Saturday, May 12, 2012

Instead of Universal Health Care, How About Universal Health Care Freedom?

Winthrop C. Dillaway III, M.D., president of the New Jersey chapter of Physicians for a National Health Program, had a guest editorial in the NJ Star-Ledger recently. In his article, Dillaway called for "universal health care." His piece is aptly titled The power of universal health care.


I left the following comments:


zemack April 18, 2012 at 2:55PM

The first major flaw is in the first sentence: Mr. Dillaway notes that “In 2009…the U.S. health care system was painfully dysfunctional” without any analysis of the causes of that dysfunction. But that is where the conversation must begin.
Before ObamaCare, almost 90 % of healthcare spending was disconnected from the consumer of healthcare; either because of government programs or the third-party-payer insurance system coercively back-doored in through the tax code. Add to that the flood of mandates and regulations on private insurers, the banning of interstate competition among insurers, and many other government-imposed restrictions on healthcare freedom, and you have all of the problems—including runaway costs and the pre-existing conditions crisis—that make for the dysfunctionality Dillaway laments.
The solution is to roll back government interference in healthcare, not to reward the government with ever more control. And make no mistake; “universal health care” is a euphemism for totalitarian government-run healthcare. The title of the article is apt; “The Power of Universal Health Care” refers to political power—the power of physical force; of government bureaucrats dictating who gets what healthcare when and at what cost. 
Contrary to Dillaway’s glowing assessment of socialized medicine, the fact is when government bean counters “do…overall budgeting, accounting, overhead control and insurance risk-pooling,” the cost in actual human lives and suffering caused by the loss of freedom is horrendous and incalculable. Example:
Sentenced to death for being old: The NHS denies life-saving treatment to the elderly, as one man's chilling story reveals.
The moral solution is universal freedom for each individual patient, consumer, doctor, and so on to make his/her own decisions in a free market where the government protects individual rights. The government’s proper function is not to guarantee “universal” anything, but to guarantee the conditions of liberty that allow the spread of technological advancements—including in healthcare--to all sectors of the population.
To place everyone’s lives and careers at the mercy of a dictatorial “elite” in pursuit of the chimera of “universal healthcare”--because under freedom some small percentage may have to depend on voluntary charity--is unconscionable. 
I'm always amazed that there are doctors who would willingly place their judgments, knowledge, skills, and careers at the disposal of government bureaucrats.  Would you want to place your medical well-being in the hands of such a person?

The words of philosopher Leonard Peikoff came back to me as I read this article. Peikoff noted that under government-run medicine, a certain kind of doctor flourishes; what he calls "new bureaucratic doctors." 

The following refers to HMOs, which are government created, but is true of any government-imposed, top-down system of healthcare. Simply substitute "government" for HMO.

After discussing how doctors under government medicine must subordinate their practice and the well-being of their patients to the dictates of cost-cutting bureaucrats, Peikoff writes:

[T]he HMO doctor ultimately has to obey: he either keeps his costs within the dictated parameters, or he is out of work. 
What kinds of doctors are willing or eager to practice medicine undei [sic] these conditions? In large part, they represent a new breed, new at leasl [sic] in quantity. There is a generation of utterly unambitious young doctors growing up today, especially conspicuous in the HMOs, doctors who are the exact opposite of the old-fashioned physician in private practice—doctors who want to escape the responsibility of independent thought and judgment, and who are prepared to abandon the prospect of a large income or a private practice in order to achieve this end. These doctors do not mind the forfeit of their professional autonomy to the HMO administrator. They do not object to practicing routine, cut-rate medicine with faceless patients on an assembly-line basis—so long as they themselves can escape blame for any bad results and cover their own tracks. These are the new bureaucratic doctors, the MDs with the mentality, and the fundamental indifference to their job, of the typical post-office clerk.
Peikoff spoke those words in 1985. I do not know what kind of a doctor Dillaway is. Was he a member of the "generation of utterly unambitious young doctors" Peikoff identified? Whatever the case--his mawkish serenades to the "profound benefits to all" that supposedly accompanies government-run medicine aside--the question remains:  Would you want to place your medical well-being in the hands of a Dr. Dillaway?










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