Your Doctor Is Not In: Healthy Skepticism About National Health Care

Liberty Favors the Paying Patient

Even without Clintonian socialism, the private practice of medicine, in which the individual doctor is responsible to the individual patient, is on its last legs. Francis A. Davis, M.D. founder and publisher of Private Practice, recently shut down his 25-year-old magazine with the lament that the battle is lost.

But I predict that Dr. Davis, a true champion of freedom, will no more give up than I will. No matter what the prospects—and they are glum—we owe it to our country, to our patients, to our children and grandchildren to uphold the banner of liberty. At worst, we can diminish the virulence of statism now. At best, because we have moral and economic truth on our side, we may win. And whatever happens, we build the intellectual foundations of freedom for the future, and our descendants will bless us for it.

But a resistance needs a central plan (if Freeman readers will excuse the expression!). A number of valuable books have been published in recent years to defend private medical care, but none measures up to Your Doctor Is Not In. Now, perhaps before it is too late, we have a brilliant and principled champion who can also organize and write: Dr. Jane Orient.

Dr. Orient, a physician who saw the socialized beast at first hand in the Veterans Administration, has revitalized the American Association of Physicians and Surgeons as executive director. AAPS is the only free-market doctors’ organization, and I proudly belong to it rather than to the corrupt and statist AMA. But as with FEE in the pre-Sennholz years, a great organization had somewhat slowed down.

Also as with Dr. Sennholz and FEE, Dr. Orient’s leadership has brought AAPS roaring back. Her newsletters are famous for their intelligence and strategic thinking. Her lawsuit opened up Hillary’s secret comintern meetings. Perhaps most important of all, Dr. Orient has now given us the handbook of freedom that our movement needed. It may already be giving nightmares to Ira Magaziner and the other leftists who wrote ClintonCare. And don’t they deserve it.

Arguing from first principles, Dr. Orient shows that the free market enforces such virtues as honesty, hard work, and conscientiousness, whereas state intervention does just the opposite, as anyone who has ever dealt with the government knows.

There is no right to medical care, she shows, any more than there is a right to housing, food, or clothing, and the attempt by government to create such a right leads to totalitarianism—the road we are traveling today. For to say that someone—the poor, the elderly, the “uninsured,” etc.—has the right to the life, liberty, and property of someone else is a moral outrage, and a grant of absolute power to the state.

And the state corrupts whatever it touches. When I was trained, I gladly took the Hippocratic Oath, solemnly pledging, in a tradition thousands of years old, never to commit abortion or euthanasia. Now young doctors, in the words of such oaths as that of Dr. Louis Weinstein, “remember that it is wrong to terminate life in certain circumstances, permissible in others, and an act of supreme love in others.”

Dr. Kevorkian could be an Angel of Love only under statism, for when the state is spending its hard-stolen money, it resents any patient who lives “too long.” In the Netherlands, the socialized system murders more than 20,000 patients a year—“involuntary euthanasia” it is called.

Socialized medicine was an invention of Bismarck, the warfare stater who also gave us social security. Lenin and Hitler institutionalized the system, and most of the world followed. As Dr. Orient shows in riveting detail, however, even the “best” of these systems, as in Canada or Germany, is a disaster for the patient and the taxpayer.

Medical statism got its start in America thanks to the AMA and its anti-competitive medical licensure laws, an intervention courageously condemned by Dr. Orient. She also shows that modern health insurance is a non-market institution. Invented by the AMA-sponsored Blue Cross and Blue Shield, health coverage violates the principle of insurance. With the exception of catastrophic insurance, health insurance is pre-paid consumption of an incredibly inefficient and bureaucratic sort.

Lyndon Johnson’s Medicare and Medicaid, Richard Nixon’s Health Care Financing Administration, Ronald Reagan’s CLIA—not to speak of the Indian Health Service and the VA—have given us a system that is more than half statized. And our Fabian socialist First Couple want to finish the job, and us in the process.

In response, the Republicans, from Bob Dole to Phil Gramm, provide their own versions of socialized medicine. They don’t call it that, of course, but once admit the principle of universal access—that the taxpayer should provide equal health insurance for every American—and there is no stopping the leviathan.

Equality is the most politically pernicious idea on earth. Claim that human beings, who are manifestly unequal, should be treated the same, and you have opened the way not only to systemic injustice, but to the omnipotent state. God created each of us as a unique individual, and we should celebrate this. We could not even have an economy or the division of labor, Ludwig von Mises pointed out, were not a “radical inequality” the chief feature of the human race.

As Dr. Orient shows, we don’t need any sort of national system of health care, any more than we do of dry cleaning. We need the free market. If we are concerned about the deserving poor, and we should be—although secondarily to the producers—a free market is best for them too.

But most important, in this clarion call to roll back the state, Dr. Orient shows us that liberty favors the paying patient. The IRS agent is bad enough. Equip him with a scalpel, as Bill and Hillary would, and we’ll soon find the government not only lifting our wallet, but submitting us to Dr. Weinstein’s “supreme act of love.”

Dr. Paul, a practicing physician and former Congressman, is chairman of the National Endowment for Liberty in Lake Jackson, Texas.

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