The Redistribution of Health (Part 1 of 2)

In her famous novel Atlas Shrugged, Ayn Rand identified the absurdity of placing one’s life in the hands of doctors whose lives had been throttled by socialized medicine.

Socialized medicine, because of the government monopoly it imposes on both doctors and patients, is the equivalent of holding a gun to a doctor’s head and saying, ‘Cure me. Save my life, on my terms— or else.’

So what is it about a doctor who’s prepared to have a gun held to his own head? In fact, he not only holds the gun to his own head, but also to the heads of every medical professional in the land. That doctor is none other than Donald Berwick, M.D., the physician appointed last year by Obama (without any Congressional hearings) to head up the Center for Medicare Services. This is the government agency which will ultimately implement the ObamaCare law—unless it is eventually repealed.

Berwick has been characterized as a ‘one-man death panel’ and it’s not difficult to see why, from some things he has said. For example: ‘Any health care funding plan that is just, equitable, civilized and humane must, must redistribute wealth from the richer among us to the poorer and the less fortunate. Excellent health care is by definition redistributional. Britain, you chose well.’

Another example: ‘We can make a sensible social decision and say, ‘Well, at this point, to have access to a particular additional benefit (new drug or medical intervention) is so expensive that our taxpayers have better use for those funds.’

This man personifies pure evil. And I’ll explain why, simply by identifying his unstated, yet glaring, premises:

Unstated premise #1
Health, like wealth, is a commodity to redistribute as the government sees fit. Individuals are not free, and should not be free, to make individual arrangements with doctors of their own choosing to maintain or restore health. This is a decision to be made by other people—not voluntarily through a competitive, for-profit insurance system, but through the monopolistic force of government. Government decides who should enjoy what degree of health, and under what circumstance. The idea here is not that government merely redistribute health care—but actually redistribute health.

Unstated premise #2
Individual decisions, literally about life-or-death matters, can and will be made by government officials. Government officials, not individuals, have the right and responsibility to make these decisions. We will call these ‘social decisions.’ Social decisions are ‘morally superior’ to individual decisions, and from now on will be the absolute law of the land.

Unstated premise #3
Health care is a public commodity. This means that it belongs to government authorities. Every hour of effort put into medical school by a physician entitles the government to take control of that physician’s life and rights, once he has completed that training and precisely because he has that training. The skills and expertise of a doctor do not belong to the doctor himself. Those skills are not his to keep or give away as he sees fit. These decisions are totally the domain of the government.

Unstated premise #4
Patients are not in charge of their own bodies. They might be self-determining in the context of the sexual partners they choose, or the choice to have an abortion or not. But in all other areas involving the condition of their bodies, all determinations are to be made by the government. The Department of Health & Human Services, at their offices in Washington DC, will determine who receives what surgery, what medical treatment, what procedure, when and why. Government decisions are by their nature valid, rational and right. They are also the first, final and only word. There will be no competing authorities, no competing third party payers, no fee-for-service between doctor and patient. Remember: Britain has the right system. America’s system will be Britain’s.

Unstated premise #5
Britain has an ‘excellent’ quality of health care, morally and medically superior to that of the United States. Its well-documented waiting lines, inferior quality of care and higher death rates from illnesses such as cancer and heart disease (often caused by waits) are irrelevant. What matters is that in Britain, government makes all medical decisions, while in the United States (up to now) these decisions have more often been made by doctor and patient. Government monopoly is the standard of excellence, not quality of care.

Concluded in tomorrow’s Column.