The Road to Servitude

This was the name F.A. Hayek wanted to use for The Road to Serfdom in 1944, but because de Toqueville had already used it a couple of hundred years ago to describe the same thing, he changed it. The sentiment remains the same after all these years: collectivism enslaves us and diminishes our productivity, creativity, and humanity. It leads to immoral man ruling immoral society.

Reading political economics from the first half of the twentieth century has an interesting dialect: "liberal" does not mean "liberal" the way Americans have known the word for a hundred years. Rather, when Hayek uses the work, he means "libertarian", or specifically, one who loves individual liberty and objects to collective planning. What we call "liberal" in the States, he calls socialism. Again, just a translational footnote. England and Germany were the centers of liberty-speak (liberalism) in the last 25 years of the nineteenth century and the first 25 years of the twentieth. He goes on to demonstrate how the evil economic-political systems of his era, Naziism and Communism, were really the same: centrally planned economy (e.g., national socialism and international socialism are both socialism).

Hayek also notes that the seeds for socialism remain in the fertile soil of Western democracies, where well-meaning moralists equate, for example, losing a job with injustice, correctable by government. He presented a novel concept (at least to me): namely, if the government guarantees a citizen a job, in perpetuity, at a given wage, then the worker de facto no longer may choose his own job. Think about it; it's true if there are no other jobs outside the government system (think especially about the new health care plan). Do you (or would you) enjoy the ability to choose what job you want to do? Isn't that one of the things that causes you to get up in the morning? Doctors will become one of the newest victims of this predicament once the second half of reform (salaried docs versus pay-per-unit-work) becomes de rigeur. Remember that health care reform as proposed is only the insurance system part. The second part is controlling costs, and that requires controlling the physician and what she/he orders: that control cannot happen in a pay-per-unit-work system. The lose-pay-for-ordering-too-much-for-the-patient system is around the corner.

In America, of course, we are already into socialism up to our kneecaps. Health care reform is socialization of one-sixth of the American economy. Its unintended sequelae are only the latest additions to government enterprises in America, and may well deliver a coup de grace to our remaining economy, and more gravely, to our determination to continue as a free society.

Es Tut Mir Leid, Herr Arzt: AmeriDeutch Medicine Kommt

There is an excellent article in Forbes Magazine this week about the German health care system. I'll cut to the chase for you Americans: everybody is happy, and the doctors get it in the neck. There are regional public option insurance companies (Krankencasse), and a few atrophied private options which don't add much to the robust public plan. The cost of medical care there is roughly half of what Americans pay per capita. And the savings doesn't come from doctors; it can't, since doctors only account for 10% of costs in the United States. Of course, if you count indirect costs from doctors ordering tests out of courthouse-paranoia, the cost attributable to doctors is at least double, but of course that is not corrected simply by changing us to Bismarcks 1880-era plan.

Nevertheless, Germany's plan works. A German told me recently that his nephew, a doctor in Germany, takes vacation for two months a year to go moonlight in Austria or England where the pay to doctors is higher, so he can supplement his salary. Ausgeseichnet? Vielleicht nicht! American doctors will do the same, or elseleave medicine and surgery en masse to get jobs as middle-school principals, where the pay is the same and the night-call responsibilities are a little nicer.

Love is More Than Government

American: your hard-earned money will go where? To sanctioned, sanctifying love-work of your master, as you perceive that his spirit may determine? Or will it become your tax-contribution to health care reform? It will be one or the other. Listen:

While he was in Bethany, reclining at the table in the home of a man known as Simon the Leper, a woman came with an alabaster jar of very expensive perfume, made of pure nard. She broke the jar and poured the perfume on his head. Some of those present were saying indignantly to one another, "Why this waste of perfume? It could have been sold for more than a year's wages and the money given to the poor." And they rebuked her harshly." Leave her alone," said Jesus. "Why are you bothering her? She has done a beautiful thing to me. The poor you will always have with you, and you can help them any time you want. But you will not always have me." (NIV, Gospel of Mark)

"It could have been given to the poor" is the government-religion's pretense to seize wealth, in every age. Service to faith is therefore a "waste," says the humanist: service led as it so often is, by women.

Was he right? Will the poor be with us always? As long as some refuse to work, yes. And the human condition tells us that is always. Jesus, the only True Humanist.

Jefferson: The Anti-Obama?

Found these quotes from Jefferson in my inbox today. I did not realize how treasonous he sounds:

--When we get piled upon one another in large cities, as in Europe, we shall become as corrupt as Europe.
--The democracy will cease to exist when you take away from those who are willing to work and give to those who would not. (According to some sources, not a verified quotation!)
--It is incumbent on every generation to pay its own debts as it goes. A principle which if acted on would save one-half the wars of the world. (Thomas Jefferson to A. L. C. Destutt de Tracy, 1820. FE 10:175)
-- I predict future happiness for Americans if they can prevent the government from wasting the labors of the people under the pretense of taking care of them.
--My reading of history convinces me that most bad government results from too much government (one site states this is unproven).
--No free man shall ever be debarred the use of arms...
--The strongest reason for the people to retain the right to keep and bear arms is, as a last resort, to protect themselves against tyranny in government.
--The tree of liberty must be refreshed from time to time with the blood of patriots and tyrants.
--1802: 'I believe that banking institutions are more dangerous to our liberties than standing armies. If the American people ever allow private banks to control the issue of their currency, first by inflation, then by deflation, the banks and corporations that will grow up around the banks will deprive the people of all property until their children wake-up homeless on the continent their fathers conquered...'

Another:
"I sincerely believe... that the principle of spending money to be paid by posterity under the name of funding is but swindling futurity on a large scale." --Thomas Jefferson to John Taylor, 1816. ME 15:23

Moondog Divines and Healthcare Proposals

As a resident 25 years ago in the emergency room, we used to see indigent street people for non-emergencies because 1) they had no other place to go, and 2) we did not have an effective (read safe) triage system to deal with the problem. Although this misdirection clogged the ERs, the poor did get seen. Now, however, the problem now has blossomed out of all preportion: witness poor mothers bringing the family into the ER so that everyone can see the routine OB ultrasound of the baby.

Meanwhile, today, we have emotionally-challenged American mainline denominational clergy preaching to their shrinking flocks that the far-left Democratic health care plan is the Church's clear solution. Nothing new in that: they have politicized their pulpits for decades. Organized medical care for the poor and uninsured, if done right, may be a beautiful thing. We have yet to see it in this country, but there may be a way to get it done without wrecking systems that work. However, be very careful when you hear preachers clamoring for specific brands of political action. Put your hand on your pocketbooks, and remind them that Providence pays them from that source as well. Finally, remember your family doctor's current waiting list when you consider dumping an additional 40 million Americans onto the routine primary care office visit rolls for the all-you-can-eat special.

George Bernard Shaw: Obama's Spinmeister

Last week, President Obama called otolaryngologists butchers-for-money, setting the AMA and most conscientious doctors on fire with ire. Now consider this expansion on his point, which could not have been done better if it were written yesterday. In his Preface on Doctors (from the play, "The Doctor's Dilemma", 1911), we have GBS wonking on health care, decades before the National Health Service was born, and while Britain still enjoyed private practice:

"It is not the fault of our doctors that the medical service of the community as at present provided for, is a murderous absurdity. That any sane nation, having observed that you could provide for the supply of bread by giving bakers a pecuniary interest in baking for you should go on to give a surgeon a pecuniary interest in cutting off your leg, is enough to make one despair of political humanity. But that is precisely what we have done. And the more appalling the mutilation, the more the mutilator is paid. Scandalized voices murmur that operations are necessary. They may be. It also may be necessary to hang a man or pull down a house. But we take good care not to make the hangman and the house-breaker the judges of that. If we did, no man's neck would be safe and no man's house stable."

I'm still not convinced. If the doctor cannot make decisions with his patient, who can?

Obama's Health Plan: Ayn Rand speaks

Doctors have not spoken loudly regarding Obama's health care plan, a Trojan horse of a government health insurance program which will blossom by killing all other insurance programs from the market (who can compete with the Government?) and leave us with a one-payer system (read: VA hospital system). Rationing for the people. But what about the doctors? Here's one:


"I quit when medicine was placed under State control...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...Men considered only the 'welfare' of the patient, 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'...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...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." (Ayn Rand, Atlas Shrugged, 1957)