A news story from Great Britain highlights an essential flaw of socialized medicine and of our own, also highly collectivized system of medical care. Namely, that it results in having to choose between bankruptcy, to pay for unlimited medical care, or the government’s rationing of medical care, including its denial to people whose very life may depend on it.
Thus, a branch of Britain’s National Health Service was upheld by a judge of the country’s High Court in its refusal to pay for the expensive cancer drug required by a 54-year-old woman to extend her life, and who had brought suit to compel it to pay. The judge wrote that he found nothing “irrational” in the refusal to pay, which was based on the proposition that “`The primary care trust has to care for the whole population . . . . We have other people in our community who don’t have a strong voice, and we have to consider them.’”
This rationale and its acceptance by a judge is an illustration of what Ayn Rand, with good reason, used to describe contemptuously as a “collectivist stewpot.” Here is an individual, the cancer victim, who has been compelled to pay taxes all of her life to help finance the National Health Service and has thus been equivalently deprived of funds she might have used for her own medical care and who now cannot obtain medical care because the funds are required for others, whose need for her money is held to be more important than her own.
Such a situation is apparently all well and good as far as New York Times columnist Paul Krugman is concerned. Last December, in arguing for socialized medicine, he wrote: “Eventually, we’ll have to accept the fact that there’s no magic in the private sector, and that health care – including the decision about what treatment is provided – is a public responsibility.”
There is a different system: namely, that medical care is the responsibility of each individual and family, with the right to keep and use its own money for its own purposes and to choose the best it can find for its money.
This is the principle we follow with tremendous success in the purchase of food, clothing, automobiles, computers, and almost everything else. Its abandonment in medical care, and also in education, is the cause of the great and growing problems we are now experiencing in these areas. But more on this in future postings.
This article is copyright © 2006, by George Reisman. Permission is hereby granted to reproduce and distribute it electronically and in print, other than as part of a book and provided that the author’s web site www.capitalism.net is included. (Email notification is requested.) All other rights reserved.
{ 18 comments }
The statists in America really do believe that nationalized healthcare will not rationed by the government. They do truly believe that nationalized healthcare is a bottomless pot of gold.
They see the level of health care the free market provides, and assume that it would be maintained or increased once the system is grabbed by the government. How that is to come about is never explained. I’d guess they’re assuming that governments can allocate resources more efficiently than the private sector, which is actually a fairly common belief despite testing the boundary between stupidity and insanity.
No has ever seen “the level of health care the free market provides”. One can witness the level of health care provided by the current, extremely hampered health care market. The problem is the vast majority of people do not know or understand that there is a vast difference between government regulated “private” enterprise and truly free enterprise. Thus the ills of the health care system are placed squarely at the feet the “market” by the public, hence the cries for nationalized health care which people have been indoctrinated to believe must be better.
Let me play Devil’s advocate, as this is an interesting case if you look at it the right way.
The only argument I can think of for any government health-care would be based on the inalienable right to life. If Government can have any function, it would be to protect the defenseless innocent from harm. Ought we restrict the definition of harm to acts of force or fraud by others?
I’ll start with a clear case of state responsibility. Consider for example if you were jailed (even pending trial). Your guardians must provide you food and shelter and everything else to keep you alive. But what if you get a disease which is fatal? Do we then say we can let you die? While you are under arrest you can’t work or do other things to arrange for treatment.
The other case is the standard cabin-in-a-blizzard. Do you break in (violating property rights) and stay alive? If you think life is more important, you can. You should make restitution for anything damaged or used, but it wouldn’t be considered criminal in the same way a burglar breaking in would. So what if the blizzard is a fatal disease and the cabin is an expensive cure you cannot afford at the moment.
But the problem is that life is something like a resource. It will eventually be used up. I don’t know the statistics – in the UK, they spend a lot of money treating sniffles and other annoying but nonfatal problems which could be done completely in the private sector. That money is probably more than enough to cover the cases where life is actually threatened.
People also tend to act irrationally. If we knew when we were going to have automobile accidents, we would wait until the day before to buy insurance, but then the insurance companies would charge the full price of the car because all their customers would have immediate claims.
Insurers or even doctors would see someone with a potentially fatal disease as a bad risk so would refuse to insure or treat them. Also consider children born with obvious defects that require expensive treatment. Insurers would exclude (or charge unaffordable rates) for expensive diseases. Do we let all of them die? Even the libertarians here – absent the existing socialized insurance – could get a bankrupting health problem, or have someone they love get one.
A libertarian is a socialist who has been arrested.
A socialist is a libertarian who has caught an expensive and fatal disease when he doesn’t have health insurance to cover the required treatment.
Insurance only works if risks can be spread. The better medicine gets, the better it can calculate actual risks, and often the most debilitated patients have the highest risks.
The market is not good at handling such things. A demand curve for individuals that goes from zero to infinite in a moment.
Before we used to have charity hospitals. Many still bear the names as they were connected with churches. I would note that the shift to benefits (a WW2 distortion) managed to destroy most of the charity in the charity hospitals. I don’t think government should handle health care, but don’t forget that the earlier version was not a pure capitalist free-market solution, but a volunteer organization solution. The forgotten 3rd dimension of society. They also provided what we today call “welfare”.
In the 1920s and earlier, fraternal organizaitons provided insurance. The Knights of Columbus still have life insurance. And legislation might allow them to offer health insurance.
So the answer may be to look to neither government nor the market. It worked before.
tz,
You’re voluntary organization solution IS a pure free market solution. You’re so-called “3rd dimension of society” is not seperate from the market but is instead a subset of it. The defining characteristic of a market society is that all personal interactions/exchanges are conducted voluntarily. A free market solution simply means a voluntary solution.
Again it must be emphasized that a free society works to maximize all participants’ psychic revenue. The desire for psychic profit subsumes the desire for monetary profit. A monetary profit is sought on the market only to the extent that is in line with an actor’s desire for psychic gain.
TZ:
Your example of a person who can not afford treatment for a fatal disease is EXACTLY the same as the article. That is: There is no system that can provide all the care to everyone. So an amazingly complicated set of decisions must be made to ration the limited resources we have.
Liberterians maintain that a free market for ANY AND ALL goods and services provides the most equitable, moral(It is the ONLY MORAL means), rational, and widest distribution of goods and services because consumers have multiple suppliers and suppliers must compete with eachother to keep customers.
In your world as with the poor woman in England, the life and death decision was made by a judge. And to make matters worse, the same government that employs the judge also has stolen her resources, money, over the years and she has significantly less left to pay for her own care.
So to sum:
1. The government gives the supplier a patent to run a monopoly on the treatment raising the price the supplier can charge.
2. It steals her money to pay for other peoples treatments thus limiting her ability to pay.
3. It forces the supplier to lobby the government to get payment for the treatment which raises the costs to the supplier.
4. Finally, it denies her the treatment she needs.
WOW what a great deal!!!!
“A libertarian is a socialist who has been arrested.”
I have never been a socialist, and I resent the implication. I haven’t been arrested either, but that’s definitely the lesser libel of the two.
While the medical needs of a person may be such that he considers them to be life threatening if he does not get the treatment he feels necessary to prolong his life, the question becomes speculative if in getting this treatment it will but prolong his life for a few short months, for the disease has progressed to the point of being beyond any medical hope of recovery….The question then becomes: while his life is very important to him, of what use is there in spending money to prolong it with no hope at all of his recovery….From an ethical point of view everything possible should be done to give him a further chance at life; from a more pragmatic point of view, it would accomplish nothing, for his medical condition was beyond any hope of extending his life to any appreciable degree to make the expenditure of money on his behalf worth the cost… I am sure the High Court judge in the case involving: “A news story from Great Britain” had, somewhat, this idea in mind when he rejected the 54 year old woman’s case…
There’s a serious misconception about libertarian notion of property rights – the rights are not a libertarian fetish, as many opponents claim. They have no inherent sacral value.
There are cases when a principled libertarian may choose to aggressively violate somebody else’s rights – as long as he is prepared to personally bear both the burden of just compensation to the rights owner (and show the good will in resolving the resulting conflict), and the burden of community disapproval (if any).
For example, if I see a person drowing in the lake and a lifesaver stowed in somebody’s boat nearby I wouldn’t hesitate to “appropriate” it. Of course, then I’d be oblidged to buy a new one (if the used one was lost of damaged) and possibly compensate the owner for the inconvenience (of course, most people wouldn’t want any compensation in a case like that!)
The key words here is *personally bear*. Socialists claim to do the good deeds, but the costs are born by somebody else. Robin Hood, stealing from the rich and giving to the needy, is a villain, not a hero, precisely because he aims to gain social standing by shifting costs of doing so onto other people. And so do the proponents of the socialized medicine.
Robin Hood didn’t “steal from the rich and give to the needy”, he “stole” from the taxers and gave back to the taxed. The “stole from the rich” thing is just the modern socialist brainwashing version.
“The key words here is *personally bear*.”
That’s a good way to put it, Averros. It should also be noted that in this hypothetical life-and-death situations, the libertarian isn’t going to use violence to borrow the lifeboat. The socialist will happily hurt the real owner of the lifeboat if necessary, in addition to imposing the costs on someone else afterwards.
It seems to me, in view of Averros’ thinking, that in order to do good in this world — help someone who needs help — it becomes necessary to first value the help to be given against the cost of giving it, and then subjectively decide if the help is worth the effort, and the possible associated costs! It further seems, too many people take refuge in using labels to denigrate those who may be diametrically opposed in viewpoint, but such labelling usually comes from the confusion of mind that resents the discipline necessary to be thoughtful and logical in order to refute such contrarian opinions.
OK, compare the British medical ruling and public education. For a hundred years the vast majority of the public has mandated public education thru 12th grade financed by taxes. The public has not mandated a college education financed by taxes.
100 years ago most medical treatments made the patiente feel better but didn’t extend life. The public now needs to determine the govt’s (taxpayer’s) responsibility for extending life.
Or do you all feel that only monied people should have access to emergancy first aid?
–”Ought we restrict the definition of harm to acts of force or fraud by others?”
It appears noone has addressed this, so…
Yes. Politics is all about interpersonal interactions. As soon as you allow that government should protect people from reality you grant it limitless scope in the name of a contest that can not possibly be won by the government. At least, not until we meet the Episiarchs.
Considering this “right to life” thing. If it is true, then everyone has an equal “right to life”, right?
If everyone has a right to their own life, then it is wrong to force me to reduce my own life for the sake of someone else, exactly as it is wrong for me to use force on someone else to deprive them of their life.
Socialized medicine relies on economic and physical enslavement in order to function. Someone is taxed to pay for someone else’s care, someone is forced to provide care.
Voluntary interaction is positive sum. Everyone involved believes they benefit from the interaction. It requires government to create negative-sum interaction, where no matter how “noble” the outcome someone, usually many someones, are damaged in the process.
The public has not mandated a college education financed by taxes — The federal govt is a huge financier of college and trade schools and these funds extracted by taxes. The state directly or indirectly is the major funder of human capital in our society. I have a really tough time believing that people couldnt provide for themselves in a truly free market. Elimante prescription drug laws, the FDA and occupational licensure and then tell me if we need socialized medicine. The role of the state is to provide people with goods they could provide for themselves, were it not for state interference.
Let’s hear it for Curt Howland!!!!….His third paragraph has descibed perfectly our Medicare System…..If he is apposed to this system for its being of a “negative-sum interaction”, I just hope that when he goes on Social Security, he never has to avail himself of Medicare’s service!
As for Mr. Phillip Conti’s belief in a “free market” I hate to break this to him, but there is no such thing….We are all wage-slaves in one way or another, and nothing can obviate that; hence, there can be no free market….Choose as you will, you still have a living to make — and those whom you work for dictate your life style, so where is the free market in that? And this concept relates to all matters of a societal nature!
Dear John Rowe: I also hope I never have to use the Medicare system, but what you’re not mentioning is taht we’re all paying into it right now, and have been for years, and in many ways we’re forced into using the service or pay the high costs of medical care…which is caused by such things as Medicare and Medicaid!
Also, what you say about us all being “wage-slaves” is a very odd thing to say. From the beginning of time all life forms have had to work in some fashion to survive, by either hunting for food or gathering, trading with others for things they found valuable, etc. To say we’re all “wage-slaves” is rather silly, and just sounds like you may hate what you do for a living. It’s true that we all have to earn a living to survive, but I’m sure you will agree that we have much more humane, pleasant means by which to survive in this day and age versus many years ago.
Some things you say about being a “wage-slave” is flase, however. “..and those whom you for dictate your life style…” is simply not true. No one dictates your life style, that just amounts to you saying “I’m not in control of my life, someone else is!”. If you don’t like where you work you are free to work somewhere else. You are also free to learn any other skill, assuming you pay most of the time of course, and get into another line of work. You’re not forced to stay in that line of work due to this great freedom we have!
To say that you’re not in charge of your life and decision you make is simply not true. It IS true that there are forces which will react with decisions you make, such as learning a skill that the market has no need for, and then you can’t find a job for that skill. So yes, there are societal forces that direct you in certain directions, but you don’t have to go those directions or heed the warnings. You’re FREE. You may not get to do what you want and earn a living at it, but that’s just life.
Comments on this entry are closed.