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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

“There are so many serious problems raised by the nationalisation of medicine that we cannot mention even all the more important ones. But there is one the gravity of which the public has scarcely yet perceived and which is likely to be of the greatest importance. This is the inevitable transformation of doctors, who have been members of a free profession primarily responsible to their patients, into paid servants of the state, officials who are necessarily subject to instruction by authority and who must be released from the duty of secrecy so far as authority is concerned. The most dangerous aspect of the new development may well prove to be that, at a time when the increase in medical knowledge tends to confer more and more power over the minds of men to those who possess it, they should be made dependent on a unified organisation under single direction and be guided by the same reasons of state that generally govern policy.”

– FA Hayek, The Constitution Of Liberty, page 300. First published in the UK in 1960.

8 comments to Samizdata quote of the day

  • […] the day is also someone else’s quote of the day, in this case it’s the quote of the day on the Samizdata blog. It concerns the problems and pitfalls that come with having a state run healthcare service […]

  • staghounds

    The idea of patient control of medical decisions is wasteful, outmoded and racist. It’s like letting the people with fires decide where the fire department responds.

    What could be more important than knowing about everyone’s medical condition and being able to control those who provide treatment? How else could we deploy the miracle of modern medicine effectively?

  • Mr Ed

    It was said that ‘War is the health of the State.‘; now ‘Health is the health of the State.‘.

  • Paul Marks

    As you know Sir, the main alterative presented to government hospitals is the government paying private medical bills – and that also has terrible problems. If the government pays for (subsidises) anything the price of that thing EXPLODES – whether it is housing (housing benefit), student tuition (the insane explosion in American college education costs), or anything else.

    Indeed the government paying medical bills, Medicare-Medicaid-SCHIP and the rest of it, is one of the two great reasons why American medical costs are so incredibly high – the other great reason being the endless regulations, which started with licensing and then spread to just about everything.


    I do not have one.

    But some countries run a system of government hospitals with most people not using them – Mexico used to be like that as private medical care was not expensive in Mexico. But a “conservative” Mexican government (President Fox – the same man who set up an incredibly corrupt private-public partnership to build and run housing schemes in all the major towns) set up government-pays-the-bills system in Mexico.

    In Britain as recently as 1911, 80% of industrial workers were members of Friendly Societies (mutual aid societies) and there were a network of free hospitals for people who were not members of mutual aid societies.

    I am not sure if it is legal in Britain to even mention this anymore – even as an historical point. I will just have to risk it.

  • lucklucky

    In relation to the apparent efficiency of Israel giving COVID vaccines to its population, i have read they 4 competing systems. A citizen is forced to choose one. Anyone know more about it?

  • Stonyground

    Would it be a reasonable solution to do a survey of healthcare systems throughout the world, find the best one and then copy it? I suspect that the practical difficulty would be in getting there from where we are now.

  • JohnK


    You are of course correct. All doctors who work in the NHS work for a socialist organization which preserves in aspic the ethos of Mr Attlee’s government. Consequently, almost all doctors have a socialist mindset. It is similar with teaching. Those who work in a government controlled sector cannot imagine how their sector could work without government control. Any doctor who remembered pre-1948 health provision must have retired decades ago, if any are still alive.

    I don’t know if you consume any BBC, but they have a family history programme called “Who Do You Think You Are?” This ocasionally throws up gems, such as “East Enders” actor and professional cockney Danny Dyer finding out he is a direct descendant of William the Bastard.

    However, in this context, I would refer you to a recent programme featuring Ruth Jones, the Welsh actress. She found out that her grandfather had been a stretcher bearer in the First World War, and in the 1920s had gone on to work for a miners’ friendly society in South Wales. By 1948 he had progressed to being its chief executive, and the programme was good enough to admit that it provided excellent medical cover for miners and their families across the region.

    Miss Jones was delighted at this information. However, she was then genuinely shocked to learn that her hero, Aneurin Bevan, had refused repeated requests from her grandfather to meet with him to discus how the friendly society could be incorporated into the NHS. Bevan had no interest in the views of a man who ran a health care system which was not controlled by the state, even if it was run by and for miners. The assets of the society were simply nationalised in 1948 without consultation, and her grandfather was told his services were no longer required. He ended up running a care home, one part of the health system which was not nationalised in 1948.

    Miss Jones was of course shocked at this. Like all in South Wales, she had been brought up to believe that Aneurin Bevan was a wise, kindly socialist hero, albeit one who called Tories “lower than vermin”. Now she had learned that he was a small minded and vindictive man, who was happy to take over a health care system miners had built for themselves without so much as a “please” or “thank you”, and then dismiss the very people who had built the system up in favour of government employees.

    I think it was a real education for Miss Jones, and indeed for the viewers. The shock to me was that it somehow found its way onto BBC1. I am sure it will not happen again.

  • Paul Marks

    Very interesting John K. – thank you for sharing this background.

    As for schools – the expensive private schools in the United States are often just as “Woke” as the government schools, and it is getting that way in Britain (see Eton).