Saturday, November 22, 2003

Where Socialized Medicine Leads

One important issue that advocates of socialized medicine fail to consider is the detrimental effect it can have on individual freedom. Once "society" is paying your medical bills, it suddenly becomes society's business what you eat, how much exercise you get, whether you smoke or not, and even who you sleep with. After all, it is only reasonable to expect a bit of supervision in return for that "free" care - how else would it be possible to keep costs under control while keeping a decent level of service? This old Guardian story illustrates precisely what I'm talking about.

Smokers 'to sign pledge' with doctors


Nicholas Watt, political correspondent
Tuesday June 3, 2003

The Guardian

Smokers and overweight people will be asked to sign contracts with their doctors to agree a programme to quit smoking and lose weight under radical plans being drawn up by the government.

In an attempt to remind people of their own responsibilities the health secretary, Alan Millburn, is examining plans for patients and doctors to agree a formal programme of treatment.

Labour sources insisted last night that the plan, outlined in a Labour party policy document as part of preparations for the next general election manifesto, did not mean patients would be denied treatment if they refused to sign.

But the Labour document makes clear that patients, particularly overweight people and smokers, will be reminded that they must have a role in caring for themselves.

Under the new contracts, overweight people would be encouraged to exercise more and to eat a more balanced diet. The document says: "Agreements could be drawn up to help people to cut down or quit smoking, to lose weight, to take more exercise or to eat a more nutritious diet."

I'm not going to claim that socialized medicine would inevitably lead to government interference in our private choices, but I will say that under such a system, the incentives to meddle in people's lives, for bureaucrats and politicians looking for quick and relatively costless "victories", would be enormous. Just imagine the savings to "society" if the extremely obese, the chain-smokers or the sexually promiscuous could somehow be coerced into doing the "right" thing, or how much lighter the burden on "society" would be if the "useless eaters" in mental hospitals, homes for the aged or care facilities for the mentally retarded could be put out of their misery ("humanely", of course) ... It would be a miracle if such thoughts were never to cross some minister's mind.

UPDATE: For those who think the reasoning I've laid out farfetched or alarmist, I recommend reading this 1997 Reason article on Swedish eugenics. It most certainly could happen here, as it has happened plenty of other places in the past. In fact, places where it did happen late into the post-war era include Switzerland, Finland, Denmark, and (as recently as 1996) Japan.