Tuesday, September 04, 2007
A horrible example of minor government functionaries I blogged about awhile back -- British doctors refusing treatment to patients whose lifestyles they disapprove of -- has now been proposed by a member of the British Conservative Party as national policy:
Failing to follow a healthy lifestyle could lead to free NHS treatment being denied under the Tory plans.Can we say, "libertarian paternalism"?
Patients would be handed "NHS Health Miles Cards" allowing them to earn reward points for losing weight, giving up smoking, receiving immunisations or attending regular health screenings.
Like a supermarket loyalty card [only enforced at the point of a gun --ed], the points could be redeemed as discounts on gym membership and fresh fruit and vegetables, or even give priority for other public services - such as jumping the queue for council housing.
But heavy smokers, the obese and binge drinkers who were a drain on the NHS could be denied some routine treatments such as hip replacements until they cleaned up their act.
Those who abused the system - by calling an ambulance when a trip to the GP would be sufficient, or telephoning out of hours with needless queries - could also be penalised.
So much for such past conservative ideas (if they ever had them) as reducing government expenditure, respecting the property rights of physicians and the personal sovereignty of everyone, and allowing non-coercive market forces to encourage people to take responsibility for their own lives -- all of which could be put into practice by privatizing the medical sector....
Even in America, which is in the midst of considering whether to hurl itself into the abyss of socialized medicine, many would look favorably upon this terrible development, seeing it as both a clever way to "cut costs" and "encourage" personal responsibility. Indeed, some, rather than taking this as the object lesson that it is, will regard it as something for America to emulate.
This incredible state of affairs is caused immediately by the fact that our long history of government interference in the economy generally and medicine particularly has resulted in individuals taking less responsibility for their own lives, thereby draining the pockets of the rest of us through taxation. Clearly, something must be done about this financial crisis.
Unfortunately, since repealing the welfare state does not exist as an option in the public debate -- because nobody is challenging the idea that one man should be enslaved to meet the needs of another -- the debate will move inexorably to a greater and greater role for the state. We are already seeing this here in America with smoking bans and trans-fat bans. What is going on in Britain is just more of the same, but further along the primrose path to hell. (And see my recent remarks on John Edwards' latest stab at "medical" policy.)
This ratcheting in the direction of statism is not unique to the debate over medicine. We see it, too, in the immigration debate with people trying to stop immigration on the grounds that immigrants use social services -- rather than looking at ending those social services.
The worst thing about this is that people, used to having their money taken from them by the government, no longer expect the government to protect their right to property. And yet, they grasp that the government can make others take less from them (or give them more) by dictating to others behaviors that will require lower expenditures by the government.
In other words, the people forget that the government has stolen from them, personally, by taxing them, and look at the public budget as a sort of communal "property". In that delimited sense, justice is on their side in demanding that some not use too much of it. It is in this way that people, having now forgotten about property rights begin demanding that the government redress crimes against "common property" by eroding what little protection it still affords of other rights.
This, I think, partly explains the prevalence of what I privately call the "dictator fantasy" in the West today, the idea that increased government controls are okay because they won't stop the fantasizer from doing anything he wants to do. (Most people who want to ban smoking don't themselves smoke, for example.) The general social consensus is (so far) reasonable enough for most people, and the behaviors the government wants to ban are (so far) harmful if done to excess or at least risky. This last point makes opposing these incremental steps towards tyranny easy to smear as "anti-health" or "anti-safety".
Unfortunately, just as people have gotten used to basically not having property rights, so will they, by acquiescing in all these "sensible" restrictions on personal freedom, slowly become used to the government telling them what to do. And eventually, they will find that something they wish to do runs afoul of the law, but by then, it will be too late.
A very wise man once said the following:
First they came for the Communists, but I was not a Communist, so I didn't speak up. Then they came for the trade unionists, but I was not a trade unionist, so I didn't speak up. Then they came for the Jews, but I was not a Jew, so I didn't speak up. Then they came for me and there was no one left to speak for me.Perhaps we need to update that. I propose the following:
First they banned smoking, but I didn't smoke, so I didn't speak up. Then they banned trans-fats, but I didn't eat them, so I didn't speak up. Then they banned eating what you wanted, but I wasn't fat, so I didn't speak up. Then they banned casting doubt on the consensus and I couldn't speak up at all.It is worse than "penny wise and pound foolish" for the Tories to attempt to solve a fiscal crisis by means of libertarian paternalism: It is a sacrilege against freedom and thus a crime against the lives of the British people.
The Tories would do well to propose, instead, a return to the private practice of medicine, and the Americans should move in that direction as well.