Mr. Johnson is a teacher at Hialeah Senior High School in Florida.
After School recently, a student posed an interesting question. His father was deceased, and he and his mother were living on a small income of which social security constituted a substantial portion. His mother had recently undergone an expensive operation, and it had been tough to pay the bills. His question was: "Why shouldn’t I favor government medical assistance?"
Other obligations prevented me from answering immediately, but the next morning the student received the following 17 points:
1. To the extent that your mother is living on social security she is already the victim of an actuarially unsound program classified by many as an outright fraud. A large part of your difficulty in meeting bills is the product of this government program designed to "help the aged." You may be sure that a government program designed to "help the sick" would fare no better, and probably worse. People do better if they are charged with personal responsibility for their welfare.
2. Social security payments are reduced or eliminated if your mother earns over $1,200 per year. This particular inequity within the entire inequitable program should be remedied, yet the problems posed by any attempt at "equity" tend to point up the undesirability of seeking "solutions" on a national basis.
3. Your mother’s income is undoubtedly suffering from inflation, which is the result of prior government activity. Please, therefore, do not ask for more government programs. Inflation raises the cost of everything, medical services and supplies included, and such "hidden taxation" affects all income, taxable and nontaxable.
4. If you ask the government to force others (through taxes) to help you in your particular situation, you cannot expect others not to ask government to force you to help them. In all probability you will end by paying out much more than you will receive through this process.
5. Assuming genuine need, private charities and local agencies would be willing and able to do considerably more along lines of aiding you if taxes were not already markedly diminishing their ability and inclination to function. The high progressive rate also tends to discourage many would-be doctors, whose terrific initial educational investment should be allowed to pay off. To the extent that a doctor shortage exists, government must share a substantial portion of the blame. My own dentist has cut his work-week from five days to four because, in the words of his financial adviser, he was "working too many days for the government." Do not, therefore, add to this tax burden.
6. Even assuming that the taxes required to run a program of government medicine might aid your mother in the short run, such taxation would also put more people into her shoes.
7. Government bidding for medical services and supplies would increase costs. Great Britain‘s program has slightly more than tripled such costs. If you are serious in your alarm over high costs, you will resist a government program strongly.
8. Since the program would be designed to help millions of others, and not your mother alone, competition for supplies and services, in addition to raising costs, might make it difficult to obtain any at all. A shortage of goods and services would immediately occur if the government were to attempt to mitigate the effects of its own actions through price controls. Priority given to more serious cases would frustrate immediate treatment of minor cases. A man who could be "back on the job" in minutes might have to wait weeks, with resulting loss of production to himself and to society.
9. A program of socialized medicine, once begun, would be extremely difficult, politically, to abandon, no matter how mistaken the program should prove to be.
10. The vast majority of doctors do not like socialized medicine. The reasons they give—dislike of regimentation, the destruction of doctor-patient relationship, and the like—while important in themselves, are secondary to the inescapable conclusion. If the government seeks to accomplish by force something that would not occur voluntarily and institutes a program which doctors dislike, the result will be fewer, and poorer, doctors. We hardly want this situation.
11. The temptation to "get something for nothing" would prove irresistible for many people. Statistics contrasting the number and length of illnesses of those who have government health insurance (in Great Britain and elsewhere) with those who have private insurance (in the U.S. and elsewhere) provide amusing proof of this. A large portion of government expenditure would go to those whose needs are questionable. This, also, would increase costs. Lack of local administration and responsibility might frequently deny sufficient benefits to those whose needs are genuine.’
12. Socialized medicine would be another long step to total socialism. Socialism, whatever else it may do, hardly increases production. By its emphasis on distribution, it retards production in a thousand ways. This will lower the standard of living for everyone, your mother included.
13. The functions of medicine are basically twofold: administration of known drugs and techniques, and research. We come in contact with the profession through the former, but progress occurs only through the latter.’ Socialized medicine would cause a shifting of emphasis from research to general upkeep, with the result that over-all medical progress would be retarded. The British experience proves this beyond question.
14. Since the science of medicine under free enterprise in the United States has given us the best medical service in the world’s history; since it has prolonged life in a phenomenal manner; since our medical supplies and services are infinitely superior to those in any other country… you should attempt to retain these advantages by fighting to retain the system under which they developed.
15. It is a mistake for the government to consider the problems of the sick apart from those of society as a whole. Such consideration is a private matter, to be solved by private and local methods. Such a narrow outlook on behalf of the government obscures the broader problem which is, in a moral sense, one of promoting respect for the individual and the furtherance of initiative and self-providence; in an economic sense, one of increasing production for the benefit of all citizens;3 and in a political sense, one of removing government as a battlefield for special favor and substituting cohesion and solidarity for division and disintegration.
16. No system, not even the free economy, can give everyone everything he wants at once. It is dangerous to allow or encourage any government to substitute its judgment for that of its citizens. It is well to keep in mind that no country has come close to matching the United States in the solution of the very problem your mother presents. I would recommend investigation of the numerous, actuarially sound private health insurance programs, which already insure a substantial majority of all American families. There are approximately 150 such programs in the United States today. Such diversification provides an ability to suit individual requirements which would be impossible under a federal program.
17. Finally, let us consider the moral issue. You may feel that this is simple—that it is not morally correct for society to neglect those in need. But is there such a thing as "collective morality"?4 Is not moral action exclusively individual? Can any action be moral if it is induced by compulsion? Who is acting and thinking in moral terms: the person who, cognizant of those in need, seeks to remedy the situation insofar as possible by resorting to his own pocketbook, or a person who thinks only in terms of legislation to force everyone else to take care of the problem?
Even if the facts were otherwise and it could be shown that the government were capable of providing satisfactory medical care, the basic moral question you should ask yourself is this: What right have I to take another’s property without his consent, for my personal use? Under what conditions does it become proper or right for any individual or group to rob another?
I feel that when you have answered the questions contained in this last point, you may find the first sixteen arguments superfluous. At least I hope so.
1. For an excellent discussion of the tragedy of socialism in Great Britain, including socialized medicine, see Cecil Palmer, The British Socialist Ill-Fare State, (Caldwell, Idaho: Caxton Printers, Ltd., 1952). The above points have been substantially documented by British experience.
2. Many complaints about the "excessive cost" of drugs (particularly in relation to the low cost of the ingredients) would cease if people realized that it is often expensive research which makes many drugs available at all. It frequently takes millions in research to make a "cheap pill."
3. Government cannot do this in any positive sense, as seems to be thought these days. Government is to do this by a policy of minimum interference, and in its capacity as referee… not active participant.
4. For development of this thought, consult William Graham Sumner, What Social Classes Owe to Each Other, (Caldwell, Idaho: Caxton Printers, Ltd.,1954).