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Socialized medicine links

I really enjoyed the following writings about health care and the proposed socialization of it in the United States. They say it better than I am (currently) able to, and are all well worth taking the time to read.

Two posts from David Z. at No Third Solution: Is it “Un-American” to Disagree with Nancy Pelosi? and Does the NHS Provide Better Health Care?

Yuri Maltsev lived under the Soviet medical system, which somewhat soured his opinion of socialized medicine.

Robert Wenzel distills the Twitter comments of Peter Fleckstein regarding the monstrous Obamacare bill in the House of Representatives: Shock: Inside the health care bill and Shock: Inside the health care bill part 2. Yeah, Fleckstein’s commentary comes off as a bit annoying and juvenile because it’s written in textese, but that’s how you write on Twitter. Too bad he couldn’t translate them into a normal blag post or two…

As a complement to David Z.’s blag post about the British NHS, read Sean Gabb’s Libertarian perspective on the National Health Service. It’s a little long but worth the time; very enjoyable, insightful, and easy to read fairly quickly. I can’t help but quote a few paragraphs:

At the most fundamental level of analysis, legitimacy and merits have no connection with each other. The NHS is funded by compulsion. I am forced, as a taxpayer, to contribute to a system that provides health care of a kind and at costings that, given any choice in the matter, I would never accept for myself and those who look to me. I am also forced to pay towards the health care of strangers. I have no objection to charity. I try to be generous to those I know. I am prepared to be moderately generous even to those I do not know, and whom I might dislike if I did know them. But so far as I am compelled, paying for the health care of others cannot be described as charitable. It is as much an act of theft as if I were to be robbed in the street. The whole present system, therefore, is illegitimate. If it were, as we are continually assured, the “envy of the world”,my opinion would not alter. It is in itself unjust. I resent its existence in my country. I join with Mr Hannan in warning the Americans not to accept it for themselves.

This, however, is the most fundamental analysis, and no discussion can be regarded as complete without some examination of its merits. And in examining these, I fell an obligation to be as fair as possible. I will begin with the quality of health care provided by the NHS.

Here, I must dissent from much of the American condemnation. There is no doubt that the NHS is inefficient, and that it rations health care by waiting list and by explicit refusal to provide certain kinds of treatment to anyone, or by refusal to provide certain kinds of treatment to those deemed unlikely to benefit from them given their cost. But rationing in one form or another is inevitable to any system of health care. …

In attacking the British system, these critics seem to argue that their own is based on individual choice and free from any taint of collectivism. I am not an expert on the American system, but it does strike me as so heavily regulated and cartellised as to have little connection to a free market. …

If I contrast what I am told about the American system with what I know from personal experience about the British, the NHS is not really that bad. [Gabb then goes into detail about the high quality of care he, his wife, and his friends have received from the totally State-run system.]
[...]
I will add that the NHS is probably not unsustainable in the long term. It costs about £90 billion a year to run. But this is about eight per cent of gross domestic product, and is about half the American level. There are more doctors per head of population in Britain than in America. British life expectancy is higher than American. …

This should not be taken as a defence of the NHS. I am simply pointing out that is is no worse on balance than the American system. They are differently organised and differently funded. Each has specific advantages and disadvantages. neither has much connection with a free market. In both countries, however, the middle classes are able to get very good health care. In both, the poor and ignorant do not. The NHS is not a bad institution relative to the American system. It is bad for other reasons—and these may be bad reasons that apply in some degree to the American system.

What is so fundamentally bad about the British system—its compulsory principle aside—is that it nearly abolishes individual control over health care. Compared with the system with which we entered the twentieth century, all real power is centralised into the hands of the professional bodies.
[...]
These [State-run] institutions impose values of hierarchy and obedience on those within them that are hostile to liberty. People who are regimented in their working lives—and who do not rebel against this—will tend to accept regimentation in their private lives. They will accept it for themselves. They will vote for politicians who promise it for everyone. They will spread these values directly to others so far as they have contact with the public as providers of services.
[...]
I believe that the NHS should be dismantled and replaced with a more diverse, private system. This does not mean that I want to cut off health care for millions of older people who have made no alternative arrangements. It also does not mean that I want to cut off state funding and leave the current system of cartellised and regulated health care otherwise unchanged. I believe in a radical attack on all state involvement in health care, and this includes an attack on all state-created and state-upheld monopoly in health care.

I believe that all drug patent laws should be repealed. … I believe that there should be no controls on who can practise medicine. … I believe there should be no controls on the development and provision of medical products. … I believe that everyone should have the right of self-medication. This means the right of any adult to walk into a pharmacy and, without showing any prescription, to buy whatever medical product he desires. …

These reforms would bring down health care costs at once. They would also clear the way for the information technology revolution to transform the market in health care. I will not try to predict how all this will be funded, though it strikes me as reasonable that it will fall into the same pattern of direct payment, charity and voluntary mutual assurance as was common before the State took over. And when I speak of mutual assurance, I mean both for-profit insurers and not-for-profit organisations. The idea that only profit-seeking organisations are consistent with libertarianism is to take a shockingly arid view of the ideology. What libertarians should like about commerce is not its taste for profit but its distaste for compulsion. …

I will repeat—cutting off state funding all at once, and leaving in place the present system of monopoly, would be cruelty and folly. It would easily result in a step away from liberty rather than towards it. But reducing this funding over several years, as part of a general attack on monopoly, would be a blessing, the fruits of which were plain even before it was complete.

It’s music to my ears.

Posted in Medicine, Socialism