Among the issues most commonly discussed are individuality, the rights of the individual, the limits of legitimate government, morality, history, economics, government policy, science, business, education, health care, energy, and man-made global warming evaluations. My posts are aimed at thinking, intelligent individuals, whose comments are very welcome.

"No matter how vast your knowledge or how modest, it is your own mind that has to acquire it." Ayn Rand

16 May 2010

Deciding Who Lives and Who Dies

Thomas Sowell has just written a column called A 'Duty to Die.'  As is always the case, he makes a good point, in this case about nationalized medical systems.  His main point is that when he grew up in poverty in the Southeast, his family took in an old aunt and cared for her for a while.  The old aunt moved from family to family so no one family was too much burdened, but they all willingly took their turns.  Now, he points out that we live in a culture in which very many of the best educated have learned that the old simply have a duty to die so they will not be a burden on the rest of us.  He points out that this harkens back to primitive societies so strained in resources and so marginal in their survival, that the old had to wander off into the wilderness alone to die.

This issue has long been bothering me.  Those who claim that they are so concerned about their fellow man and his welfare that they believe it is right to use government force to manage scarce medical services resources to provide for the poor or for those who simply do not choose to buy their own health insurance, have taken it upon themselves to make the decisions of who will live and who will die.  In the not too distant past, this decision in the United States was made by a combination of the following filters:
  • A lifetime of hard work and savings by an individual provided sufficient money or a substantial part of the money needed for either adequate health insurance or savings for medical care.
  • Family members volunteered to help financially or with direct care services.
  • Friends did the same.
  • Many physicians volunteered their services to those in medical need who could not afford to pay, as my own grandfather did for thousands of patients, especially during the Great Roosevelt Depression.
  • Charities provided financial aid and medical services.
As Great Britain  is already doing and we will have to do under ObamaCare, decisions are being made more and more by medical and governmental bureaucracies about who will live or die.  The socialists who favor this approach like to say such things as:  The life and death decisions are now made scientifically by specialized panels on the basis of broad categories of cost, the likelihood of success, and the social worth of the patient based on the patient's age.  These decisions are made in the light of day and reviewed by the democratic vote of the citizens in general elections.  This, they say, is so much better than decisions made by soulless health insurers.  Now, note that they leave out the role of the individual in how he lived his life, the role of his family and his friends, and they assume that doctors do no volunteer work and that taking private charity is somehow demeaning, while taking government charity is not.

In a nationalized health care system, all those who either love the patient or who are voluntarily disposed to help the patient are removed from the decision-making process.  A "scientific" decision of how to spend the limited funds of the government medical program takes the place of all these people who may actually know the patient or who may evaluate the patient as an individual to determine if he or she is worthy of their voluntary help.  The government must make some kind of pretense of providing medical aid equally, so it must do so with no regard to individual character.  One of the easiest ways to do this is with the now inevitable rule of the form:  You are older than 70 years old and you have cancer which is expensive to treat, so you will not be treated.  Is this a more moral system for determining who gets medical treatment and who does not?  To me, it is clear that this system is designed in Hell.  The people who choose this system have no heart and are disloyal to every person of good character that they know.  They are betrayers of those they claim to love.  They are supporters of government-run death panels.

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