What does socialism have to do with the health care reform debate?

by David Alway, MD

In thinking about socialism and medicine in the United States let’s adopt socialist point of view and ponder some logical conclusions.

Injustice Exists

The socialist notices that some people are starving, don’t have adequate shelter, or are relatively uneducated. He also observes that others are very well off, having access to the finest meals, enough money to buy grand homes and are well-educated. This state of affairs, he concludes, is unjust. After all, many of these people are in bad circumstances through no fault of their own or are in good circumstances through no effort or merit on their part. Why should there be such injustice?

So what are we to do about it? The socialist view is that we should we try to evenly distribute everyone’s money and assets – so that each adult has the same or similar amounts.


The most ominous issue relates to what kind of government we must have to be able to count and redistribute everyone’s wealth.

What if some people resist this grand undertaking, deciding that they wish to keep their wealth? This, of course, will have to be treated as criminal activity, lest others get the same idea. Jails, police and investigators will be needed to keep these tendencies in check.

And who can be trusted to have control over an entire nation’s wealth? Won’t those in charge do as they will with the money, find ways to keep more of it for themselves, or even run the country as their personal fiefdom?

And what of the total wealth of a nation? In our socialist scenario, people who take no risks and who do not work hard will be given the same as those who do. So what is the motivation to take risks or to work hard? What is to prevent them from slowly reducing their output, their motivation, and their interest in productivity?

And what shall we do with people of ability and drive who decide to leave the country? Aren’t they depriving the country of ‘justice’, since they are taking the wealth that would result from their productive abilities out of the country? Will emigration become illegal?

This simple idea of attempting to ‘correct’ perceived injustices in the world has resulted in some unfortunate consequences. We have an autocratic government with great power over poorly motivated people and a poor rate of production.

So Let’s Rethink This

This whole set of results could have been avoided had we thought more deeply about the problem in the first place. Yes, there are injustices in the world, but systematic injustice on a massive scale is created by attempting to redistribute wealth, without regard to merit. And it creates a dangerous concentration of power in the government. In addition, we have attempted to redistribute something (wealth) the source of which we really did not understand.

In the end, we killed the very source of wealth: the individual who is seeking his own wealth and happiness.

The system that allows individuals to be free and to keep their own property is called capitalism. Capitalism has an unmatched ability to create wealth and improve everyone’s standard of living. The capitalist recognizes that people are not psychologically like ants, selflessly sacrificing themselves (like drones) for the state or state leader (a stand-in for the queen of the colony). People can become motivated, though, to actualize their potential and become inventive and spectacularly productive.

What About Health Care?

Keep in mind, many people do not understand that health care in the United States is already dominated by governmental controls and government purchasing of health care. At the local, state, and federal levels, there already exist massive controls over physicians, laboratories, medical devices, drugs, hospitals, clinics, storage of patient information with the government itself responsible for 50 percent of all health care spending in the country.

The degree to which the government becomes involved in providing goods and services is the degree to which further socialism is being instituted in medicine. Every bit of money the government spends on health care is money taken from someone else. Government health care is a massive form of wealth redistribution.

In the socialist’s view, no matter how much you paid into the system, you don’t ‘deserve’ any more of it than any other person in the country. But you don’t deserve any less of it either, for bad personal habits like smoking or becoming obese.

If you speak to a socialist, he will probably consider health care to be a right – with the consequence that others (including physicians, hospitals, nurses, etc.) have no right NOT to provide these services. This creation of slaves in medicine will (and has) inevitably lead to health care workers exiting the field or people deciding not to train for it in the first place.

And who will increasingly have power in this system? Not the individual, for his desires are being crowded out. Those with real
power will be government bureaucrats and politicians.


So in the current health care debate, pay attention both to the details of the proposals and to the overarching arguments. If you listen closely you will notice that those pushing for more government involvement are not actually saying that their proposals will work, that the proposals can be paid for, or even that they have read them in detail. They say, instead, that it is simply the ‘right’ thing to do.

There is a choice to be made. One road leads to greater individual rights, freedom, productivity, good doctor-patient relations, further advances in health care, and better lives. The other leads to statism, government control of the individual, falling levels of productivity, a lack of innovation in medicine, drone-like doctors and nurses, and ultimately, more death.

David Alway is a neurologist.

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