The Free Market versus Death Panels by Alpheus Madsen
A few days ago, I encountered a question on the evil time-sucking website called Quora that I wished I could answer, but I had lost track of. The question in question was something about wondering if the Free Market could provide health care, and the answer that I wanted to counter said, essentially, “No, because the profit motive doesn’t belong in health care, because the value of any given life is infinite, so doctors will charge millions of dollars to save every single life.”
On the surface, the argument makes sense, but it’s not hard to find a good example that will show that something about the reasoning is very flawed: food is far more necessary for life than medical care. Why doesn’t a farmer charge $1.5 million for every apple? Indeed, for every grain of wheat? Or even for every particle of flour? The answer is complicated — thousands of people get PhDs of perhaps somewhat dubious value in their attempts to answer this question — but clearly, things like competition and “marginal utility” work together to make food affordable, and it’s altogether not clear at all why these same forces shouldn’t cut medical costs as well.
Furthermore, the answer ignores the biggest problem with socialized medicine in all its forms — indeed, the problem that any government controlled resource has — the exact same problem that develops every time the Government steps in and tries to “fix” market forces: you get shortages and surpluses because bureaucratic meddlers cannot predict what people will want, or even what people need, or how people will respond to the price controls, incentives, and punishments they set up in their infinite lack of wisdom to provide health care to “all”.
The Free Market is the only way we can balance costs in a reasonable way. I want to go a step further, though, and make the case that the Free Market is the only moral way to address these issues as well.
Consider the case of Charlie Gard, who has been in the news recently because the courts of the United Kingdom have declared him brain dead, and wish to pull the plug on him. The parents would like to seek treatment, and barring that, would like to take him home so that he could die in peace with them — but bureaucrats insist that he must die in the hospital. The bureaucrats only have the best interests of all involved, after all — not just Charlie, whose life, apparently, isn’t worth trying to save, and who shouldn’t be allowed to continue to live on account of the pain he is suffering — but he can’t receive care, because of all the people in Great Britain’s health care system who also need the resources that could go to Charlie. The Bureaucrats have made their decision, and they will enforce it. And according to many people, this is the most humane outcome that we can receive in this situation.
Compare this to the alternative that Charlie’s parents seek: they have asked doctors who wish to help, some of which have said “Yes, I will, if you give me money”, and others who have said “We’ll even do it for free”. They have asked friends and strangers alike for donations to pay for the treatment, and people have responded, to the order of about £1.7 million, last I’ve heard. Yes, it’s possible that Charlie might now be braindead, but doctors have been wrong about this before — and besides, the disorder is rare, and even treating a braindead patient can help doctors understand the disease better, and allow them to be better prepared to address this disease in future patients. It may even help doctors understand the human body a little more, and thereby help patients suffering from other diseases, some seemingly unrelated to the rare mitochondrial disorder that Charlie suffers from.
No one is being forced to help little Charlie. Every person who donated money, did so knowing that they can afford to do so, and if not, they did so knowing that a little bit of sacrifice is acceptable if it can be used to save a little boy. Even the doctors who won’t do this for free are willing to offer their services, and as the number of doctors who can provide such services grow, the price of the services will naturally come down. (Probably not too much, in this case, because of the rarity of the disease — only 16 people in the world are known to suffer from it — but it’s also clear that it’s not all that hard for strangers and friends to come together to donate to the rare child who is diagnosed with this disease.)
The friends and strangers who have donated money get to take pleasure in supporting the care of a child in dire need. The doctors who receive money get to put food on their table, and pay for shelter for their family; those who don’t accept the money will treat the child for the pleasure of doing so as well — and in both cases, these doctors will be better prepared to help others. And while the parents might not be able to save Charlie — and I suspect that Charlie’s condition has likely deteriorated during the months that his parents fought the courts and the hospital for treatment, in their efforts to do everything they could to save their son — in the end, they will have the satisfaction that they had done everything in their power to save their child. Well, not <i>quite</i> everything, but only because Bureaucrats barred them from certain actions that any compassionate soul would have allowed.
Charlie’s case is not an isolated incident. I still remember the testimony of a cancer patient who explained that she was sentenced to die because the National Health System would not approve in a timely manner breast cancer drugs that would have stopped the cancer (if I remember correctly, she was eventually allowed the drugs, and the National Health Service even paid for them — but only after it was too late: the disease had progressed to the point where it couldn’t be stopped) — and they would not allow her to buy the drugs herself, unless she were willing to pay for all her treatment, which she could not afford to do — all in the name of equality (because it wouldn’t be fair to the poor souls who couldn’t afford those drugs, you see), and of keeping NHS costs down, and doing the greatest good for the greatest number of people. I don’t know how many cases like this occur in Great Britain; sadly, most of these cases most likely never make it into the news, and likely even have a hard time making it into statistics.
The irony here is that everything we’ve been told about why the Free Market is evil — that treatments would be prohibitively expensive, because we all will pay anything to save the lives of our children from hypothetical illnesses — is exactly the evil that Socialized Medicine Bureaucrats impose on actual children, even when the parents are literally willing and able to pay $1.7 million for the care of their son. And yet, for all this, those who defend the cold-blooded, heartless, and soulless Socialist Bureaucrats have the gall to accuse the Free Marketers of cold-blooded heartlessness, and insist that they only have the best interests of everyone in their hearts, all because it’s somehow evil for a doctor to charge money for his services!
George Bernard Shaw is known for insisting that we should have a panel, where every person has to go before the panel to justify their existence — and if the panel finds the justification wanting, they will have the power to take the person and make sure that they are eliminated in a humane way. (I have always suspected that Shaw imagined himself on the panel, and never imagined himself standing before the panel, trying to justify his own existence…and being found wanting…) This is literally what is on display in Great Britain. And this is what Socialists consider to be humane.
But consider an alternative: that every day, each of us must justify our existence to others — through job interviews, and through appealing directly to friends, strangers, and charities for support — and if we are found wanting, rather than be eliminated immediately, we get to make more appeals the next day. If our ability to do things is hampered by injury or disease, there’s a good chance that people will take pity on us; if we are able-bodied, and can find a little bit of time each day to improve ourselves, we might very well become useful in ways that we weren’t before. Granted, we are in danger of dying in an inhumane way — we’re in danger of starving — but this is countered by being given a chance, every day, to prove our worth.
Which is more humane? To have your life held at the mercy of the whims of Bureaucrats, who alone will determine your worth? Or to be free to make the case that you are worth something to everyone you can talk to, and if found wanting yesterday, nonetheless might find you worthwhile today? I will not answer this question directly, but I will simply suggest that you look at societies that embrace the former, and compare them to societies which embrace the latter, and then ask yourself: which type of society prospers more? And I would propose that you would then have your answer.
(Alas, it is too late for the tiny victim of socialism. The End of Charlie Gard’s Story)