Two Major Issues with Socialized Medicine

A wise and frugal government, which shall restrain men from injuring one another, shall leave them free to otherwise regulate their own pursuits of industry and improvement, and shall not take from the mouth of labor the bread it has earned. —Thomas Jefferson

     Recently I engaged in a little back and forth with a person whose name I don’t remember in a comments section on the Internet. She was apparently a devout leftist, and was indulging in a little mild-mannered trolling of a right-of-center news site. Anyway, she informed me that although western Europeans are getting more and more fed up with violent Muslim migrants who don’t assimilate, they would never actually turn to the political/economic right because they love their socialized health care too much. In fact it seems that many non-American westerners, and quite a few leftists in America too, consider a society without socialized medicine to be still wallowing in barbarism and darkness. Free healthcare is practically a hallmark of a truly compassionate, enlightened, and civilized society.

     It has occurred to me quite a lot lately that these same socialized westerners who consider socialized healthcare to be so essential, also seem to be in favor of the citizens of a nation being as weak and defenseless as possible, and in favor of forfeiting the sovereignty of the individual, submitting to an all-observing, all-controlling central government, in exchange for a kind of superficial security. In effect, they appear to prefer cultural emasculation to the dangers, insecurities, and responsibilities of genuine freedom. But let that be for now. I mainly would like to discuss two major difficulties with a socialist approach to medicine. The first issue may be fixable, but the second strikes me as a practically inevitable, unavoidable disadvantage—so disadvantageous in fact that it can hardly not tend, sooner or later, toward the dystopian and Orwellian.

     Personally, I am just socialist enough to accept that in a civilized state nobody should starve, freeze, or die of neglect from an easily curable disease, unless that is the person’s choice. (Some would argue that the person should not be allowed to make that choice, but such people seem to reject the sovereignty of the individual, and to be fine with citizens being the obedient servants of a presumably benevolent Big Sister. Freedom can be scary.) Consequently, to the extent that private charities do not provide free or very cheap healthcare for the very poor, the government should step in and take up the slack. I think to some degree this has already been the case for as long as I can remember; even back in the 1960s hippies would be going to the local free clinic to get cured of their latest venereal disease. This level of socialized medicine—free clinics with at least a registered nurse qualified to make diagnoses, administer hypodermic injections, and dispense pills—is not socialized enough really to generate serious problems, and I seen no problem with them, especially if they are funded privately. But when medicine reaches the level of free operations for everybody, at the expense of the government and the taxpayer, problems arise.

     The first problem I see, the possibly fixable one, is that healthcare is now extremely expensive. This is for various reasons. First, pharmaceuticals are very expensive—which is an artifact of capitalism and not really necessary. I know that in a country like Burma, state of the art pharmaceuticals, including antibiotics and anti-malaria medications, cost only a small fraction of what they cost in the USA. (Keep this in mind if you ever travel to the tropics: you’ll be able to get very cheap medicine there.) I don’t think this is necessarily due to subsidies from organizations like WHO, but simply a matter of inexpensively made medicines with huge markups in countries where people can afford to pay through the nose, and smaller markups where they can’t.

     But other reasons for exorbitant medical costs are not so easily fixed. Medicine is very complex now, relying upon very expensive technology. The days of a family doctor making house calls with his little black bag are long over. Furthermore, it has gotten to the point where doctors will require a patient to undergo a battery of (expensive) tests before he dares to make a conclusive diagnosis, for fear of making a mistake and being sued for malpractice. Malpractice insurance (standard even for veterinarians now) further adds to the overhead.

     So providing state of the art healthcare for an entire population, including the best treatments for cancer, heart transplants, treatment of rare and difficult-to-cure diseases, could easily double or triple the amount of taxes paid by the average citizen. How much can a government afford to pay to cure any person on welfare, or any illegal migrant, of leukemia? And this even without free psychiatric treatment for stress or self-esteem issues, boob jobs, sex change operations, free abortions as a means of birth control, etc. If one throws in everything, including the sex change operations and psychoanalysis, then the middle-class citizen should consider himself lucky if he gets away with paying only two thirds of what he earns in taxes.

     This difficulty of astronomical expenses, though, as I have said, may be minimized to some degree. First, ensure a reasonable price for medicine, and moderate pay for physicians. Also, make it harder for doctors to be sued for honest mistakes—even doctors are human. And of course, socialized medicine should be only for necessary health care, not cosmetic surgery, genital modifications, abortions as after-the-fact birth control, or aid in feminine emotional processing. Presumably there would also have to be a limit to the expense one would be entitled to impose upon society—say, the government will pay for your disease so long as it doesn’t cost more than $50,000 to cure it. If it costs more than that, and you can’t pay, and your family and friends can’t (or won’t) pay, and the wealthy philanthropists won’t pay, then you die. Everyone dies anyway, and that’s just the way it is. A line must be drawn at a realistic, and not extremely compassionate, level. I assume nations with socialized medicine must certainly have dealt with this and come up with solutions, or at least compromises, resulting in taxes only twice as burdensome as what an American pays.

     Thus the great expense of socialized healthcare is a burden on the healthy, possibly a very heavy one; but many people, in the name of compassion, humanity, and progress would say it is definitely well worth the expense. On the other hand, the second difficulty I see with socialized medicine is a much graver and heavier burden still, from a more philosophical point of view. Socialism not only deprives the worker of much of his money, it also inevitably deprives him of liberty. I’ll illustrate this with an introductory example.

     Long ago, when I was a student, I had a friend who was a real free spirit, a maverick, a lover of personal freedom. When I returned to the USA after many years I found that he had joined the “establishment” by becoming a high school teacher, and that he thought the smoking of tobacco should be illegal, because he considered it unfair that he should have to pay for somebody else’s lung cancer. This was with mandatory health insurance, just a step away from fully socialized medicine. So a lover of freedom becomes a person who wants to criminalize smoking, because socializing medicine causes the mistakes of others to be shared with everyone. Even back in the 1980s when I was opposed to laws requiring the use of a seatbelt in a car and a helmet on a motorcycle, people, usually female, would inform me that if a person was badly injured in an accident they could become a ward of the state; meaning, of course, that people shouldn’t unnecessarily do what is dangerous because other people may have to pay for their accidents.

     When medicine is socialized, and everyone has to pay for the unhealthy choices of the obese chain-smoker who doesn’t wear a seatbelt, then people start wanting dangerous lifestyles to be prohibited. This can be taken to arbitrary extremes. Sugar’s not good for you, therefore sugar should be taxed if not banned outright. Wearing a MAGA hat can get your face punched and your nose broken, therefore wearing a MAGA hat should be made illegal, for the good of society. Speaking in a way that is politically incorrect may traumatize others, requiring them to attend expensive psychiatric therapy at the expense of the public, therefore all “hate speech” must be made illegal. See where this goes? Almost anything can be considered a threat of some sort or another. As with expensive medical treatments, some sort of line must be drawn with regard to how much of an imposition upon society a person is allowed to be. Yet with an increasingly feminized, timid, security-oriented population, the line may eventually be drawn where individual freedom is dead. Even anything borderline dangerous could result in someone being a “ward of the state.” So an increasingly timid, insecure, and decadent populace may favor more and more restrictive laws to prevent people from being hurt, for their own good and the good of a tax-paying society. Our liberty is taken away from us for our own good. Because with socialism we all become wards of the state.

     No doubt there are unfortunate consequences of socialized medicine in addition to the two big ones mentioned above—for example the universal problems that arise with socialism in general, such as lack of competition leading to reduced quality of products and services, and the entropy and inefficiency of anything run by bloated bureaucracies; but the two above, especially the second one, strike me as more bad than good. Old-fashioned free clinics, fine. Wealthy philanthropists and charitable organizations paying for the health needs of the poor, excellent, and conducive to treasure in heaven. But socialism, like government in general, although to some degree a necessity, should be kept to a minimum, because the bigger and stronger it gets, the more people serve and fear the system, instead of vice versa, as it should be.

     

Fat Freddie goes to the free clinic