The Forgotten Man of Socialized Medicine
Posted by LetsShrug 12 years, 1 month ago to Philosophy
THE FORGOTTEN MAN OF SOCIALIZED MEDICINE (Ayn Rand)
This is the explanation given by a distinguished brain surgeon of why he joined Galt’s strike.
“I quit when medicine was placed under State control, some years ago,” said Dr. Hendricks. “Do you know what it takes to perform a brain operation? Do you know the kind of skill it demands, and the years of passionate, merciless, excruciating devotion that go to acquire that skill? That was what I would not place at the disposal of men whose sole qualification to rule me was their capacity to spout the fraudulent generalities that got them elected to the privilege of enforcing their wishes at the point of a gun. I would not let them dictate the purpose for which my years of study had been spent, or the conditions of my work, or my choice of patients, or the amount of my reward. I observed that in all the discussions that preceded the enslavement of medicine, men discussed everything—except the desires of the doctors. Men considered only the ‘welfare’ of the patients, with no thought for those who were to provide it. That a doctor should have any right, desire or choice in the matter, was regarded as irrelevant selfishness; his is not to choose, they said, only ‘to serve.’ That a man who’s willing to work under compulsion is too dangerous a brute to entrust with a job in the stockyards—never occurred to those who proposed to help the sick by making life impossible for the healthy. I have often wondered at the smugness with which people assert their right to enslave me, to control my work, to force my will, to violate my conscience, to stifle my mind—yet what is it that they expect to depend on, when they lie on an operating table under my hands? Their moral code has taught them to believe that it is safe to rely on the virtue of their victims. Well, that is the virtue I have withdrawn. Let them discover the kind of doctors that their system will now produce. Let them discover, in their operating rooms and hospital wards, that it is not safe to place their lives in the hands of a man whose life they have throttled. It is not safe, if he is the sort of man who resents it—and still less safe, if he is the sort who doesn’t.”
This is the explanation given by a distinguished brain surgeon of why he joined Galt’s strike.
“I quit when medicine was placed under State control, some years ago,” said Dr. Hendricks. “Do you know what it takes to perform a brain operation? Do you know the kind of skill it demands, and the years of passionate, merciless, excruciating devotion that go to acquire that skill? That was what I would not place at the disposal of men whose sole qualification to rule me was their capacity to spout the fraudulent generalities that got them elected to the privilege of enforcing their wishes at the point of a gun. I would not let them dictate the purpose for which my years of study had been spent, or the conditions of my work, or my choice of patients, or the amount of my reward. I observed that in all the discussions that preceded the enslavement of medicine, men discussed everything—except the desires of the doctors. Men considered only the ‘welfare’ of the patients, with no thought for those who were to provide it. That a doctor should have any right, desire or choice in the matter, was regarded as irrelevant selfishness; his is not to choose, they said, only ‘to serve.’ That a man who’s willing to work under compulsion is too dangerous a brute to entrust with a job in the stockyards—never occurred to those who proposed to help the sick by making life impossible for the healthy. I have often wondered at the smugness with which people assert their right to enslave me, to control my work, to force my will, to violate my conscience, to stifle my mind—yet what is it that they expect to depend on, when they lie on an operating table under my hands? Their moral code has taught them to believe that it is safe to rely on the virtue of their victims. Well, that is the virtue I have withdrawn. Let them discover the kind of doctors that their system will now produce. Let them discover, in their operating rooms and hospital wards, that it is not safe to place their lives in the hands of a man whose life they have throttled. It is not safe, if he is the sort of man who resents it—and still less safe, if he is the sort who doesn’t.”
It has simply been assumed that those who practice medicine will see patients regardless of the personal cost, loss of freedom, or financial incentive.
My thought on bending the cost curve is there should be more Doctors and hospitals with less government intervention. When Doctors are on every street corner like gas stations, McDonald's, and barber shops the costs will come down to the nominal level because customers will have maximum choice. Scarcity causes price to rise. This Rube Goldberg scheme of ObamaCare is in reality a method to create scarcity in the health care market. With fewer outlets and choice for patients, it will be easier for government to manage for equal outcomes. Ultimately, it's the perfect Utopian scenario. Since we all eventually die, we will have equality of outcome.
“Is man a sovereign individual who owns his own person, his mind, his life, his work and its product — or is he the property of the tribe, the state, the society, the collective that may dispose of him in any way it pleases, that may dictate his convictions, prescribe the course of his life, control his work and expropriate his products?”
Atlas Shrugged is obviously a statement that we own ourselves, and should be able to withdraw our consent and not be governed if it conflicts with our values That seems to be the ideal Rand is holding up very often, but then she backpedals into minarchism. To me, holding both views simultaneously must be a source of cognitive dissonance.
As for the other crime - it is just a social pact. If you stay with us the state will handle our "light-work". Outside of society each person has to provide the "force of law" themselves - think "wild west".
I think individuals within a society can adequately provide for their defense voluntarily. Lack of government (as defined above) doesn't necessarily mean everyone is on their own.to fight the bad guys. Interestingly enough, some Americans who pay their taxes and supposedly have the "protection" of government laws, police, and courts are turning to the free market and private security as the only effective solution: http://thelibertarianrepublic.com/citize...
Have you read any works by Lysander Spooner? He was fired up about the government's taxation and trampling of rights way back in the mid 1800s. He was a lawyer, and actually started a mail delivery service that was besting the U.S. post office by delivering mail faster and cheaper -- and the government shut him down, using taxpayer money, of course. Yay monopolies, right? (sarcasm)
Going back to the great Ayn Rand quote that prompted my comment, the question is, "Is man a sovereign individual who owns his own person, his mind, his life, his work and its product — or is he the property of the tribe, the state"? As I said elsewhere, if there is no opportunity to opt out and choose another service provider -- even for police and military -- then I think we're state property. It really doesn't matter if the politicians and bureaucrats demand a lot or a little, or whether it's for a purpose deemed important or frivolous; if they're able to make demands and penalize non-compliance, they're our masters.
As an Obj's we consider defense from crime and war the only legit purpose of the govnmt.
How do you propose handling that?
I think we agree on this issue, I'd willingly pay into a voluntary system for defense, but I think it's immoral if I don't have the right to opt out (without penalty) and hire a competing protection service if I don't like the job the current one is doing.
The Pentagon is unable or unwilling to account for trillions of dollars of our money, I've read. I really think we need to look for another solution with more accountability. The proposals I like for providing defense without government amount to a private security force or forces. The key difference is competition which will lead to innovation, and accountability since customers can go elsewhere if they don't like the service.
Miss Rand is the goddess of my secular idolatry.
Been an OBJ for decades, read most of the books, listened to a quite a few tapes. Introduced Her work to a few kindred spirits.
Sometimes I can quote scripture, but at very least I can paraphrase accurately. (I'm sure corrections will be forthcoming if I go astray.)
Lets see now, here's the official party line on...
Drugs: legalize all drugs. In fact all "victimless" crime (drugs, prostitution and gambling). You shouldn't do them for reasons of rational self-interest, but so long as you neither "break my leg, nor pick my pocket" it is not a crime.
Crime: is the initiation of force (by private citizens) - including it's derivative manifestations, theft and theft by deception.
Illegal immigrants: The US should maintain border security, should know who comes and goes and grant permission accordingly. But the bar for immigration is very low. Shouldn't be a criminal - that's pretty much it. Economic immigration is entirely OK since anybody coming here to better themselves is "our kind people". The weight of their numbers is more than made up by their productivity.
(Important note: no state-financed "social" programs means no sneaking across the border, ploppin' your ass down and suckin' up welfare.)
Forcible taxation: No. Cannon is clear on this. "Voluntary" taxation is problematic but not held impossible. Lotteries are OK of course, and I've seen essays on other ideas - a voluntary "court fee" collected when contracts are registered. Kinda like a voluntary fire department. You don't have to pony up but if you don't and something goes sideways the courts will not enforce it. (Considering the size of our economy, that one idea is often thought to be enough to finance everything.) There are other ideas. (BTW, before you ask, contract law falls under "theft")
Competing protection services: Police - OK. Courts - no. ("Rule-of-law" is one set of laws covering all equally.) Military - no. OBJ's say you have the right to defend yourself with any "reasonable" weapon (any defensive weapon proportional to the threat you face.) But the possession of "unreasonable" weapons - even by the law-abiding - constitutes a danger to a free state. Handguns, rifles - certainly; automatic weapons - meh, iffy; machine guns - no. Nor artillery, nor tanks, nor fighter jets. Libertarians say you should be allowed to own nuclear weapons - OBJ's do not.
Pentagon waste? Preachin' to the choir! All gov't spending is inefficient and prone to waste and excess. But OBJ's are hawks for National Defense. Oil is worth going to war over, rebuilding nation-states are not. American soldiers fight only for America's self-interest. At home or abroad - we are not isolationists.
Privatizing: Hell yes. As much as possible. Even down to the military? Not sure on that one. I'd have to go check my books. I imagine she'd be cautiously approving of the concept but uncertain of it's application. (But that's just my expectation. My mind often falls short of her Genius.)
How about that one? Anybody? Not looking for "opinion" - looking for cannon. Privatizing the military? Li'l help here?
(BTW, Kittyhawk, well-met Sir (Miss/Ms/Madam). Think I forgot to say that. Please pardon my lapse!)
Your bio sounds very much like mine, even down to being a deist and holding Ayn as a "goddess of my secular idolatry." I do agree with all of these issues in the canon, with the exception of what you described in your "Competing protection services" section, that Objectivism maintains the necessity of a government to provide at least military and laws and courts, and perhaps police.
In just the past few years, I've been reading a lot and watching many videos about government, philosophy, politics and history, and I've come to the conclusion that government is not necessary, and the free market could provide much better solutions. Government is an invitation for power-hungry individuals to abuse some and benefit their cronies. It creates a separate set of rights for those in the government, and those who aren't, which is clearly unfair when you think about it.
Most of us have been brought up in government schools (public schools), and otherwise subjected to relentless cultural messages that tell us we need government and it's the only solution to our problems. I no longer think this is true. Have you seen the Stossel episode about the towns that removed all street signs and traffic lights? Accidents went down. People took responsibility for themselves, disproving the assumption that we need government to tell us how to behave and punish the wrongdoers. http://stosselintheclassroom.org/videos/...
To me, now, anarchy a.k.a. voluntaryism is the only moral and logical political choice, as it's the only one that truly honors self-ownership. It seems to me to be the unstated end point of everything Ayn Rand believed, demonstrated by her quote above. Someone made a brilliant comment recently to the effect that, "Ayn Rand taught me to reason and think for myself so well, that I've come to the point of sometimes disagreeing with her." I'm at that point, too.
Here are a few videos which show how government laws and courts could be replaced in a voluntaryist society: http://www.youtube.com/watch?v=8kPyrq6SE...
One of the videos that started me down the road to being an anarchist was Michael Rivero's "All Wars Are Bankers Wars." http://www.youtube.com/watch?v=5hfEBupAe... It's lengthy, but very informative on why our wars have been fought, and who profited from them.
And this should be my 100th point, so I get to vote now, too! Yay!
BTW, please note that I presented a reasonable alternative to outright greed in medicine with examples. Kinda blows the idea that alternative ideas are tolerated around here when I see a score of -2 at the moment. If everything is so great why hide alternative positions?
I question your statement that you don't want doctors who are in it for the money. Everyone of us is in it for the money. Doctors have to attend universities and then medical school for a toal of approximately 20 year including primary school. this schooling is at great expense and their training has tremendous benefit to patients. Are they not entitled to a greater income than an auto mechanic? Not to disparage mechanics, but there is a great difference. When you pay for a doctors visit of $200 for example, do you take into consideration all his costs of doing business? Few people do. Perhaps we need to add up the hidden cost of all the people that a medical office employs to take care of a patient. Doctors income varies by specialty from about $200,000 to $500,000 annually after 6 years of practice. Is that really so outrageous considering all that goes into becoming a doctor? There are many professions that earn as much, attorneys,and people in the financial industry for example.
Fred Speckmann
commonsenseforamericans@yahoo.com
Yes, they need to cover expenses but, for example, a doctor in the military isn't going to do nearly as well financially as someone out to make money for the sake of making money.
Why should they be thought of as inferior in any way other than they choose not to go after every dollar?
To the best of my knowledge, particularly for Shriners', the patient pays nothing for the services rendered for the malady they were admitted for.
But some choose, for their own reasons, to serve in positions where the situation is weighted towards cutting edge science, and making the lives of some kids better, like Shriners', rather than grind a bunch of patients through and racking up the insurance remuneration. Different ways to practice for different doctors.
It has always been my understanding that shriners are a charitable organization for the purpose of raising money to operate hospitals. I assume that the doctors working at the hospital while specializing in children do get compensated as any doctor would. Please advise if they are working under different contracts than doctors in other hospitals.
Fred Speckmann
commonsenseforamericans@yahoo.com
I don't get it. Some Doctors don't milk the system for every nickle they can get out of it and around here it seems to be automatically presumed that something is wrong with that.
Why is it so hard to accept the fact that some people aren't motivated by money?
my doctors are now accepting me (after I turned 65 last December) at a reduced rate. I have told them that I can afford to pay more, but they are prohibited by law from accepting extra money.
I am trying to think of ways to thank them which are not illegal.
let's accept that professionals are motivated by an assortment of goals, OK? that is not the problem here.
the problem is theft at gunpoint. if someone wants me to design them an infinitely-variable gearbox -- at gunpoint -- I will give them a different box than my friends would get.
see what I mean?
the current V.A. debacle shows how gov't administration of medicine works out. awful. -- j
The current problems with the VA is like saying Kermit Gosnell, convicted in Philly., represents all doctors. In a large organization under pressure problems can come up.
My doctor has a relatively small practice. I actually knew some of his patients before I met him. He's active in the community, drives an older car, has a nice family, etc. Some of his staff have been with him for decades. He isn't in it to get rich. He is in medicine to help people. He does get paid, etc. but it's not the the same degree as some who are charging for everything they can as often as they can.
http://www.straightlinelogic.com/straigh...
And I don't think we should underestimate the power of the free market, and the ability of creative individuals to get things done despite the obstacles. Here's a great article about a new trend in medicine: http://reason.com/archives/2013/03/13/th... Here's a quote from it: "Direct primary care is part of a larger trend of physician-entrepreneurs all across the country fighting to bring transparent prices and market forces back to health care."