If and when ObamaCoup passes, one-sixth of the economy will belong to the feds. The American Medical Association (AMA) and all the other medical unions (that’s what AMA comes down to) will go to D.C. to get their money, against fierce competition from the psychologists and social workers, who are also trying to get their share of the loot.
You and I will no longer be the main clients for our medical doctors. We won’t be in the loop. Your money will be forcibly extracted from your taxes, and when we get sick we will be passive recipients of the kindness of strangers — like Barney Frank and Harry Reid. And Nurse Ratched. It’s not your doctor anymore; it will be the state’s doctor.
I would not trust my doctor under socialism. Right now I think he is on my side. If I get some dread disease I think he will try to cure me. Why? Because we have the same incentive: my health and well-being. That’s not true anymore in Britain, where the National Institute for Health and Clinical Excellence (NICE) decides how much money the state can spend on you.
If you have a statistical twenty years to live, you get one-third as much as a teenager who has sixty years to live. It’s tax money per year of expected life. The old and sick are likely to die sooner, so they get less care — not more, as we do today — because we are much more compassionate than Dr. Obama will ever be. For him, “compassion” is just a rhetorical sledgehammer to get money out of the middle class.
That’s how they do it in Europe. The ruling class has its own high-quality medical system, just as the U.S. Congress has the best medical insurance today. It’s just like an Agatha Christie murder mystery, where the old lady is always afraid of being poisoned by her heirs, who will get the loot when she dies. It’s the biggest theme in British murder mysteries, because when Christie was writing murder stories, upper-class families were totally dependent on the family fortune, which was controlled by the oldest family members.
The younger ones received stipends, or they just had to go earn a living. So fantasies about giving rat poison to Auntie were part of everyday life. People speculated on when their parents or uncles and aunts would die and they would finally get all that money. The incentive was always there for the heirs to kill off their elders. Under socialism, the state will do it for them.
Trust is a funny thing. We want to trust our families and friends, totally. In a time of prosperity we can indulge that desire to trust. But in time of tradeoffs, when money for Auntie’s doctor really has to come from the food budget, you see fierce competition in families. That’s what the whole Oedipal complex notion is about: generational politics in a time of great scarcity.
Most of human history was that. In every imperial family in history — Rome, Ottoman Turkey, the Saudi kingdom — it turned into literal killing. Read the Bible, and you’ll see it repeated over and over again.
We live in a time of amazing prosperity and medical progress. We are used to allocating money for poor people, for children with illnesses, and for the dreaded illnesses of old age. Historically that is a great luxury. Europe created socialized medicine after fifty years of huge catastrophes and class warfare — after World War I, the Russian Revolution, the Great Depression, and World War II. So fifty years of real, daily suffering, with more than a hundred million people dying. That’s when they created socialized medicine. It was a sort of rational decision at the time. The Brits had to ration food and gasoline during World War II. So did everybody else. So rationing medicine made sense, especially to the poor.
America may become the first nation to choose socialized medicine at a time of unprecedented prosperity and medical progress. It is an interesting experiment in national masochism. I don’t think we’ll like it, because the trust we have for each other and for our doctors will evaporate. Taxes will go out of control, and medical services will get cut and “rationalized.” Your doctor will work for the state, just like your children’s teachers and college professors. They will all talk up the state systems, because that’s where the money and power will be.
Yes, but it’s hope and change.
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