Key ideas: “In the spring of 1962, some two hundred New Jersey doctors, led by Dr. J. Bruce Henriksen, signed a resolution of protest against the Kennedy Administration’s King-Anderson bill, which was the precursor of President Johnson’s Medicare program. The doctors stated that they would treat the indigent aged without charge, but would not treat anyone whose medical care was financed under the Kennedy plan. The King-Anderson bill was soon afterwards defeated in Congress.”
I want, therefore, to make certain suggestions to the medical profession—on the subject of how not to fight against socialized medicine.
The majority of people in this country—and in the world—do not want to adopt socialism; yet it is growing. It is growing because its victims concede its basic moral premises. Without challenging these premises, one cannot win.
The strategy of the Kennedy administration, and of all welfare-statists, consists of attempts to make people accept certain intellectual “package deals,” without letting them identify and differentiate the various elements—and equivocations—involved.
The deadliest of such “package deals” is the attempt to make people accept the collectivist-altruist principle of self-immolation under the guise of mere kindness, generosity, or charity. It is done by hammering into people’s minds the idea that need supersedes all rights—that the need of some men is a first mortgage on the lives of others—and that everything should be sacrificed to the undefined, undefinable grab bag known as “the public interest.”
Doctors have no chance to win if they concede that idea and help their enemies to propagate it.
Yet the ideological policy of most spokesmen for the medical profession—such as the A.M.A.—is as permeated by the collectivist- altruist spirit as the pronouncements of the welfare-statists. The doctors’ spokesmen declare, in net effect, that selfless service to their patients is the doctors’ only goal, that concern for the needy is their only motive, and that “the public interest” is the only justification of their battle.
The sole difference is this: the voices of the welfare-statists are brazenly, self-righteously overbearing—while the voices of the doctors’ spokesmen are guiltily, evasively apologetic.
Whom can one expect the people to believe and to follow?
People can always sense guilt, insincerity, hypocrisy. The lack of a morally righteous tone, the absence of moral certainty, have a disastrous effect on an audience—an effect which is not improved by the triviality of the arguments over political minutiae. And the terrible thing is that the doctors’ spokesmen give an impression of guilty evasiveness while the right is on their side. They do it by being afraid to assert their rights.
They are afraid of it because they do not believe that they possess any rights—because they have conceded the enemy’s premises—because they have no moral base, no intellectual guide lines, no ideology, no defense. …
The text of the agreement reached between the doctors and the government contained the following horrifying sentence:
“The doctors fear that if the government becomes their only source of income they are in danger of becoming servants of the state and not servants of their patients.” [Emphasis added.]
A more abject statement of self-abnegation could not be hoped for or extorted by the most extreme collectivist.
No self-respecting labor union would declare that its members are “servants” of their employers. It took so-called “conservatives” to declare that professional men—and of so responsible, so demanding, so unusually skilled a profession as medicine—are the “servants” of their patients or of anyone who pays them.
The concept of “service” has been turned into a collectivist “package deal” by means of a crude equivocation and a cruder evasion. In the language of economics, the word “service” means work offered for trade on a free market, to be paid for by those who choose to buy it. In a free society, men deal with one another by voluntary, uncoerced exchange, by mutual consent to mutual profit, each man pursuing his own rational self-interest, none sacrificing himself or others; and all values—whether goods or services—are traded, not given away.
This is the opposite of what the word “service” means in the language of altruist ethics: to an altruist, “service” means unrewarded, self- sacrificial, unilateral giving, while receiving nothing in return. It is this sort of selfless “service” to “society” that collectivists demand of all men.
One of the grotesque phenomena of the twentieth century is the fact that the “package deal” of “service” is most vociferously propagated by the “conservatives.” Intellectually bankrupt, possessing no political philosophy, no direction, no goal, but clinging desperately to the ethics of altruism, such “conservatives” rest their case on a cheap equivocation: they proclaim that “service” to others (to one’s customers or clients or patients or “consumers” in general) is the motive power and the moral justification of a free society—and evade the question of whether such “services” are or are not to be paid for.
But if “service” to the “consumers” is our primary goal, why should these masters pay us or grant us any rights? Why shouldn’t they dictate the terms and conditions of our work?
If socialized medicine comes to the United States, it is such “conservatives” that the doctors would have to thank for it, as well as their own spokesmen who recklessly play with an intellectual poison of that kind.
Doctors are not the servants of their patients. No free man is a “servant” of those he deals with. Doctors are traders, like everyone else in a free society—and they should bear that title proudly, considering the crucial importance of the services they offer.
In any issue, it is the most consistent of the adversaries who wins. One cannot win on the enemy’s premises, because he is then the more consistent, and all of one’s efforts serve only to propagate his principles.
Most people in this country are not moochers who seek the unearned, not even today. But if all their intellectual leaders and the doctors themselves tell them that doctors are only their “selfless servants,” they will feel justified in expecting and demanding unearned services.
When a politician tells them that they are entitled to the unearned, they are wise enough to suspect his motives; but when the proposed victim, the doctor, says it too, they feel that socialization is safe.
If you are afraid of people’s irrationality, you will not protect yourself by assuring them that their irrational notions are right.
The advocates of “Medicare” admit that their purpose is not help to the needy, the sick, or the aged. Their purpose is to spare people “the embarrassment” of a means test—that is, to establish the principle and precedent that some people are entitled to the unrewarded services of others, not as charity, but as a right.
Can you placate, conciliate, temporize, or compromise with a principle of that kind?
As doctors, what would you say if someone told you that you must not try to cure a deadly disease—you must give it some chance—you must reach a “compromise” with cancer or with coronary thrombosis or with leprosy? You would answer that it is a battle of life or death. The same is true of your political battle.
Would you follow the advice of someone who told you that you must fight tuberculosis by confining the treatment to its symptoms—that you must treat the cough, the high temperature, the loss of weight—but must refuse to consider or to touch its cause, the germs in the patient’s lungs, in order not to antagonize the germs?
Do not adopt such a course in politics. The principle—and the consequences—are the same. It is a battle of life or death.