Myth 22. “Health care reform” is a moral imperative.

In a telephone call to clergymen, also broadcast over the internet, Obama dismissed the concerns of opponents of his health agenda as “fabrications.” Dissenters were making up allegations about death panels, government funding of abortions, and a government takeover of medicine, he said, because they want to “discourage people from meeting…a core ethical and moral obligation…that we look out for one another…that I am my brother’s keeper” (Commentary by Star Parker 8/25/09).

“Forgive me if sermons about morality are a little hard to swallow from a man who supports partial birth abortion,” Parker writes.

She also notes that reform proposals would outlaw the voluntary Christian sharing communities through which 100,000 Americans take care of their own medical expenses, independently of government and insurance companies.

In contrast, government compelling taxpayer A to pay provider B for care of patient C is not the same thing as “looking out for one another.”

There are in fact core moral issues involved in “health care reform”: a radical change in the physician’s code of ethics. The New Ethics transforms the physician from a healer, who places his individual patient’s welfare first, to a tool of the state, sacrificing individuals for the good of the collective.

Rationer-in-chief Ezekiel Emanuel describes his ethics as “communitarian.” He blames the Oath of Hippocrates for the “overuse” of medical care, regardless of cost of the effect on others, and he favors the “complete lives” concept for allocating scarce resources. Those resources (including people’s earnings) are assumed to belong to the collective, to be appropriated and redistributed as the rulers think best.

The existence of “disparities” or of profits is taken as evidence of immorality. Disparities of concern are those based on “invidious” discrimination, as by race or gender. Allocation by age can be just and rational. See: Persad G, Wertheimer A, Emanuel EJ. Principles for allocation of scarce medical interventions. (Lancet 2009;373:423-431).

Disparities have not been eliminated by nationalized health systems; quite the contrary. Thirty years into the British National Health Service (NHS), an official task force (the Black Report) found little evidence that access to care was any more equal than when the NHS began. Almost 20 years later, a second task force (the Acheson Report) found that access had become even less equal. There is also pervasive inequality in Canada, with differences in per capita spending as great as seven-fold between urban and rural areas ( John Goodman, Cato Policy Analysis 1/27/05).

One of the features of the NHS that has persuaded the British of its social justice is “the difficulty and unpleasantness it throws in the way of patients, rich and poor alike,” writes Theodore Dalrymple. “For equality has the connotation not only of justice but of hardship and suffering” (Wall St J 8/8/09).

Additionally, the differences in health between the rich and poor in Britain are not only among the greatest in the western world, but they are as great as they were in 1948, “when health care was de facto nationalized precisely to bring about equalization,” Dalrymple continues.

The whole population has been pauperized in the name of an inalienable right to health care—in the dirtiest, most broken-down hospitals in Europe, writes Dalrymple in an earlier article (Wall St J 7/29/09).

“Morality is always the justification,” writes Mark Steyn. “Inaugurating Britain’s National Health Service on July 5th 1948, the Health Minister Nye Bevan crowed, ‘We now have the moral leadership of the world.’”

Roy Romanow, the Canadian politician who headed the most recent of numerous inquiries into problems with the Canadian system, defends the state’s monopoly on medical care by saying that “Canadians view medicare as a moral enterprise, not a business venture.” But Steyn asks, “What’s so moral about relieving the citizen of responsibility for his own health care?”

If the man who died of a ruptured appendix, after being turned away from a Quebec clinic for not having an insurance card (see Myth 17) had entered a business venture, they would’ve greet him with: “You’ve got stomach pains? Boy, have we hit the jackpot! Let’s get you some big-ticket pills and sign you up for surgery!” Steyn suggests. “But because it’s a moral enterprise they sent him away with a flea in his ear.”

But if disparities cannot be eliminated, profit surely can be. Government has consistently succeeded, if profit elimination was its purpose.

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12 thoughts on “Myth 22. “Health care reform” is a moral imperative.

  1. Engrave this Quote The basic principle of altruism is that man has no right to exist for his own sake, that service to others is the only justification of his existence, and that self-sacrifice is his highest moral duty, virtue and value. Do not confuse altruism with kindness, good will or respect for the rights of others. These are not primaries, but consequences, which, in fact, altruism makes impossible. The irreducible primary of altruism, the basic absolute, is self-sacrifice – which means: self-immolation, self-abnegation, self-denial, self-destruction – which means: the self as a standard of evil, the selfless as a standard of the good.

    -Ayn Rand

  2. Helping others by free will is goodness in action. Mandatory service to others not only is not goodness, it prohibits–places a ban on–goodness. Ergo, mandatory service to others is immoral.

  3. This is the real “moral imperative”, if one is to use that method of describing it, in health care reform:

    A man’s right to live for his own sake, sacrificing neither self nor others.

    Yet, in this climate of collectivism, the government upholds the opposite principle. Instead of rational selfishness, one living for his own sake without sacrifice of anyone to anyone, the government’s mission is the sacrifice of all to all: irrational selflessness.

    For all those naysayers who believe that self sacrifice will lead to the production of goods, check your premises. A good must be produced before it can be traded (or stolen by governments). The only way to actually produce over the long term is to do so without sacrifice.

    The immorality of it all is that the government wants, desperately, for physicians to continue producing, all the while deriding them for their productive effort. How long do they think it can possibly continue before physicians say “enough”!

    It’s sooner than they think. Consider the morality of that.

    Mark A. Hurt, MD
    Creve Coeur, MO

  4. What??

    “There are in fact core moral issues involved in “health care reform”: a radical change in the physician’s code of ethics. The New Ethics transforms the physician from a healer, who places his individual patient’s welfare first, to a tool of the state, sacrificing individuals for the good of the collective.”

    The “radical change in the physicians’ code of ethics” has already happened. If you sign away your automony to a payor, even to a minimal degree (such as conforming your documentation to payor requirements, and allowing yourself to be audited on that account) you now work for the payor. Period. All this posturing about “putting the patient’s welfare first” is just that – posturing. You don’t even know you’re doing it, or that it’s happened to you: Like when you reach across the desk for the formulary for the patient’s insurer so you can prescribe “what’s covered.” Or when you submit to requests for “prior authorization.” Or where CPT codes and CMS “bullet points” govern your medical record-keeping. Or when you sign a managed care contract putting your income at risk based on the cost of the care you deliver. Or when you dash madly from exam room to exam room, whining about how you don’t have time for your patients (TAKE THE TIME, DOCTOR!). Or when you become an employee of MegaHealth Systems Incorporated, and your face appears on billboards as “A [caring, loving, competent, expert, special, etc] MegaHealth System Doctor.” Or when you perform an elective abortion.

    Our profession has lost it’s moral gag reflex. It’s all about protecting physician incomes, and everybody knows it. That’s why physicians have no traction in this debate. Everyone knows that physicians have (long ago) given up the moral high ground they claim to occupy … everyone, it seems, except the physicians.

  5. Morality is the driver of every man’s actions whether he knows it or not.

    The crucial life or death issue is the nature of his moral code. Until Ayn Rand identified and expressed the code for men to live on earth (The Objectivist Ethics) in a presentation at a conference “Ethics In Our Time” at The University of Wisconsin on February 9, 1961, Altruism and its variants had been the dominant code in human existence. Altruism holds that giving up to others for less value or no value at all in return, the values that every human must bring into existence for the preservation and promotion of his individual life is the essence of a moral life. The blatancy of such a monstrous evil is hard to believe. Accepting that code enslaves every man to his fellow men to the detriment of all.

    I highly recommend that all physicians and those interested in happiness and life on earth read Ayn Rand’s “Objectivist Ethics” the first essay in her book “The Virtue Of Selfishness” available at book stores everywhere.

  6. I believe we have a moral responsibility to help those who are less fortunated than ourselves. However, the medicaid queens and kings who can work, put nothing into the system that they benefit from and working people who contributes to the system but cannot access it, thats immoral. How about the COPD patients who continues to smoke and is in the ER monthly in distress or the child with frequent asthma attacks and the mother and father smokes in the house, how moral is that? I believe in being responsible and accountable for your actions. That’s moral. So far as abortions, they will continue regardless of whose president. The doctors that perform them will have to answer sooner or later. Do worry, payday is on its way. Finally, physician heal thyself. Power seeking, cut-throat behavior, and greed is a self full-filling prophesy. We all perish.

  7. The BIGGEST moral imperitive is restoring the doctor patient relationship, it is NOT to replace an insurance cleark who stands between the doctor and the patient with a government bureaucrat who stands between the doctor and patient.
    Then we need to strike down the price fixing model inherent in the CPT system, and replace it with open market pricing, and restore the true principles of insurance

  8. Mandatory insurance & “public option” equivalents are founded on government coercion. They invariably drive charity and altruism out of medical care ( Cf. the End of welfare & the poor http://www.jpands.org/vol10no4/crespo.pdf ).

    Coercion of individuals ultimately leads either to slavery or to strife: Obama’s health care agenda is not compatible with his Nobel price for peace.

  9. Dear Collegues:

    While we fight to preserve our autonomy, how do we address the obvious inequities of our society that drive the call for beneficence, justice and health care coverage for all? We can not remained parked on our steadfast defense of our interests without adequately addressing the rightful concerns of others and the plight of the our fellow citizens.

    Please view the vignette below:

    http://www.democracynow.org/2009/10/16/amnesty_international_head_irene_khan_on

    Let not our pre-conceptions or past programing prevent us from “doing justice, love mercy and walking humbly before our God”. (New American Standard Bible, Micah 6:8)

    This comment is submitted as food for thought, constructive and comprehensive action.

  10. Pingback: Myth 25. Medical care costs too much because private corporations make a profit. « AAPS News of the Day

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