Health Care Collectivists

August 4, 2009 in Health Care by Greg | 6 comments

Last week, Sheldon Richman wrote an article entitled “Are We Really All Healthcare Collectivists?” In this article, he points out how the rhetoric of collectivism is used in today’s health care debate.

Health_Care_Collectivists “We have to do something about health care.”

The scariest word in that sentence is not something. It’s we.

The first-person plural form is not merely a convenience, as in “We’re in for a cold winter.” It indicates that decisions about “the healthcare system” are to be made collectively, with one decision binding everyone.

That’s collectivism.

So why is virtually everyone a collectivist when it comes to heath care? I do not exaggerate. Every prominent participant in the current debate over how to “reform” the medical and insurance industries — regardless of party — approaches the issue in collectivist terms. They have differences at the margin — tax increases versus tax credits, a government-run “public option” versus subsidized nonprofit cooperatives — but there is no disagreement that we must have a policy.

But why must we do anything about health care? Why can’t you do what you want, I do what I want, and he and she do what they want? Isn’t that what’s supposed to happen in a free society? Reformers would say that costs are rising too much and some people can’t afford insurance. But that is no answer. It tells us only that possibly ameliorable conditions exist, not that collectivism is a good approach.

When we see problems in the other important markets, most of us don’t expect televised presidential town-hall meetings, congressional committees, and omnibus legislation to give us The One Answer. We individually adjust our behavior in the marketplace and anticipate that entrepreneurs will cater to us. Solutions are micro, marginal, and tailored to individual needs, not macro, holistic, and procrustean.  Out of this arises an orderly marketplace — without a conscious overall plan. That’s why it works so well. No one has found a better way to make masses of people at all income levels better off.1

Reiterating what Dr. Edward R. Annis wrote in 2002 in the History of Socialized Medicine in America, Michel Accad wrote earlier this year:

In the broadest sense, medical collectivism results from the belief that medicine cannot be left to voluntary and unrestricted transactions between individual patients and individual healers but must be improved, directly or indirectly, by the hand of government. Medical collectivism has a long history that begins with the licensing of practitioners by the state, increases with the regulation of drugs, and flourishes with the advent of government financing of medical care. Medicine today is dominated by the collectivist ideology and Harlan Krumholz is one of its most prominent champions.

Circulation This past summer, Dr. Krumholz published in Circulation a manifesto entitled “Outcomes Research: Generating Evidence for Best Practice and Policy.” In this series of articles he educates the reader on his field of study and its demonstrated scientific promise to help shape “high-quality health systems.” An examination of the first sentences of the introductory paper exemplifies the language, method, and creed of twenty-first century medical collectivism.

It thus begins:

In an era of fundamental concerns about the way that health care is provided to individuals and populations, there is a need for a scientific discipline to bridge the capabilities of the medical profession and the best interests of patients and society.2

See the quotations on collectivism listed at the Ayn Rand Lexicon for additional information.

Sources:

  1. Richman, Sheldon. “Are We Really All Healthcare Collectivists?”. 31 July 2009. Foundation for Economic Education. 2 August 2009.↩
  2. Accad, Michel. “Harlan Krumholz’s Manifesto and the Creed of Medical Collectivism”. 22 January 2009. Alert & Oriented. 2 August 2009.↩

Tags: Collectivism, Health Care, Legislation

  1. kamschronNo Gravatar on August 6, 2009 at 8:22 am

    The relationship between cost and outcome is different for health care than for many other things. If I decide that I need a dishwasher, I probably can buy one for a few hundred dollars and have a good chance that it will last for ten years or more. When the dishwasher eventually fails, I can pay to have it repaired, or I can extend its lifetime for another ten years by buying a replacement. Even if the dishwasher fails with a catastrophic leak that destroys everything I own, I at least have the option of starting over without anything and going forward from where I am.

    Compared to the dishwasher, my body is built to last several decades longer if I am lucky and take good enough care of it. By spending enough money on health care, before my body fails, I may be able to repair it and extend my life for a few more years, although I probably will never be able to buy a new body to get a new lease on another eighty years of life. In most years, the overall cost of my health care is likely to be fairly small. In contrast, I know a neighbor across town who has taken good care of her body throughout her life and who nevertheless has medical conditions that require a high level of spending on health care in order to maintain a relatively low level of health. If she needed to buy health insurance as an individual, there is no possibility that she would be accepted by an insurance company.

    If I decide that I have been spending too much on cable TV, I can change to a different level of service, or I can cut out cable TV completely and go on living without it. It would be a simple choice, and there would be no injustice in it. If my neighbor with serious health problems similarly decides that she has been spending too much on health care, she can choose a lower level of service, but she doesn’t really have the option of going on living without her life, and there is little justice in forcing her to give up her life earlier than necessary in order to spend less.

    There are some things such as national defense that naturally require a collective solution. In our present world, where health care can make a genuine difference in the quality and length of a person’s life, with costs that vary widely and unpredictably from one person to another, health care is an area that seems to me to require a collective solution. I doubt that the ideas of Ayn Rand would support this conclusion, but there are other teachers and other ideas.

    In any individual or collective approach to health care, there is a point where diminishing returns seem to me to support the choice of letting nature take its course instead of putting more and more resources into a losing battle. If we choose a collective solution to health care as a society, it does not have to be an extreme solution that removes the right of individuals to make decisions about their own care. Respect for individual rights can lead to a solution that recognizes the right of individuals to refuse excessive services or to pay for extra services with their own money, as long as the impact on public health is reasonable.

  2. GregNo Gravatar on August 7, 2009 at 9:29 pm

    kamschron – I strongly disagree with the premise that health care should be run by a state-sponsored political collective for all the reasons listed in the post Collectivism.

  3. frankgNo Gravatar on August 8, 2009 at 11:58 pm

    “we” could decide to tell the politicians to back off.
    The politicians who oversaw the mortgage meltdown. Remember? HOUSING was a right? How’s that working.
    The policymakers who sold us the wonderful social security plan. Or medicare. What have we been told about these plans for years and years now? I remember news about medicare in the 90s about how they couldn’t account for (hundreds?) billions of dollars. But we must push on for MORE government intrusion? Scores of more agencies?
    They havn’t fixed much. Maybe they can’t. Or won’t.
    And they’re dissipating our nation’s financial independence.

  4. GregNo Gravatar on August 9, 2009 at 1:22 pm

    Sad, isn’t it? We seem to be witnessing the greatest deterioration of liberty in perhaps the shortest span of time since FDR.

  5. frankgNo Gravatar on August 9, 2009 at 5:54 pm

    Gregg, I have watched this debacle for over 25 years.

    Thanks for your measured, thorough articles on matters going on around us.

  6. GregNo Gravatar on August 10, 2009 at 8:35 am

    Thanks frankg. Dr. Edward R. Annis, former president of the American Medical Association, traced the History of Socialized Medicine in America back to the English Fabian Society and the Intercollegiate Socialistic Society in America. At the bottom of that post he wrote:

    What I have related is not an exaggerated fantasy. It is in fact true history and provides a realistic perspective as to how the Lilliputian-like bands have been steadily applied to harness our profession. In our society, things don’t happen — people make them happen!

    See American Fabianism for additional information.