The Ayn Rand School of Medicine
You know how most doctors get frustrated when their patients try to bring up stuff they read on the internet about their disease? I feel the same way when some doctors talk about health care policy. It’s like medicine is this super-duper arcane and esoteric craft where only twenty years of education can train you to understand even the most basic facts, but somehow all you need to be an expert on social policy is to read Atlas Shrugged.
Today’s case in point, Dr. David Alway – a guest poster on Kevin, MD:
If you speak to a socialist, he will probably consider health care to be a right – with the consequence that others (including physicians, hospitals, nurses, etc.) have no right NOT to provide these services. This creation of slaves in medicine will (and has) inevitably lead to health care workers exiting the field or people deciding not to train for it in the first place.
See what he’s doing there? Socialists think health care is a right, ergo anyone who thinks health care is a right is probably a socialist. Dr. Alway’s understanding of “socialist” is so watered down, it just means anybody who thinks we ought to give a crap about other people. If you think the government can run the fire department, or schools, or Head Start – guess what! – you’re a socialist. Don’t sweat it: you’re in good company.
Dr. Alway’s discourse on economics and policy is about as sophisticated as you might find in the freshman boys’ dorm of a very conservative, not-very-selective private university: “Capitalism is good; socialism is bad. Nobody has a right to my wealth!” But guess what: nobody has a right to a medical license, either. And if you think capitalism means nobody has a right to your labor, it also means that you don’t have a right to a government-enforced scarcity of the same. You wouldn’t be nearly so wealthy if the government let just anybody practice medicine – so why not finish your wine cooler, say the Pledge of Allegiance, and get to bed before the resident assistant calls “lights out” for the night?
And here’s another thing: this bullshit about providers being slaves. Slaves can’t leave their circumstances; that’s what makes them slaves. Dr. David Alway can quit being a doctor, if he wants – and the world might be better off for it. But some people’s participation in health care is not discretionary. Some people are forced into a system that proceeds to extract as much revenue as possible from their suffering. If Dr. Alway wants to talk about slaves, he’d do well to remember that I can’t stop being chronically ill any more than Kunta Kinte could stop being black.
Thanks for bringing this to my attention and good luck on the Stupid Cancer Show next week. I pity the patients of Dr. Alway, for some reason I don’t think he’s the most open physician you’ll even meet.
Mr. Cross:
I certainly understand from reading above that you are very angry. And I understand that you think Dr. Alway is pretty much an idiot. But beyond that, I don’t really understand much else.
Maybe you can interrupt your ranting about Dr. Always just long enough to tell us exactly how you define socialism and to explain how using government force to requiring one segment of the population to pay for the medical services of another does not qualify as socialism under your definition (at least I think that’s what you are trying to say). If the altruistic and egalitarian philosophy of socialism is not the justification for giving “rights’ to some person or group while requiring that they be produces and/or paid for by others, could you please explain what principles justify this type of social arrangement.
I understand that you think Dr. Alway does not make a very good presentation of economics. Would it be possible for you to briefly outline your economic theory so that we readers could all have a better context for understanding the points you are making. I’m not asking for any detailed theory, just a brief overview of how you see economics operating successfully in a complex society and what the guiding goals are for that economic activity.
I was also confused by your discussion of slavery. I understand that in your view, regardless of how much regulation and authority the government exerts over a profession or industry, so long as any participant can abandon their livelihood, possibly forsaking a huge investment of time and money in training, then it is unreasonable to categorize the arrangement as slavery. Okay. If we do not use that term, could you please explain your views on this issue. Do you see any limits on the power of the government to encroach on the lives of its citizens? Do the citizens have any guaranteed rights that may not be violated? If so, could you please explain what those rights are and how they are manifest in action?
I was confused by your piece, because these were the issues that Dr. Alway seemed to be addressing, and I could not really understand where you stood regarding them. If you could please take some time to present your thoughts on these points, I think it would make your disagreements with Dr. Alway much clearer.
Thanks.
–
C. Jeffery Small
Aftercancer – thanks, and agreed!
C. Jeff – thanks for your comments, and welcome to DuncanCross.net! I’ve actually been blogging on these issues for more than a year; let me direct you to the search box on the left, which I think will answer all of your questions. For example, try “socialism” and you will get several results which ought to illuminate my views. You can do the same for “economics”, “slavery”, “rights” – just about any other term that isn’t adequately fleshed out in this post has been discussed at length elsewhere on the blog.
Nice post. I am cognitively impaired and it seemed pretty straight forward to me.
Have a good weekend.
Kelli
Great post. Especially that last line, LOVE it. Title’s not too shabby either.
Thanks for pointing out Alway’s post. However, it (and most of the comments following it) made me want to pull my hair out. Well, the hair which isn’t still falling out because of all the steroids I’ve taken in recent months to deal with my chronic illness.
And to Mr. Small – you’re feeble attempt at humor failed.
Lisa:
I think you are confusing a respect for ideas, a commitment to truth and fidelity to the concepts underlying language, with humor.
For the record, I don’t mind when patients bring up stuff they’ve read on the internet – often it is interesting and relevant.
Being a physician certainly does not qualify me as an expert in social policy. But neither does it disqualify me from entering the debate. We (including you) should all be open to new ideas, or new perspectives on old ideas, without attacking their source (which is the informal fallacy of ad hominem – attacking the person and not the argument).
You wrote: “You wouldn’t be nearly so wealthy if the government let just anybody practice medicine.” I agree that the government should not control the practice of medicine, including licensing.
You wrote “See what he’s doing there? Socialists think health care is a right, ergo anyone who thinks health care is a right is probably a socialist.”
Your ‘insight’ is off the mark. My reason for linking these two concepts is that it is logical that a socialist would consider health care to be a right, and so that furthers my arguments regarding the implications of these ideas. This is a formal logic problem for you, perhaps some Venn diagrams would help: Socialists like cupcakes. John likes cupcakes. Does it follow that John is a socialist? Your error is one of ‘affirming the consequent’. You can read about it here: http://en.wikipedia.org/wiki/Affirming_the_consequent
I didn’t actually define socialism in my piece, but implicitly it would be defined as those who would attempt to equalize wealth among all adults (in this case, everyone in a nation). That’s hardly watered down, but you don’t have to use the word socialism if you don’t like it. While I did not intend to use socialism as a pejorative, you can simply substitute ‘redistributionist’ into the essay.
You also said “Dr. Alway’s discourse on economics and policy is about as sophisticated as you might find in the freshman boys’ dorm of a very conservative, not-very-selective private university…” Interesting. Some might consider it cowardly to diminish an argument without actually taking it on. But giving you the benefit of doubt, the essay you read was a markedly pared down version of a 2,500 word essay. Kevin, of Kevin MD, said he couldn’t publish anything over 1,000 words.
Perhaps, though, you should appreciate what I’ve done in a different context. My essay is an attempt to get inside the reasonable heads of people who do, in fact, believe these things and to come up with some ‘in principle’ truths. Einstein, Aristotle, Plato, and Newton were engaged in the same process. Of course, the conclusions I arrived at are informed by my view of history, governments, markets, capitalism, etc.. – they certainly do not stand alone. But I think that taking ideas seriously, even ones that I ultimately conclude are bad ideas, is important. I do not believe ‘redistributionists’ are purposefully evil – rather, I think they are mistaken. Looking at some implications of their ideas might help them to understand this.
You also reference slaves in your response, thinking it too strong a word. I agree that it is a strong word. The idea I am getting at is a loss of freedom and property imposed by a government. I am pitting the freedom of the individual against the control of the state. How much loss of property (say, in the form of taxes) and freedom is enough for you to be able to use the word slavery? That is for you to decide. If I decide to devote many years of my life to medicine including training, late hours, and the never-ending process of keeping up in my field – then have that field taken over by autocrats, limiting my freedom to practice medicine as I see fit, then a distinct loss of freedom has occurred – for myself and my patients. If I have to leave the field, then all of my work and devotion will have essentially been stolen from me.
Your chronic illness is not a form of slavery, in that it is not imposed by another person on you (I’m assuming). I truly wish for great advances in medicine to combat all forms of illness. The goal of improved health for everyone is a shared goal – we just have different views on how this can be accomplished.