August 21, 2012 by Julia
In case you missed it, the indomitable Theodore Dalrymple has an excellent piece exploring why the British are so attached to a mediocre health care system. By mathematical measures, NHS is neither the best nor the worst; every system has horror stories (although not every system includes government-sponsored euthanasia).
The most important points raised by Mr. Dalrymple, however, don’t relate to numbers or anecdotes. Echoing Runaway Slave, he suggests that the most pernicious dangers of government-run health care are the entitlement mentality and government control it engenders; both the class of entitled patients and the class of doctor-bureaucrats are, in the end, under the thumb of a health care system with little humanity and few incentives to succeed.
But the principal damage that the NHS inflicts is intangible. Like any centralized health-care system, it spreads the notion of entitlement, a powerful solvent of human solidarity. Moreover, the entitlement mentality has a tendency to spread over the whole of human life, creating a substantial number of disgruntled ingrates.
And while the British government long refrained from interfering too strongly in the affairs of the medical profession, no government can forever resist the temptation to exercise its latent powers. Eventually, it will dictate—because that is what governments and their associated bureaucracies, left to their own devices, and of whatever political complexion, do. The government’s hold over medical practice in Britain is becoming ever firmer; it now dictates conditions of work and employment, the number of hours worked, the drugs and other treatments that may be prescribed, the way in which doctors must be trained, and even what should be contained in applicants’ references for jobs. Doctors are less and less members of a profession; instead, they are production workers under strict bureaucratic control, paid not so much by result as by degree of conformity to directives.
This can happen under any system with third-party payment: it is an old observation that he who pays the piper calls the tune. But to have only one paymaster is to compound the problem, to make sure that there is only one tune. Therefore, even when the paymaster gets something right, an intangible harm is done.
That’s what the American Left doesn’t get. We AGREE that it would be awesome if we could find a way to get the best quality care to every single person, and we totally want to find a solution that will create that result. However, we aren’t willing to trade our freedom for empty promises–and it is sheer naiveté to believe the promises of centralized health care are anything but empty.