Physicians as "Little Dictators"

[Gus Van Horn blog]

By Gus Van Horn from Gus Van Horn,cross-posted by MetaBlog

At Spiked is a chilling article by Rob Lyons that describes what can happen if we delegate to the government all control over the medical sector: Doctors in Britain are beginning to refuse certain forms of medical treatment to people who smoke, drink, or are obese.

In the latest example of this trend, health chiefs in Norfolk and Newcastle-under-Lyme have decided to refuse certain kinds of non-urgent surgery to smokers --- including hip and knee replacements. Both [National Health Service] areas are in financial crisis and are looking for ways to save money -- and the government's relentless campaigning against our bad habits have made smokers, drinkers and the overweight an easy target for these bean-counters.

...

Whatever happened to humane medicine? It is one thing to advise a patient that giving up smoking or losing a few pounds will aid their recovery or increase the chances of success. It is quite another to refuse treatment altogether.

There is also the small matter of patient autonomy. While rationing of one form or another has been ever-present in the NHS, there has been the general principle that patients will be treated on a first come, first served basis, regardless of their income or lifestyle. Using access to public services to modify behaviour is something more closely associated with dictatorial regimes. The result is a peculiar form of torture. Those who require hip or knee replacement operations are clearly in pain, and usually severely hampered by their condition. This is coercion through healthcare, as surely as twisting someone's arm. The defence of autonomy, our freedom to live as we choose rather than as our government or our doctors see fit, is far more important than balancing the books of a cash-strapped NHS. [bold added]

When a good is offered for "free", as medical care is in Britain, shortages occur and rationing becomes inevitable as pricing information is unavailable to consumers about the state of the demand for that good versus its supply. Furthermore, given that the government must pay for medicine there, unhealthy habits by patients therefore become the business of the government to the extent that it will attempt to remain accountable to those whose wealth it expropriates in the process of providing that "free" service. Some form of government interference in the personal habits of Britons was an inevitable consequence of this scheme.

It should be obvious that such a situation provides all the rationale needed for any " little dictators" who happen to practice medicine to refuse to treat smokers and drinkers who might be well able to afford the operations in a free market system.

As objectionable as the behavior of the physicians is, it is absurd to complain on the one hand about a loss of "personal autonomy" and yet on the other to leave the system that makes their behavior possible unchallenged. The only way to preserve personal autonomy -- be it the freedom of a doctor to run a private practice (which seem not to concern Lyons), of a patient to look for the best physician he can afford, or for a patient simply to get care at all -- is to return to the system that protects it, capitalism.

And those who want to import this hideous system to America whine that some cannot afford medical care or medical insurance! Their "cure" for poverty is clearly worse than the disease!

-- CAV

http://ObjectivismOnline.com/blog/archives/002067.html