren or daughter than my self. In a perfect world, everyone would have adequate medical care, but unfortunately more people want iPods than want to make this happen. Rather than discriminating based on wealth, it is more humane to allow those who have not lived a full life a chance.
The strength of the Dominion is that it is valuable in both a universal health care system, and a free market health care system, as both would strive to keep costs down.
It lowers health care costs in a broader scope than just it's purchase price. Making the machine portable and less expensive makes it more accessible to facilities other than hospitals, this will make diagnostics cheaper and more accessible, which in turn will lead to better preventative care. Treating a condition in the early stages is universally less expensive, and provides a better prognosis that treating it later.