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Wednesday, August 26, 2009

Waiting Under Socialized Medicine

Another day, another socialized medicine horror story and another ominous preview of what is to come under Obamacare. The Daily Mail reports that in the UK:

Thousands of women are having to give birth outside maternity wards because of a lack of midwives and hospital beds.

The lives of mothers and babies are being put at risk as births in locations ranging from lifts to toilets - even a caravan - went up 15 per cent last year to almost 4,000.

Health chiefs admit a lack of maternity beds is partly to blame for the crisis, with hundreds of women in labour being turned away from hospitals because they are full.

Of course, as facts and reason unequivocally demonstrate, socialized medicine must lead to spiraling costs, shortages, rationing, and declining quality. It is a fact of nature just the same as gravity or electromagnetism. I have previously argued that ultimately, the real problem underlying this issue is not the minutia of Obama's monstrous thousand page bill but the inability to think in principle [1, 2,3]. If one thinks in principle, it is clear that the disastrous results of socialized medicine can be seen as a concrete example of a larger principle - the principle that socialism is immoral and impractical and leads to chaos, misery, and tyranny. And, yes, medicine is a service like education, mail delivery, or carpet cleaning. With this in mind, two quotes from this article stand out. First,

Jon Skewes, a director at the Royal College of Midwives, said: 'The rise in the number of births in other than a designated labour bed is a concern. We would want to see the detail behind these figures to look at why this is happening.

This statement represents pure pragmatism, or the total rejection of thinking in principle in favor of "experience". Such a statement follows directly from modern philosophy which rejects the absolutism of reason in favor of pragmatism. Pragmatism reduces man to the level of an animal, rendering him unable to make even the simplest generalization. Consequently, Mr. Skewes is intellectually paralyzed. The facts before him are not enough (because it is never enough), and he yearns for even more "detail." And since he can not think in principle, what is he likely to conclude from his observation of this "detail"? Do you think he has the ability to grasp that the ultimate solution is to scrap socialized medicine and return to a free market in health care which ethics and the science of economics proves will be moral and practical? Quoting:

'There is no doubt that maternity services are stretched, and that midwives are working harder and harder to provide good quality care.

However, we know the Government is putting more money into the service. 'The key now is to make sure this money is spent by the people controlling the purse strings at a local level.'

To a pragmatist, making sure the money is spent by people at the "local level" appears to be the "key". Incidentally, such an idea is not only abstractly similar to what the Obama supporters tell us, it is literally equivalent to Obama's claim that the key to his plan is cutting "wasteful" spending. This topic is the subject of an excellent editorial by Amit Ghate titled Misconstruing the Cause of Waste. Ghate argues that fundamentally, "government is the source of waste — not its solution." Why is this always true? Ghate writes:

The ramifications to waste are threefold. First, by prohibiting certain activities, government eliminates competition. For example, private companies like FedEx are legally barred from competing with the Postal Service — creating that paragon of efficiency, the USPS. Next, because it can confiscate our money to pay its bills, government has little incentive to control costs. Should it overpay for services, salaries, or pensions, government simply takes more from helpless taxpayers. Finally, because the government has usurped their prerogatives, individuals no longer decide what is worthwhile and what isn’t. Government forcibly disconnects the decision of what’s valuable from the people who actually pay for the values.

Consider one last quote from this article that represents an underlying premise of socialism which never ceases to amaze me: the myth of the omnipotent Central Planner. This is the idea that a handful of government bureaucrats know better than millions of individuals who coordinate their decisions based on free market price signals. Quoting:

Care services minister Phil Hope said: 'The number of maternity beds in the NHS reflects the number of women wanting to give birth in hospital. Giving birth can be unpredictable and it is difficult to plan for the exact time and place of every birth.[emphasis mine]

Really - giving birth is "unpredictable"? Is it as unpredictable as how many people will buy pizza, shoes, or computers? Somehow, those businesses know how much to make (and they can't even use the nine month rule...). Hope is right that "planning" is difficult which is exactly why it should not be left up to government bureaucrats who are motivated by politics and not profit. As Beth Haynes stated in The Fatigue of Central Planning:

A market economy is the result of an uncountable number of individual decisions and actions, coordinated through price signals which provide crucial information on the availability of every imaginable resource. Profit and loss calculations provide essential feedback on the relative efficiency with which a multitude of producers use those recourse to meet the needs and desires of an even larger number individual consumers.

Central planning consistently fails because it is impossible for a small number of individuals, let alone one man, to obtain the requisite information, create the necessary plans and subsequently attempt to implement them.

Or, as Dr. Reisman stated in A Word to Environmentalists:

More fundamentally, what is the appropriate method for Man to use in dealing with Nature in general? Is it the motivated and coordinated human intelligence of all individual market participants that is provided by a free market and its price system? Or is it the unmotivated, discoordinated chaos in which one man, the Supreme Dictator, or a handful of men, the Supreme Dictator and his fellow members of the Central Planning Board, claim a monopoly on human intelligence and on the right to make fundamental decisions?

Mr. Hope continues:

'Local health services have plans to ensure high quality, personal care with greater choice over place of birth and care provided by a named midwife.

So, why are women giving birth in elevators and toilets? Anyway, what is his plan? Quoting:

'We recognise that some parts of the country face particular challenges due to the rising birth rate and that is why last year we pledged to increase funding for maternity by £330million over three years.

'We now have more maternity staff than ever before and we have already met our target to recruit 1,000 extra midwives by September.' [emphasis mine]

In other words, after over one hundred years of facts and evidence from dozens of countries that have experienced first hand the stagnation, misery, chaos, and tyranny (or in Hope's newspeak, "challenges") of socialism, Mr. Hope believes that this time - he will make it work.

I do not need to wait for more detail to know how this will turn out, but unfortunately, for those living under socialized medicine, they will have to wait.


Anonymous said...

I am a physician, and I worked for a time in the Hospital Clinico de Barcelona (Spain) about 12 years ago. No appointments, the waiting room fills up by 11 am and then they close the front door. People have to take the day off from work to go to the doctor, and plan to wait all morning to be CHECKED. Then they were given a card with a return date for the blood work, biopsy, Xray, whatever. Then take another day off. ANd so on!
SO you see, it is a system where every possible step is drawn out in a frustratingly long process with dire health ramifications. Of course, if you have the cash, a private clinic exists across the street where you can get all the work done in one day and be done with your health problem. Those with money go there. Those without go to the Hospital Clinico.
This is rabidly different from how it is currently in the US. At the end of the day, physicians, nurses, janitors, techs, etc all have to be paid, and paid well, to do their jobs in many stressful and taxing emotional circumstances. If they were paid like postal workers, my sense is that the empathy would fly out the window and people would be treated like objects, much more so than one can moan and complain about today.

In Europe, "loser pays" so people think long and hard before they bring a case to court. There is no malpractice insurance, nor is there a culture of legal offices chasing ambulances
The fear of lawsuits keeps physicians here eager to keep patients happy. Hence extreme situations like Michael Jackson's doctor, who signed a bargain with the devil/drug addict to provide him the legal means to a daily coma. This doc will not escape a lawsuit in the end!

A few years ago, some cardiologist got sued by a patient who waited 4 hours for him in the office, while said cardiologist was unclogging another patients arteries in the hospital. The case I believe eventually was settled. The great unwashed masses will have to learn to waiting a LONG time to be seen, and there will be doctors stupd enough to sign on to this, and then be sued, because Obama and his cronies are all lawyers and they will not curtail the legal worlds' right to make a living.

So I plan to re-train as a plumber.

Kevin said...

In government systems there are always mandates to eliminate waste, and they always require more planning.

It's not enough that you have nine months warning that the baby will be coming. People should plan their pregnancies so that there is an even distribution throughout the year. And then there is the question of how many nurses and doctors will need to be hired and where they should live so that we don't have to waste money by training too many. So maybe we should plan our pregnancies 8 years in advance to that we will be able to select and approve the right doctors before they are trained. Of course that means women and men will need to be married and have adequate time to learn good parenting practices prior to being admitted into the future parents planning system and that takes a few years as well. So to give enough time we will need to plan marriages, probably from early childhood so that the child will be born when the woman is young enough to avoid unnecessary complications..... etc

Giving power to people who think they can plan such things turns the rest of us into cogs in their planning machine. There must be something mentally wrong with me, because I for one prefer not to be a cog.

Amit Ghate said...

Great post Doug, and thanks for the link! (And nice comment Kevin, that was a really good way of illustrating their approach!)

The Rat Cap said...


Thanks for sharing your story. Unfortunately, what you describe is so typical of the misery that socialized medicine must bring. I agree with implementing the "loser pays" rule here. It would dramtically reduce the instances of frivolous lawsuits and rightly decrease malpractice insurance costs.

I suggest that rather than "retrain as a plumber", you proudly defend your right to freely contract with others and assert your right to your life and property as any other individual in any profession. Check out this website that defends freedom and individual rights in medicine on principle.


thanks again.

The Rat Cap said...


LOL. What you describe is exactly why regulations beget more regulations. It is why we are already hearing about government food and health regulations (disallow fast food, etc.) in order to reduce the "costs" to "society". It is exactly why if current trends continue, as you describe, we will all soon be herded to a state mating centers which will enable increased efficiency and predictability for the central planners.

The Rat Cap said...


You're welcome. Great job and congratulations on being published again on pajamasmedia.com.


Dan hutchinson said...

The Daily Mail is a UK Tabloid- both the current system and the proposed reforms are seriously flawed. http://www.pbs.org/moyers/journal/07102009/potter_testimony.html

garret seinen said...

Doug, as a resident of Canada, I fully agree with your analysis about socialized medicine. If we receive good treatment, it is by accident rather than design. The ruling bureaucracy is concerned only with seeing that the well-off do not receive better treatment than the destitute. The doctor's monetary focus is to satisfy the payer, the bureaucrat in charge, rather than the patient. The system is structured to generate incompetence and apathetic consideration for the sick.

As an aside, Art Robinson of Access to Energy, has a 1/2 hour presentation of how the medical system should be reformed, given in 2007 at a George Gilder Telecosm seminar. I believe the case he makes is valid and shows a tremendous potential. It's here, http://www.oism.org/health/ and I hope you can find time to check it out.

Once again, thanks, gs