Freeman

ARTICLE

17 Arguments Against Socialized Medicine

NOVEMBER 01, 1960 by DARRYL JOHNSON

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.

Footnotes

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).

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November 1960

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