“I’ve never paid for private healthcare because I’m a socialist. Now I find you can get tummy tucks and cosmetic surgery on the NHS but not the drugs I need to stay alive. It is a scandal,” – socialized medicine patient Tony Wilson
The title of this entry doesn’t refer to any sense of hypocrisy. Mr. Wilson’s friends chipped in to pay for a five-month’s supply of the medicine he needed, so I’ll accept that he was stuck on his socialist beliefs. But I am not surprised at the irrational disbelief and outrage at finding out that socialism doesn’t work. It probably is a scandal that the NHS will pay for something unnecessary while rationing away from something necessary. But again, this isn’t a surprise.
In socialism, rationing decisions will be made by bureaucrats. Bureaucrats can’t know, and almost by definition don’t care, about individual needs or desires. Their job is to manage with limited resources, so they will make the tough decisions. There is some balance of uninformed and political involved, but neither should be reassuring or viewed as a path to competent choices. Success is percentages and luck, not merit.
As such, I’m fascinated by this mixed-up e-mail sent to Andrew Sullivan by a reader:
Every healthcare system, public or private, must choose which care to provide and the cost versus efficacy arguments must be weighed carefully. It is always bad to base public policy on a single anecdote and we certainly should not be denying people Sutent solely because someone taking it died within the month. It is telling, however, that you used this story to bash the NHS for being conservative with other people’s money – rather than bash the drug company for refusing to sell its product at a price the customer is willing to pay.
The first statement I’ve bolded is misleading if you don’t dissect it properly. Of course difficult rationing decisions must be made. This is true of any good or service with a finite supply. The correct analysis is who does the choosing. In public health care, it’s the government, with a preference for your opinion only if you’re politically connected or important. In private health care, the individual makes the decision.
The second bolded statement demonstrates what advocates for socialized medicine claim is the fatal flaw of the free market. We must bash the drug company because it didn’t sell at whatever cost the customer is willing/able to pay. No. Life has costs and no party should be expected or forced to offer something in a way that doesn’t meet its preferred terms. The result can be viewed as heartless, but coerced compassion is merely coercion, not compassion.
It would be better to run with this quote from Mr. Wilson:
“I used to say some people make money and some make history – which is very funny until you find you can’t afford to keep yourself alive.
Decisions have consequences. Socialists are just as capable of making “bad” decisions as capitalists. It’s a tragedy when anyone can’t afford to keep himself alive. I am not advocating heartlessness. I do not believe that a free market system should or would allow poor patients to die. I’m just saying it’s more effective to raise standards for everyone rather than setting a maximum standard so that everyone can be covered minimally on the public dime.
It is not reckless or immoral to earn wealth. Mr. Wilson apparently contributed much to his industry, but eschewed personal financial gain for his efforts. I wouldn’t make that choice, but it’s not my place to force him to earn wealth. But wealth isn’t a zero-sum game. It doesn’t have to be finite, to be stolen and shared.
To me, there is no greater achievement than when a man can take care of himself. I accept that someone can disagree. Everyone is free to pursue a goal of voluntary collective responsibility and support. But don’t try to force me to join you. If your economic idea can’t survive without force, it’s immoral.