I’m feeling a bit ill this morning. I’m not surprised, since I just read Malcolm Gladwell recent article advocating socialist medicine. Apparently, my husband should be sold into slavery so that a few idiots with rotting teeth can smile again.
I’m quite serious about socialist medicine meaning the enslavement of doctors. If our government ever voted itself control over our health care, doctors would not be permitted to practice medicine except under the terms dictated by government bureaucrats. My husband would be told what treatments he could offer, what equipment he could buy, what fees he could charge, which patients he can or must accept, and so on. If any of his patients wanted to pay him more for some safe and effective treatment unacceptable to the government, he could not offer it. (He would be exploiting their need!) If too many doctors refuse to work under those conditions — as I know Paul would — the government could follow the lead of Pennsylvania by requiring doctors to ask for permission to quit, retire, or move to another state. Of course, some doctors would welcome socialist medicine, but such happy slaves are still slaves.
Given the well-known disasters of socialist medicine — like ever-rising costs, long waits for diagnosis and treatment, substantial lags in technology, treatments not offered, and so on — for an intellectual to pretend that “universal health care” would simply extend our high standard of medical care to all is inexcusable.
Certainly, much is wrong with our current health care system. Yet all the serious, chronic problems are rooted in our decades of government intervention. The government has substantially distorted the market with its massive regulatory schemes and ever-expanding welfare programs. For example, the unprecedented use of employer-provided health insurance to cover normal, expected medical expenses is a direct consequence of government wage freezes during World War II. For example, since insurance companies determine their payments based upon the arbitrary fee schedule of Medicare, doctors are paid very poorly for reading those all-important mammograms, even though they assume a huge malpractice risk in doing so. The solution to these kinds of problems is to eliminate the source government intervention, not to increase it.
My mood was slightly improved upon re-reading Leonard Peikoff’s excellent essay “Health Care is Not a Right“. Altruism, collectivism, and statism drive the engine of change for socialist medicine — and so the battle must be fought in moral terms. Economic arguments about the practical effects of socialist medicine are a helpful adjunct, but by themselves, they lapse into absurd irrelevance.