Examining government health care
The Hippocratic Oath states, "I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know." When a government bureaucrat is inserted into this dynamic, the very nature of care is altered
In the movie 'One Flew Over the Cuckoo's Nest', Jack Nicholson in his singular style represents a mental patient with a significant, if under-stated, mental condition, who has been remanded to a government-run mental health facility as penalty for some minor act of perceived insanity.
Portrayed in stark relief against the carefree Nicholson, his nemesis is Mildred Ratchel, the head nurse. While her declared intent is the wellbeing of her patients, it becomes clear throughout the course of the film that her true goal is in fact the stability of the small community of insane. As her attempts to control the ineffable Nicholson fail, she becomes increasingly heavy handed in her responses.
Behind the veneer of compassion and the rhetoric of the caregiver lies the constant spectre of violent coercion. In the end, forced to choose between the forced tranquillity of the community and the emotional outbursts of her most challenging patient, she has Nicholson lobotomized.
If there is one word that describes the federal government, that word must be coercion. According to Webster's dictionary, coercion is "to restrain or dominate by force." Naturally, any act of coercion is unpopular and wholly unwelcome. People generally do not want to follow speed laws. Those who choose to smoke do not wish to have the venue limited. Young people wishing to drink, or to marry, resent the age limitations imposed upon these activities.
More egregious, as seen by the affected populations, is taxation for the benefit of the functioning of the federal government. And even more unacceptable, the military draft in the 1970's, to fight one of Washington's many unpopular wars, was seen as the epitome of authoritarian intrusion by the federal government into the private lives of "we the people," and provoked a backlash unseen since the civil rights era.
This coercion, everyone understands, is enforced by that one primordial tool of government -- the gun. By giving the sole right for the use of deadly force to our elected leaders, we who live in democracy have legitimized the use of violence against each citizen who fails to abide by the social contract established by the people through laws and upheld by the government. This is the essence of legitimacy derived from the consent of the governed.
Therefore, it must be recognized that coercion is an important part of the work of any federal government. This coercion is a fundamental component of the aforementioned social contract held with elected leaders; the understanding that acts of coercion be for the common good and limited to in scope to the basic defence of the people.
The job of our representatively elected leaders, as seen by most of the mainstream population, is to uphold this social contract (and the people this contract defends) by protecting people from each other and from those who would do them physical harm. This is unpleasant -- and often controversial.
Case in point -- the Transportation Safety Administration (TSA) is probably the most reviled of Washington institutions and exemplifies this government responsibility. Intrusive, unionized bureaucrats are granted the authority to violate even the most sacrosanct of American rights -- the right to our own bodies. Their only and final tool for this function is, again, the "legitimate" use of the gun. Their only and final justification: to protect and to serve.
To be sure, the government's right to intervene in the daily lives of its citizens, for their protection, is a commonly understood and generally accepted reality. We live in a dangerous world. Even Ludwig von Mises, godfather of modern libertarianism (although he would probably have called himself a classical liberal), supported the coercive role of government. In his seminal work "The Concept of a Perfect System of Government," he stated, "The authority of man-made law is entirely due to the weapons of the constables who enforce obedience to its provisions".
As unpleasant as the common, law-abiding American finds the intrusion of the federal government in these issues -- they are begrudgingly accepted. The common man sees the alternative on the streets of Cairo, Kabul, Damascus, Caracas and Kinshasa -- and surrenders.
Yet, far too often, the federal government sees its own role extending beyond the simple act of coercion for public protection. Instead -- deluded by their power and goaded into grandiose acts of social engineering -- they believe they can take their coercive legitimacy and apply it to other aspects of daily life. None of these is more malevolent than the intromission into the health of each individual.
For the naysayers, they need look no further than the stated motivation for the federal government's interference in their illnesses. President Obama has recently stated, "... and I've heard from Americans with insurance who thought that 'the uninsured' always referred to someone else -- but between skyrocketing costs and insurance company practices, they're beginning to worry that they could find themselves uninsured too."
This faux compassion does not come from the concern by the executive for the private health of 300 million individuals. And how could it? Nobody can "care" for that many people without suffering depression and eventual insanity. Care -- real empathy -- is most often reserved for those with whom the infirm have a personal relationship; everything else usually descends quickly into pity.
This pity is the motivation of the Social Democrat's unrelenting drive for "social justice". Like the communist party leaders of yesteryear, political operators use this unhealthy emotion to manipulate their societies; demanding from the rich their subservience and from the poor their perpetual gratitude. Massive bureaucracies are set in place to cement these emotions into entitlements and an unending parade of faceless doctors-cum-bureaucrats treats their patients as they are instructed. Those who decry this system are christened selfish, compassionless capitalists.
This is the benevolent system imposed upon the infirm individual.
There is but one, simple and eloquent rationale which need be presented to seal my argument: the inarguable reality that at the other end of the "benevolent" hand of government is the maximum implement of its coercion -- that same, old gun.
The obvious problem with this is that health is an individual and desperately personal issue. The sacred trust established between the doctor and the patient is second to none and only akin to that of the priest and his confessor. The Hippocratic Oath states, "I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know." When a government bureaucrat, in possession of a gun, is inserted into this dynamic, the quality and in fact the very nature of care is altered. Compassion takes second seat to pity; individual care is replaced by communal concerns and unionized bureaucracies supersede the elemental rights of that fundamental building block of health care: the sick.
For the unbeliever, ask Jack Nicholson -- lobotomized for the public good -- how well communal, bureaucratized health care works.
Joel D. Hirst is a Principal with the Cordoba Group International and a defender of Human Rights and Democracy. He tweets at @JoelHirst
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