We are developing the social individualist meta-context for the future. From the very serious to the extremely frivolous... lets see what is on the mind of the Samizdata people.

Samizdata, derived from Samizdat /n. - a system of clandestine publication of banned literature in the USSR [Russ.,= self-publishing house]

Samizdata quote of the day

“With regard to the idea of whether or not you have a right to healthcare, you have to realize what that implies….I’m a physician, that means you have a right to come to my house and conscript me, it means you believe in slavery. It means you’re going to enslave not only me, but the janitor at my hospital, the assistants, the nurses…There’s an implied threat of force, do you have a right to beat down my door with the police, escort me away, and force me to take care of you? That’s is ultimately what the right to free healthcare would be.”

Rand Paul.

I came across this quotation via Facebook, which in turn had been posted up by someone on a sort of “celebrity” website. The person who put up the posting in the first place is clearly traumatised at the statement of principle by Rand Paul about the bogus “right” to healthcare. RP is to be congratulated for spelling out in the clearest fashion what is wrong with notions of claim rights where what is involved is not the classical (correct) notion of a right to be left alone, but the contrary attitude about a “right” to demand that others give you something even if those others haven’t taken it away in the first place.

This sort of confusion, famously skewered many years ago by Isiah Berlin in his essay about two concepts of liberty, still persists. I often find Rand Paul’s sort of argument particularly powerful when putting the problem with such “rights” in human terms.

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58 comments to Samizdata quote of the day

  • Patrick Crozier

    Would it be pedantic to point out that Mr Paul is not quite right? In the UK, where we have “free” healthcare it is not the doctor who is the slave but the taxpayer. I assume similar arrangements are being proposed in the US.

  • Alex

    Rand is correct in his argument as when you remove the market in healthcare, or the state assumes a dominant position in said market (or any market), the distortions are incredible. Doctors may be compelled to work for government-set wages or rates (if charged to the consumer) and may not, indeed probably will not, have the option of withdrawing their labour. A ‘right’ to healthcare implies the corresponding compulsion of healthcare professionals. What form this takes, and how velvet the gloves over the iron fist, is really a secondary concern.

    However: regarding Patrick’s comment, I think that is the huge danger in Rand’s argument. It presupposes an understanding of liberty that simply isn’t there in most people. Despite a distrust of authority and the state in youth it took me until my 20th year to fully shake off the statist concept of rights. The statists have so thoroughly indoctrinated the idea that they are the compassionate force that even proto-libertarians will believe it unless they undertake a lot of thought on the matter. Most will never do so.

  • Runcie Balspune

    Another aspect is the notion of responsibility, and the fact you get ill, without someone or something causing it, is in fact your responsibility, there is no recompense from anyone else for your own health issues, in today’s modern world a lot of the health problems are actually down to irresponsibility on the part of the individual, and it does not become a “right” to evade that responsibility, and the costs of that responsibility, to pass it to someone else or some nefarious entity such as “the state”.

    I can understand Paul’s argument, and it is correct, but the key issue from a libertarian standpoint is that some things are your fault, and getting sick due to genetics or fate is also part of that, as unfortunate as it sounds, that is the reality of the situation. Insurance is recommended, especially if you are in a risky profession or you willingly undertake risky lifestyles, the choice not to take out insurance is personal responsibility, nothing more, and should not be forced on by the state (third-party insurance is another matter).

    In fact, as well as the compelling “slavery” argument against health care professionals, it is also coercion on the business of health care insurance to provide you with it at a defined cost.

  • Patrick Crozier
    May 23, 2015 at 10:26 am

    Does the State set Dr. pay? Or does supply and demand?

    Every tax, every regulation comes with it an army of bureaucrats and behind that an army (with guns) of enforcers.

  • Runcie Balspune
    May 23, 2015 at 11:06 am

    We have a cheap cure for a considerable amount of illness genetic and otherwise. The State has made it illegal. Cannabis.

    And in America one of the chief supporters of the “Drug Free” campaign is Big Pharma. Might there be a conflict of interest there? Putting people in jail to maintain profits is such an ugly venture.

  • And what else might cannabis do? Wipe out a considerable fraction of the health insurance market.

  • woodsy42

    The falacy to the entire argument is that the doctor made a decision to become a doctor knowing the responsibilities of that role. He also has free will, he can deregister and take on an entirely new and different career.

  • Andrew

    So your “falacy” is that it’s fine for the state to use force because it said it’s going to use force…

    Nice.

    Apologist scum.

  • Andrew

    Sorry, an unnecessarily harsh final comment.

  • Laird

    Andrew, I don’t think it was “unnecessarily harsh”. Statements like that deserve a quick slapdown.

    And in any event, no one in the medical profession today made the “decision” to become a slave of the state. The state changed the rules in the middle of the game.

    Dr. Paul is of course correct. The problem is that it takes a certain amount careful, logical thought to come to his conclusion. Most people today (and all leftists) are either incapable of deep thought or unwilling to expend the energy.

  • StarDasher

    MSimon – the UK state offers an inducement. The doctors negotiate. Figures are agreed. The doctors remain independent contractors. The last contract with general practitioners has received widespread condemnation as having given too much to the doctors. Even some gps seemed embarrassed.

    I guess RP would be happy with that result. The doctors screwed as much as possible out of the system. Which is the way things should work.

  • bloke in spain

    For Rand Paul, in the arena of the USA, probably an accurate summary. But for the UK….

    The UK does have socialised healthcare. And has had it 70 odd years. So that’s going to be everyone who’s connected to The NHS knew the ballgame when they chose a career. Hence obligations.
    And because anyone earning in the UK is obliged to pay for the thing, we here, have to look at this slightly differently. Because “rights to health treatment”, for us, is getting something we’ve already paid for. And we need those “rights” because there’s a lot of interfering buggers would like to deny them because we don’t meet their standards of lifestyle choices.
    Just saying, that’s all.
    I’m quite happy with UK medical people being slaves. I’d use whips as well.

  • The Wobbly Guy

    Wasn’t there a minor hoohah on social media recently regarding doctors and how the public perceives them as robots to pander to their every need without need for rest or food?

    I find it quite related to this discussion. In an ideal world, doctors, medical professionals, and medical institutes would be free to set their own prices and discriminate between patients, free from the hypocritical Hippocratic Oath that practically obliges them to be slaves.

  • Richard Quigley

    I have a problem with the assertion of a right without a balancing responsibility. The right to life comes with the responsibility of sustaining that life (I think).
    I don’t believe I can demand that a doctor help me if, for whatever reason, he cannot.

    Having grown up as the son of a GP who went (bitterly) through the transition phase from private to public health service in Canada I know that he referred patients, mostly drug addicts and disability fakirs to other GP’s because he could not deal with their disrespect of themselves.
    Doctors are not saints, patients even less so.

  • ap

    I’m quite happy with UK medical people being slaves. I’d use whips as well.

    Yes, slave societies historically have been noted for their efficiency and innovation since good people aspire to be slaves!

  • Pardone

    But surely the state pension is far more immoral than anything else.

    Forcing the young to pay for the old is enslavement.

  • Alex

    The falacy to the entire argument is that the doctor made a decision to become a doctor knowing the responsibilities of that role. He also has free will, he can deregister and take on an entirely new and different career.

    Can he, though? The NHS announced plans some time ago to ‘encourage’ GPs to retire later. What happens if the inducements fail to effect a change in retirement age? When will it become a civil offence to retire from, or leave ‘front line services’ while there is a ‘staffing crisis’? How soon does it become a criminal offence? When the state takes over industries it can make the life of those who work in those industries impossible.

  • Richard Thomas

    Most people today (and all leftists) are either incapable of deep thought or unwilling to expend the energy.

    I think for quite a lot of people, it’s more like once the argument starts to go in a direction that doesn’t fit their worldview, psychological walls go up. It takes an effort of will to overstep that and explore the arguments on the other side and see where that leads. This does occur on all sides and unfortunately ends up with people arguing past each other with their fingers in their ears.

    The thing is, even for those who are right (as I am 🙂 ), it’s important to be able to look beyond those walls. You can’t really pick apart the arguments of another unless you know where they’re coming from. Epithets are not really a good way to conduct debate (as much fun as they can be).

  • Richard Thomas

    If you want to talk about right to access to healthcare, let’s start with when you need some medical care and end up on a waiting list.

  • Barry Sheridan

    Not sure I agree with this argument. Surely anyone who freely elects to become a doctor does so knowing that the work is about treating someone who is not well. That is fundamental. This has nothing to do with some patient thinking they have rights to the doctors skill, that surely is just a given. I leave aside here the complications of payment, demands on time and the like, but to compare this arrangement with slavery is nonsense.

  • Johnathan Pearce

    Barry, the argument is about being forced to care for those who those who can’t or won’t pay for it

  • Fred the Fourth

    RP’s remark is merely a specific case of the description I first heard back in the 80’s:

    “So you are in favor of this law? Would you shoot your own grandmother to enforce it?”

    Because ultimately all law enforcement come down to that, if a lawbreaker refuses to accept the governmentally imposed sanctions.

  • Mr Ed

    Stardasher

    the UK state offers an inducement.

    When the NHS was formed by seizing many charitable hospitals and directing their operations (ha!), the Labour Minister responsible, Aneurin Bevan, was reported to have replied to a question as to how he got doctors to work for the State ‘I stuffed their mouths with gold’.

    http://blogs.independent.co.uk/2011/04/14/stuff-their-mouths-with-gold-part-iii/

  • StarDasher

    So they had no complaints.

  • Kevin B

    You cannot demand that someone saves you from whatever fate has ordained for you or from the consequences of your own choices. Not even God will forgive such sins.

    Your only recourse in such extremis is to beg for succour from your own excegis and to hope that your friends will save you from your the consequences of your own destructive actions.

    Or in other words, you’re on your own, chum. Deal with it.

  • Fred IV:

    Rand Paul tried to make pretty much the same point after the execution of Eric Garner by NYC cops allegedly for selling untaxed ciggies (because heaven forfend the State not get its cut of everything). The caterwauling from the establishment was that oh no, you’re only allowed to discuss police violence through the prism of race relations.

  • William O. B'Livion

    Rand Paul is wrong, and he SHOULD know better.

    It is unfortunate that he says these things when he could use the same questions to challenge the narrative and redefine the discussion.

    See, he’s wrong, I *do* have the right to health care, the same as I have the right to food, to housing, to a car, to a firearm or any one of a *huge* laundry list of items the government, society and my fellow idiots MAY NOT PROHIBIT ME FROM OBTAINING.

    My rights do not obligate you to provide them, they only require that you not unduly prohibit me from obtaining them.

    I have a *right* to go see a doctor. He is not obliged to take me (in general, [1]), and he is perfectly free (or should be) to set his own terms.

    This is the same as my right to go buy food, or to choose which motorcycle I wish to own, or which firearm I will buy in July (Leaning towards a Mossberg SA-20, but might get a Glock in 10mm).

    It is a shame that Rand Paul has bought in to the lie that rights obligate others to provide. OTOH, maybe I can convince the USG that since I clearly have a right to firearms (it’s in the Constitution) that they should provide me with a M107a1, and a thousand or so rounds to practice with.

    Because it’s my right damn it.

    [1] I do think that if one chooses to work under the “emergency room” banner one is more-or-less obligated to take any *emergency* that comes in.

  • Forcing the young to pay for the old is enslavement.

    No it is not. It *is* wrong, but taxation is like paying protection money to the mafia (exactly the same actually) it is not slavery. Why? Because once you pay off your protection money, you are (more or less) free to do other stuff. Slavery has no such mitigation. That is why being conscripted into the military is indeed slavery but taxation is ‘merely’ paying protection money.

  • William O. B’Livion is wrong, and he SHOULD know better. What Rand is talking about is not your right to health care or anything else, it is the ‘right’ to FREE healthcare.

  • Richard Thomas

    You have a right to seek healthcare, you do not have a right to be provided healthcare.

    The issue with emergency rooms is that they do end up treating non-emergency cases (and in the case of one hypochondriac I know, this happened many times over the course of a year) also, for both emergency and non-emergency cases, there are those patients for whom recovery of the charges they ran up is not financially viable so their charges just get distributed to those who can pay. Then the influence that insurance companies and medicare exert over the whole thing just muddies the waters even further.

  • Paul Marks

    There is indeed a massive difference between a right not to be murdered and a “right to life” in a positive sense.

    Although even John Locke utterly confused the two things – they are quite different.

    There is no “right to life” – I have no “right” to force you to feed me to keep me alive.

    And I have no “right” to make you treat my medical problems.

    You may choose to do so for free, out of the goodness of your heart, but that is mercy (benevolence – the great virtue of charity) it is NOT “justice”, it is NOT a matter of “right”.

    A “right” is something that is still valid between two strangers meeting in a new place.

    Rights do NOT come from being in a “community” (T.H. Green was wrong), they apply (or do not apply) between two people who have never met before in the “American wilderness” to give John Locke’s example.

    If I am meet a stranger in a new country do I have a right to demand UNDER THE THREAT OF VIOLENCE that he feed me?

    Of course I do not.

    And nor do I have a right to demand UNDER THE THREAT OF VIOLENCE that he treat my medical conditions.

    My “right” in relation to this stranger is that he not violate my body or goods.

    And he has the same right in relation to me.

  • thefrollickingmole

    OT but I think this seen at another site might be worth a thought.

    Fact is, SSM is currently and will only ever be passed mostly in countries that are European or Euro colonised making it A WHITE SUPREMACIST POLICY.

    I can almost hear the Guardian readers heads exploding now.

  • Mr Ed

    Dinna fret, folks. In Scotland, you have the right to free healthcare, and get it you will, good and hard, even if it means using a rusty saw to amputate your leg, when a trip to B & Q (a hardware store chain) fails to provide a new one.

    http://www.dailyrecord.co.uk/news/scottish-news/scots-surgeon-uses-rusty-hacksaw-5752649#rlabs=3

  • pete

    I don’t see why a doctor should fear ‘free’ nationalised healthcare.

    Our NHS, run on a not for profit basis by allegedly saintly staff, has some of the highest wages for doctors in the world.

  • bloke in spain

    @ap

    “I’m quite happy with UK medical people being slaves. I’d use whips as well.”

    Yes, slave societies historically have been noted for their efficiency and innovation since good people aspire to be slaves!

    I’ll leave it to others to extoll on the boundless efficiency and innovation to be found in the UK’s NHS.

    But I will take back the whips. And substitute goads. Spiked ones.

  • Laird

    Pete, they may indeed be among the highest wages in the world. That is not relevant. Those doctors are not “free” to seek employment elsewhere, or to charge whatever they choose (and the market will bear) for their services, and you are not “free” to seek out the services of private physicians or to pay them what you think they are worth. Yes, some doctors might like that system, as it insulates them from market forces in exchange for a guaranteed wage and secure employment. Such doctors are rent-seekers.

    Health care, like any other good, is limited in quantity. And just as with any other good there is generally more demand than there is supply. The only real question is by what method is that good allocated. Most of us here would prefer a free market system, which demonstrably produces the optimal* quantity of that good at the lowest price, as well as permitting consumers to make a conscious trade-off between price and quality. Some view that as “unfair” because those unable to pay receive less (in quantity and quality) health care than their wealthier neighbors. Other allocation methods are possible, and national health service is one of them. Under that system health care is allocated on a political basis, which ultimately means rationing and inevitably leads to inequities as those who are politically favored (for one reason or another) get better and faster health care. It also inevitably leads to a lower quality of care overall, as there is no incentive to improve the quality of care or customer service or to minimize costs.

    Every system is necessarily “unfair” from someone’s perspective. Pick your poison.

    I have to believe that WOB is being intentionally obtuse (or is merely “stirring the pot” to elicit a reaction). It is quite clear from Rand Paul’s comment that the “right to healthcare” to which he was referring is the claim of a “right” to such care provided and paid for by someone else, not to the (obvious) right to seek to purchase health care services on a voluntary basis from a willing seller.

    * Not “optimal” in any absolute sense, but as close to optimal as any human system is capable of producing.

  • CaptDMO

    “Ted”
    “the execution of Eric Garner by NYC cops allegedly for selling untaxed ciggies..”
    With the exception that it was not an execution, and it was not over selling untaxed ciggies,…sure!

  • pete

    Laird, all doctors are free to seek employment wherever they want to.

    People are also free not to become doctors or to stop being doctors.

    The NHS has been around since 1948 so anyone freely choosing to become a worker in an industry which is largely nationalised knows what they are doing.

    Anyway, my point was that we in the UK are not free to pay doctors what other, more privatised health services pay their doctors. The state forces us to pay them superbly generous wages, something which I don’t think many UK doctors mind regardless of Rand Paul’s comments.

  • With the exception that it was not an execution, and it was not over selling untaxed ciggies,…sure!

    One of the frustrating things about the problems we in the States have with our police is how many people want to turn it into a “there’s only one proper way to talk about it” thing. On the one hand, you’ve got the race hustlers, who think you can only look at abusive police through the lens of race. And then you’ve got other people who subscribe to the “obey or die” school of policing who think that because it’s the race hustlers protesting, the dead person must obviously be guilty and the case doesn’t deserve scrutiny.

    And yet the double problems grow apace. Consider the Michael Brelo case. He jumped on the hood of a car and fired 49 bullets into it, but was found not guilty because a dozen of his fellow cops shot into the car and it couldn’t be proved that his was the gun that fired the fatal shot. Does anybody think such a defense would fly for a non-cop?

    The Supreme Court case Heien v. North Carolina, decided last year, basically said that ignorance of the law is an excuse if you’re a cop pulling somebody over even though they weren’t breaking you law you used to pull them over.

    There’s a website called “Photography Is Not a Crime” which details how it’s established law that one is free to photograph/video the police doing their jobs in public. Yet many police will still try to stop you from so ding, and will try to destroy the evidence, in full defiance of the law.

    Ultimately, all laws must be predicated on the threat of using lethal force to enforce them. Consider the zoning/building code cases that pop up once in a while of a person who wants to let their lawn grow “naturally”, ie. unmown weeds and wildflowers. Some neighbor will sic the state on them, and what happens when the homeowner refuses to do anything about the lawn? What happens when the homeowner refuses to pay the fine? What happens when the homeowner refuses to leave the home to be carted off to prison? Just because most people don’t take it that far doesn’t mean that the law doesn’t have lethal force behind it.

  • People are also free not to become doctors or to stop being doctors.

    What happens when all the doctors do an Atlas Shrugged and nobody wants to become a doctor?

  • Oddly enough I commented on the effects of Socialist medicine six years ago on my blog:

    Central to the practice of socialized health care as with the socialization of every other field of endeavor is the legal and moral reduction of the care givers, the doctors and nurses and other staff, to the status of domestic animals. As the actual experience of socialization has shown this will result in the early retirement (and other forms of departure) of many practitioners and the discouragement of those who where thinking of entering the field.

    The actual long term result of the socialization of medicine will not be the improvement of our standard of living, it will of course be the opposite, with the addition of the needless deaths of people who would have been saved and returned to health under the present system. One only has to look at the practice of socialized medicine in Europe. Most of the horror stories about “Euro-Care” could be summarized in the phrase: Take two aspirin and drop dead in the morning. (And in full blown Marxist states you won’t even get the aspirin.)

    Instead of being the saviors that they present themselves as, the socializers will in fact, as usual, be committing murder through an indirect process.

    How much longer must we put up with this nonsense?

  • Nicholas (Self-Sovereignty) Gray

    You are all so wrong! Slavery is full-time, for life! The State, if you are a doctor, just wants your services 8 hours each working day, until you retire. See the difference?
    Well, put on the communist-coloured glasses. Now can you see the difference?

  • Runcie Balspune

    @ Mr Ed, that story is a bit misleading, whilst undergoing a regular amputation the surgeon discovered an undisclosed metal plate in the patient and a regular bone saw probably wont do the job, so he had to improvise, not that it matters as they should have known about the metal plate and had an appropriate tool at hand.

  • Mr Ed

    @ Runcie: Well, one would hope that:
    (i) the insertion of a metal plate in a patient’s leg is recorded in his medical history, hardly a controversy;
    (ii) a surgeon would read the notes before the operation;
    (iii) that a hospital has on hand all tools that might be necessary in the event of an emergency, in appropriate condition, i.e. sterile, ‘sharp’ and/or fit for purpose.

    We don’t know if (i) or (ii) was lacking, one or the other, or both and (iii).

    And the number of people fearing for their jobs as a consequence of this? Around 0, I suspect.

  • llamas

    I would have to waste my time searching but I do believe that there have been multiple occasions where a court in Canada has ordered specific physicians to work specific shifts at specific hospitals that are part of the Canadian socialized healthcare system, and sent its officers to enforce the order. In other words, armed agents of the state were ordered to ensure that a private individual report for work at a state facility. So Dr Paul’s warning, while maybe poorly-worded or -constructed, may not be so very far-fetched. It’s certainly one step beyond ‘the right to obtain healthcare’ towards ‘other people will be forced to provide you healthcare.’

    It may not be slavery, but it’s certainly involuntary servitude.

    llater,

    llamas

  • bloke in spain

    With reference to the leg amputation case, one might hazard even the NHS doesn’t hack legs off for convenience reasons. Just generally in the way or the unavailability of longer beds. One suspects a circulatory problem. Therefore, would one be wrong in imagining there would have been an x-ray or other investigatory scanning to identify circulatory problems. And be wondering why a bloody great piece of metal didn’t show up.
    On the other hand, in the final hours of Dad’s life:
    District nurse: “I’m going to give him a sedative injection so he’ll rest more easily”
    “But not diamorphine? He was given it yesterday. That’s the box of vials your colleague left.”
    ” I can’t. I don’t have the authority. And the box hasn’t been opened” Shows sealed end of box.
    District nurse’s companion: “It does say in the notes he’s authorised for diamorphine”
    “Oh. Er. They’re very badly written.” takes diamorphine vial from unsealed end of box & fills syringe.
    Checked the notes after they’d left. Clear in black & white. She hadn’t read them.

    I wouldn’t trust these f**kers with a sick cat.

  • llamas

    @ BIS – I think, tho’, that the issues you describe with your Dad (MHRIP) is a cultural thing that’s built into the culture of the NHS, not a failing of socialized medicine per se.

    I well recall, when my Dad (MHRIP) was in the process of passing away, in the Netherlands, I would take him for long walks in the country in his wheelchair. Along the towpaths of the canals on sunny days, or maybe to Vincent’s watermill. I would typically have flown over from the US a day or two before. My mother had enough morphine in tablet form (MS-Contin) in the house to euthanize an elephant. Make that TWO elephants. There were various dosages. I had the hospice nurse tell me exactly how and when to give it to him. Didn’t know me from Adam. Didn’t care. We turned in all the left-overs after he passed away (and there was a metric sh*t-load of it) but nobody ever asked for an accounting of how much we’d given him, or who had done it. Nobody cared about that sort of trivia. If he asked for it, or if it sure looked to us like he could use it, he got it, as much as he wanted. The core principle was ‘relief from suffering’ (‘verlossing’) and nothing was allowed to stand in the way of that core principle.

    The issues you describe are, I think, more issues with the culture of UK healthcare staff, than they are with the fact that it’s a socialized system. I suspect that most nurses in BUPA hospitals could have done the same sort of thing, because they are trained and managed in the same ways.

    llater,

    llamas

  • bloke in spain

    Oh, I’m convinced it’s a cultural thing, Llamas. But I’d say it starts with “NHS Envy of the World!!!”
    They all buy into this view so, by extension, they as individuals must be the envy of the world. So they’re almost totally un-self-critical. Whatever failings one points out are always either someone else or “the system”. There’s no sense of responsibility that it’s THEIR job* to pick up the failings of others or the “system”. In the last week of Dad’s life they began the incontinence assessment should have been done a month before, to deal with a problem we’d been struggling with. I had the bloody woman taking me through the chart I was supposed to fill in with his fluid intake AFTER telling her he hadn’t had a fluid intake for 2 days. But boxes must be ticked.

    *It’s something I used to tell my guys. I never want to hear “I’ve done my best”. I don’t care. Means someone or something else failed & it’s your job to make sure it doesn’t. We’re judged by results, not intentions. In our paypackets.

  • Sigivald

    Unfortunately, in practice all I saw of it was people on Facebook (mostly my Canadians) mocking it.

    Because, you know, they have a “right to health care”, and nobody’s enslaving Canadian doctors, so plainly Paul is crazy-go-nuts. Obviously!

    Sure, he said “ultimately”, but nobody can be bothered to read The Other’s actual words before reacting, nor can anyone be bothered to think about what a “right” to provision of services might mean – because naturally somehow money will pop into existence to pay for anything, and there will never be any shortage of doctors, regardless of compensation or incentives.

  • Hoth

    Nothing that must be paid for by someone else can ever be considered a right.

  • Laird

    Llamas, I suspect that it is “a failing of socialized medicine per se” because such a mindset is the inevitable, and entirely predictable, result of socialized medicine. Such a system either attracts individuals with that mindset to begin with, or it distorts people to that mindset once they’ve been working in it for a while.

  • llamas

    Well, I’m not sure that it’s ‘inevitable’ that this mindset develops. And I’ve seen the same tick-box culture in the US system, although when we consider how much of that is effectively socialized already, I suppose I’m actually proving the point. I understand the VA is notorious for this – a government-run single-payer system. OK. Point taken.

    Things is, while my memories of NHS care as a patient and observer may be (quite a few years) out of date, it was certainly the second or third generation of 100%-NHS employees, with very few people left who had ever worked in the pre-NHS system. I don’t recall ever seeing anything like this attitude, not even a suggestion of it. Sure, it was bureaucratic, and the medicine was sometimes somewhat rough-and-ready, and some of the people were kind of rough-and-ready too – but I never got the feeling that they ever neglected patient care in favour of (anything else). I know for a fact that the discipline and professionalism expected of nurses in those days was of a very high order indeed, and that avoidable or negligent clinical mistreatment of a patient was treated very seriously. The standard of care I remember in the NHS is not so very different than what’s seen in ‘Call the Midwife’, when you make suitable allowance for dramatic license. When did it change?

    Purpl-Xed.

    llater,

    llamas

  • When did it change?

    These things never happen overnight – mindset and culture take time to develop, some times over several generations.

  • I agree totally.

    This matter was dealt with very fully by the advertising-blokes that wrote “Rip Van Australia”.

    The key phrases were: “If someone has a “right” to healthcare, or a free video player or a foreign holiday every year, than that means that someone else is forced to provide it. That makes him, the provider, a slave of the person demanding the right.”

    It wassomething like that, anyway!

  • William O. B'Livion

    Perry de Havilland:
    > William O. B’Livion is wrong…

    No, I’m not.

    If Rand is specifically talking about the “Right to Free Health Care” as opposed to the general right to “Health Care” then he needs to put the word “Free” in there. He needs to specifically and directly argue what a right is, and what it is not.

    The left (at least dedicated leftist intellectuals, as opposed to liberal intellectuals) has a VERY different notion of rights than those of the Libertarian/Anarchist/Conservative bent, and it is exactly *that* difference upon which we need to shine the light and argue.

    He’s also opening himself up to counter arguments that are about implementation details–as if those matter–rather that the core moral issues.

    I can design you a “free” health care system where doctors, nurses and janitors are not conscripted at all, because after all “free” doesn’t mean without cost, it simply means without cost to the patient–we all know that right?

    So if you take his words as shorthand for the expanded concepts where “right to health care” really means “right to free health care” what you’re really allowing is “the right to health care paid for by one or more large insurance pools which people pay into as part of their tax dollars, and if people what they can opt to see private doctors much like the education system”.

    After all we have a “right to education” in the US, which *now* means “a right to an education provided by the state” and there are few teachers and janitors who feel conscripted (although more than a few teachers might feel disgruntled), and we could “easily” build a health care system on that model.

    Why should the “right to health care” be any different than the “right to an education”?

    (The only real difference is that the schools are nominally under control of locals, not the central federal government. Nominally).

    The left has corrupted the political language to it’s own benefit, and unless we can successfully argue the difference we specifically open ourselves up to the argument that we *WANT* people to die in the streets, which none of us do because it’s unsightly, not to mention unsanitary and slows down the commute.

    The Left’s notion is that a “right” is essentially something that must be PROVIDED by the state/society rather than something to be protected/preserved by society. This is a maul they use to drive wedges into every possible crevasse pushing state influence deeper and deeper and making people more dependent. It is also incredibly dangerous because by putting the state in as arbiter of who gets what when, the states then assumes the power to do exactly that.

    Which is an argument you know very well.

    Rand is, by his use of language, continuing to concede that point.

  • William O. B'Livion

    Richard Thomas
    Me:
    > You have a right to seek healthcare, you do not have a right to be provided healthcare.

    The issue with emergency rooms is that they do end up treating non-emergency cases (and in the case of one hypochondriac I know,

    That is why I said:

    [1] I do think that if one chooses to work under the “emergency room” banner one is more-or-less obligated to take any *emergency* that comes in.

    I worked at a Class 1 (we take *anything*) trauma center at a hospital that was part of a major state university and the cases *I* helped ingest ranged from a young lady who couldn’t get the sponge out, to a severe asthma attack (dead) and a gun shot wound (also dead. Also the first time I’d ever seen the inside of someone’s chest).

    So I’m well aware of how folks of all classes abuse the emergency system. Unfortunately it’s not always possible to reliably sort emergency from non-emergency cases, but where it is IMO the non-emergency cases should be sent packing with a bill for time used. Of course in today’s system they wouldn’t *pay* that bill.

    Then the influence that insurance companies and medicare exert over the whole thing just muddies the waters even further.

    As a conservative, it is my position that any *radical* changes to the existing institutions and systems need to be *seriously* thought out before making them. However, when it comes to health care, both the health care bureaucracy and the government bureaucracy involved in Medicare/Medicaid (US) and NHS (UK) need to get drug out in to toxic waste dumps and shot once in the back of the head with small caliber bullets and left for nature to clean up.

    Not the practicing health care professionals, the time servers, the bureaucrats, the telephone sanitizers of the health care world and their masters.

    Either that, or we need to build the B ark. One of the two, but those people have *GOT* to go. One of hte top 20 highest paid state employees in my home state is the CEO of the University Hospital. Not a doctor, not a neurosurgeon, not someone who’s had someone’s life hanging on their skill, nerve and judgement, no, some pissant bureaucrat WHO DOESN’T EVEN HAVE TO TURN A PROFIT EVER because it’s a state/teaching/non-profit hospital, and he makes about 1/2 a mill USD a year.

    And we wonder why health care is so bloody expensive in the US. Wanna bet his “executive assistant” makes as much or more than a senior developer in Silicon Valley?

  • William O. B'Livion

    bloke in spain

    But I will take back the whips. And substitute goads. Spiked ones.

    Cattle prod mate.