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Lawrence Reed Columnist

Published Thursday, August 09, 2012

The end of the socialized medicine road

Two years ago, the mish-mash of promises and regulations known as “Obamacare” was rammed through Congress. Most of it hasn’t even kicked in, but estimates already suggest it will cost two to three times what we were told in 2010. We’re well down the dead-end road to socialized medicine, complete with mandates for “free” contraceptives.

What’s wrong with socialized medicine? Twenty-five years ago, a friend of mine put it more concisely than I’ve ever heard it put before. His name was Dr. Roberto Calderon and he was a radiologist in Managua, Nicaragua.

Dr. Calderon didn’t just answer this question with exotic theories. His insight was derived from the time when the Marxist Sandinistas ran his country and tried to put the state’s bureaucracy in charge of almost everything. He saw socialized medicine from the inside and argued that it doesn’t work for the following five reasons:

The patient can’t choose the doctor.

The bureaucratic process ends up making the important assignment of which physician shall treat the patient. He who pays the piper calls the tune. Too much freedom for the patient makes life difficult for the bureaucrats, who already have more than enough of their own paperwork to deal with.

The doctor can’t choose the patient.

Assignments are assignments under socialized medicine. Referring a patient to another doctor is an unnecessary complication, and it screws up the system. Because medical services are made “free” by the state, demand for them goes up, which means that every doctor quickly becomes overbooked and overworked. So, doctors receive their order: Just get the job done whether you like the patient or not and whether or not you are suitable for him.

The doctor gets paid at the end of the month regardless of what or how well he did.

Even an eighth-grader understands why this is a prescription for high cost and poor performance. What in the world makes socialists think that people work harder and better for some faceless bureaucracy than they work for themselves?

The patient doesn’t get consoled.

Dr. Calderon told me that it was common in Nicaragua in the 1980s for patients to complain that “the doctor hardly speaks to me; he just says to sit there and be quiet.” An important, even vital, role of the healer is to provide comfort, reassurance and a positive mental attitude to the sick. This gets lost when doctors become short-order cooks in a government-run soup-kitchen.

The patient doesn’t get well.

That’s exactly the way Dr. Calderon put it, but he really meant that far too many patients under socialized medicine are “chronically sick” as a direct consequence of the previous four points. People go on waiting lists and many of them die before they ever get to the head of the line.

But, you say, this is a worst-case scenario and surely Obamacare would never evolve into such a nightmare. Yeah, just like they said in 1913 when the income tax was passed that nobody would ever pay more than 10 percent.


(Lawrence Reed, a resident of Newnan, is president of the Foundation for Economic Education in Irvington, N.Y., and Atlanta.)

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