Two worlds as dif­fer­ent as life and death

The Washington Times Weekly - - Commentary -

Afew weeks ago, I had what seemed to me a small med­i­cal prob­lem, so I phoned my pri­mary physi­cian. How­ever, af­ter we dis­cussed the prob­lem, he di­rected me to a spe­cial­ist.

Af­ter the spe­cial­ist ex­am­ined me, he di­rected me to a dif­fer­ent spe­cial­ist else­where. When I was ex­am­ined and tested in the sec­ond spe­cial­ist’s of­fice, he im­me­di­ately phoned a hos­pi­tal, ask­ing to have an op­er­at­ing room avail­able in an hour.

No more than 5 hours elapsed be­tween my see­ing the first spe­cial­ist and the time when I was on an op­er­at­ing ta­ble.

This was quite a con­trast with what hap­pens in coun­tries with govern­ment-run med­i­cal sys­tems. In such coun­tries, it is not un­com­mon to have to wait days to see a physi­cian, weeks to see a spe­cial­ist and months be­fore you can have an op­er­a­tion. It is very doubt­ful whether I would have lasted that long.

In the in­ten­sive care unit, where I was sent af­ter the first of two op­er­a­tions, I was hooked up to high-tech ma­chines and had a small army of peo­ple look­ing af­ter me around the clock. Would a govern­ment-run med­i­cal sys­tem have pro­vided all this, es­pe­cially for a man in his eight­ies?

In some coun­tries with govern­ment-run med­i­cal sys­tems, in­di­vid­u­als are not even per­mit­ted to pay out of their own pock­ets for med­i­ca­tions that the govern­ment has ruled are too ex­pen­sive for peo­ple in their age bracket or med­i­cal con­di­tion.

That same mind­set has al­ready be­come ev­i­dent in the United States, where a very ex­pen­sive can­cer drug has been re­fused fed­eral ap­proval to be sold, be­cause it helps only a lim­ited num­ber of peo­ple and at very high costs.

But what if you are one of those lim­ited numbers of peo­ple, and you are will­ing to pay what it costs, with your own money?

You are free to take your life’s sav­ings and gam­ble it away in a casino, if you want to, but you are not free to use your life’s sav­ings to save your life.

This is not an iso­lated para­dox. This is the log­i­cal con­se­quence of a vi­sion of the world that pre­vails all too widely among the in­tel­li­gentsia, and not just as re­gards med­i­cal care.

In that vi­sion, peo­ple can

You are free to take your life’s sav­ings and gam­ble it away, but you are not free to use your life’s sav­ings to save your life.

draw on the avail­able re­sources only to the ex­tent that the govern­ment con­sid­ers ap­pro­pri­ate, in the light of other claims on those re­sources. This treats what the peo­ple have pro­duced as if it au­to­mat­i­cally be­longs to the govern­ment, and as if politi­cians and bu­reau­crats have both the right and the wis­dom to over­ride the per­sonal de­ci­sions that the peo­ple want to make for them­selves.

This is­sue in­volves a dif­fer­ence be­tween a world in which peo­ple can make their own de­ci­sions with their own money and a world in which de­ci­sions, in­clud­ing life and death med­i­cal de­ci­sions, are taken out of the hands of mil­lions of peo­ple across the coun­try and put into the hands of politi­cians and bu­reau­crats in Washington.

One of the big claims for govern­ment-run med­i­cal sys­tems is that they can “bring down the cost of med­i­cal care.” But any­one can bring down the cost of any­thing by sim­ply buy­ing a smaller quan­tity or a lower qual­ity.

That is why coun­tries with govern­ment-run med­i­cal sys­tems have wait­ing lists to see doc­tors, and even longer wait­ing lists to see spe­cial­ists or to get an op­er­a­tion. That is why those coun­tries sel­dom have as many high-tech med­i­cal de­vices as in the United States or use the new­est med­i­ca­tions as of­ten.

In those things that are cru­cially af­fected by med­i­cal care, such as can­cer sur­vival rates, the United States leads the way. In things that doc­tors can do lit­tle about, such as obe­sity, homi­cide or drug ad­dic­tion, Amer­i­cans shorten their own lives, more so than peo­ple in other com­pa­ra­ble so­ci­eties.

This en­ables ad­vo­cates of govern­ment-run med­i­cal care to cite longevity sta­tis­tics, in or­der to claim that our more ex­pen­sive med­i­cal sys­tem is less ef­fec­tive, since Amer­i­cans’ longevity does not com­pare fa­vor­ably with that in other com­pa­ra­ble so­ci­eties.

For those who think in terms of scor­ing talk­ing points, as dis­tin­guished from try­ing to get at the truth, this kind of ar­gu­ment may sound good. But should some­thing as se­ri­ous as life and death med­i­cal is­sues be dis­cussed in terms of mis­lead­ing talk­ing points?

Thomas Sow­ell is a se­nior fel­low at the Hoover In­sti­tu­tion, Stan­ford Univer­sity.

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