A Physician’s Perspective on the Dangers Of Government Health Care Reform

A Physician’s Perspective on the Dangers Of Government Health Care Reform

Nicholas J. Gonzalez, M.D.

Introductory Remarks

In recent weeks, as the tenor in the health care debate has become more contentious, and the passage of some far-reaching legislation now more assured, I felt, as a physician, and one who practices what others consider an “alternative” nutritional approach to cancer, obligated to investigate the issue myself. I felt this way because any health care legislation, regardless of its final form, will inevitably influence my practice of medicine, and will affect my many loyal patients whose lives in many cases depend on the continued availability of my regimen. So for me, the issues have become of some import directly and personally. Furthermore, I find the rush to pass some sort of health care “reform,” as do others, a sign of more serious dangers looming for our Republic, dangers that I felt needed addressing.

As a first comment, I find it somewhat intriguing that all politicians, regardless of party affiliation, and seemingly most pundits in the “mainstream” media whom I have heard, agree that with some urgency health care needs to be “reformed,” implying of course what exists is hardly suitable, humane or sustainable. This notion our politicians and alleged experts routinely express as incontestable fact, though the various proposed solutions may vary somewhat in approach, or in the actual extent of government oversight. The Democrats began the debate with a frantic crisis mentality about the immediate need for reform of a “broken system” with allegedly 47 or 50 or 52 million uninsured Americans victimized by a cruel system – though the actual figure appears closer to 15 million. I have heard more than one fanatical far left pundit claim “16” people or some other such number die each day due to the lack of health care, though none of them ever provides a reference to substantiate the outrageous claim. I find the statement outrageous, since Federal law mandates that anyone with any type of health problem who arrives in an emergency room in the US, whether he or she be American citizen, non-American citizen legal resident, illegal immigrant, angel or Martian must be treated appropriately, regardless of the disease or the expense. So I have a hard time understanding why so many people are dying each day, and where the bodies might actually be. In any event, the “me too, we can spend just like you” Republicans have jumped on the bandwagon, insisting too that the system is “broken” and needs to be “reformed,” though their vague proposals seem only footnotes to the urgent Democrat remake of our apparently horrendous health care system. Politicians may argue about the small details, ie, should abortion be federally funded or not, but no one in Washington seems to disagree that the system needs dramatic change.

I personally have not heard anyone, Democrat or Republican, with the exception perhaps of Congressman Ron Paul, say health care doesn’t need to be reformed, it needs to be left alone and protected from endless, inevitably counterproductive and destructive government meddling. I suspect the unanimity of the chorus, all shouting the mantra of “reform” reflects perhaps the gradual evolution of the Republican Party as the “Democrat Lite Party,” a weak echo of their colleagues across the aisle. It’s interesting to me that the Tea Party movement and the Town Hall Revolt represented essentially spontaneous expressions of despair over government interventionism in our lives, expression of disgust with the indifference of politicians to the world outside the Beltway, and a reflection of the extraordinary American individualism that makes us different from any other country in the world.

These protests, both the Tea Party and more recently the Town Hall Revolt, have been a wondrous phenomenon to see, catching as they did both gluttonous political parties completely unawares. The surprised and unprepared Democrats lapsed into demagogic, petulant name calling (“How dare anyone question we know best”). The embarrassed Republican leaders tried desperately to minimize the movement – presumably because they didn’t start it – then sought to capitalize on this non-party revolution. But, despite the somewhat lame accusations of Democratic leaders that Republicans inspired these movements, they, sorry, involve them not at all. In fact they owe little to any political party as such entrenched institutions currently exist, but much to the precepts of our founding fathers, whose wisdom seems absent from the minds of our current crop of narcissistic politicians.

When I was growing up in the late 1950’s and 1960’s, pundits and journalists generally portrayed true conservatives as narrow-minded bigots “living” in the past, a supposition, in my naïve adolescent liberalism, I readily accepted. As I matured – thank goodness for maturity – I began to understand that the past in terms of our traditions of liberty and individualism are actually quite wonderful as well as unique, that politicians like Thomas Jefferson, John Adams, and Ben Franklin spoke truths that need to be looked at and respected with the most profound admiration. I also came to realize that the constant change demanded by liberals and progressives to correct terrible evils inevitably leads to endless intrusions into our lives, with personal, family, community, and national instability, cultural breakdown, chaos, and along the way, ironically, epidemic poverty and a vastly lowered standard of living for all.

If true conservatives – not the half baked Republican Party leaders in Washington masquerading as such – look toward the past for wisdom and guidance, liberals, I began to realize in time, at least as the term is currently used, seem absolutely unable to learn from the past, whether the issue be big government, the risks to us all when big government attempts to run our lives in its most minute of details, and the dangers in the liberal ideology that always “government knows best,” and “bigger government knows even better.”.

Winston Churchill, whom the DNC Chairman Dr. Dean in his typical fashion not too long ago completely mischaracterized, was an extraordinary man. As an adventurous young graduate of Sandhurst, the English West Point, he experienced combat in India and the Boer War, wrote a best selling novel about his exploits, wrote five books before age 26, worked as a lauded journalist before entering public life as a member of Parliament. During World War I he served as First Lord of the Admiralty, subsequently wrote a five-volume history of World War I, achieved some fame as a realistic landscape painter, served of course as Prime Minister of England during World War II successfully holding out against the Nazis after the French Army collapsed in six weeks, with their Maginot Line guns left famously pointing the wrong way. After leaving public life, Churchill then wrote a magnificent six-volume history of World War II, which ultimately garnered him the Nobel Prize in Literature – quite a series of accomplishments, for one man, accomplishments surely that put the rest of us to shame – including Dr. Dean.

In his early life, Churchill espoused quite liberal ideas in the contemporary sense that is, government knows best how to end “inequality,” poverty, unhappiness, and misery in all its forms. But after years of public service and with maturity setting in, he gradually changed, becoming more and more conservative, recognizing that wherever it treads, government creates only more “inequality,” poverty, unhappiness and misery, along with a loss of liberty. Poor Sir Churchill, after essentially guiding Britain to victory in the war, he lost to the neo-Socialist Attlee, who in true liberal form promised all things to everyone – including universal health care, which the Liberal British government introduced to the world in 1948. As an aside, in Dr. Dean’s recent Churchill misadventure, the Democratic leader claimed, with rather astonishing ignorance, that it was the “conservative” Churchill who brought in universal government-regulated, government-controlled health care to his nation, a complete fabrication. Churchill knew better, opposed it bitterly, and coined his priceless adage, which I paraphrase: “A man of 20 who isn’t liberal has no heart, and a man of 40 who isn’t conservative has no brain.”

Obama’s health care plan, which with great calculation to misled he has referred to in varying ways, first as a “public option” or more recently a “consumer option” to make it appear that it is of and for the people when in reality it is only of and for government intrusion and ultimate total government control. His position reflects his deep seated belief that government always knows best, a stance that in this day and age, after the world’s long disastrous experience with communism and other collectivist adventures in its various forms, seems to defy common sense or historical reality. I have heard that our current President, unlike a President such as Ronald Reagan or the much loved Democrat John Kennedy, has little use for history, in fact, has a deep contempt of it and studies it little. It shows.

I am astonished by our current President’s belief that the government can manage and regulate everything in America, better than non-government Americans, from General Motors, to the Banks, to our health care – to our own individual lives. It seems evident that our President and his cronies share the perspective Churchill avidly rejected, that government knows best, that big government knows better, and as in all tyrannies, that unelected groups of centralized experts who answer to no one – such as the Federal Reserve in the financial sphere – know far better what is best for all of us. That the tightly regulated “collective” always works better for all of us than loosely knit communities of free-spirited citizens pursuing their own lives, that sacrifice for the good of the community should always take precedence over the desires and needs of the individual, that government, big government working for the common good can someday somehow produce a heaven on earth, each of us cogs in a giant well oiled machine, reaping the joy that – at least in the liberal mind – can only be felt when each turns over every aspect of our lives, from our salaries to our health, to the government.

Health Care Reform, Soviet Style

I find it most extraordinary that liberal thinkers, even the alleged liberal “experts” who weekly Obama adds to the government payroll, act as if none of this has been tried before, that the great collectivist experiment represents a new promising dream, a new vision untarnished by past failings. In reality the collective notion ideal hardly represents something new at all and lies at the basis of all modern oppressive states be it Soviet or Chinese Marxist-Leninist Communism, or German National Socialism, the peculiar German strain of “communism” known as Nazism. It’s been tried, the grand dream of an all powerful, all beneficent government run by experts who answer to no one, it has been tried and failed miserably, causing everywhere it reigned untold misery, endless suffering and death. And it continues to do so in those few outposts where tried and true Marxism remains transcendent – in North Korean, in Cuba, for example, where poverty reins supreme, where famine and disease are epidemic, and where the leaders live like kings.

Collectivist thinking in the old Soviet Republic, after the fall of Czarist Russian, led to failure in every aspect of national and in turn, individual life. After the Leninists rose to power, the new breed of Marxist experts in Moscow took over managing the vast realms of productive land in that nation, removing from direct control those horrid landowners who had successfully farmed their parcels for generations. Collectivist thinking in agriculture, with the end of individual ownership of farms and property, destroyed Russian agriculture, produced untold misery, suffering, and death, and to this day it still has not recovered. It is estimated that during the great famines of the 1920’s and 1930’s, occurring under aegis of the Soviet “experts” in Moscow, 25 million people died with agricultural production only a fraction of what it had been under the Czars.

In the industrial sector, centralized experts in Moscow confiscated all production of all aspects of all industry. Despite the enthusiasm for an endless series of “five year plans” to boost productivity that would, the experts claimed, bring unimagined wealth to Russian and help bury the West, by the time the Soviet Union collapsed in 1992, its Gross Domestic Production (GDP), with its population of 280 million, was equal to that of Holland, with a mere 17 million inhabitants – and Holland is only half free-market capitalist at that. The average income of a Russian professional – professor, scientist, or doctor – was in the range of 55 dollars a month, educated Russians lived three families squeezed into two bedroom Moscow apartments. Collectivist thinking produced poverty of untold magnitude, to complement the absolute repressions of individual freedom – always of course, for the greater good. Even the arch Marxist-Leninist Stalin, in his later years finally lamented, after the collapse of yet another much lauded five-year industrial leap into the future, that the Russian economists needed to take a lesson from Western free-market, competitive capitalism, to boost production.



The pride of Leninist-Marxist thinking was neither its agriculture nor its industrial production, but “universal health care” for all, free from cradle to grave. Beginning with the Revolution of 1918, the State guaranteed all Russians health care from birth, free for everyone, the ultimate single payer “public option.” But as collectivist agriculture and collectivist industrial production failed, so too did Russian medicine, almost from its inception.

By the time the Soviet Union began to wither in the late 1980’s, the average lifespan of a Russian male was 57 years, equal to that of many third world countries. Diseases such as tuberculosis and hepatitis had become rampant, alcoholism and drug addiction were epidemic. With the collapse of the Russian economy, money for medical education dwindled, along with funding to support the infrastructure of hospitals, clinics and research labs. Doctors who worked for the “greater good” with no personal means to survive, earning the standard professional wage of about 55 dollars a month, often moonlighted at second jobs simply to survive. Many quit, or tried to escape to the West.

Vermin ran wild in filthy hospitals, the underpaid poverty stricken staff grew indifferent to the surroundings and the needs of patients, or even basic sanitation. Why care, when hard work reaped no reward? Soap was scarce, let alone drugs and high tech equipment for the masses. It is estimated that 75% of all HIV positive patients in Russian contacted the virus from unsterile syringes repeatedly reused in the medical setting, not out on the street or in back alleys. I have Russian patients in my practice, all highly educated and now appreciative US citizens, who tell me endless horror stories. Two have hepatitis, courtesy of physicians who no longer cared enough to sterilize their reused hypodermic syringes. These folks tell me that only the desperate would ever consider entering a Russian hospital, they were so filthy, the care so indifferent, the dangers very, very real.

From the beginnings of the Communist Revolution, the leaders knew the health care they mandated for the masses hardly suited such glorious examples of humankind as themselves. Consequently, a two-tier system developed, with, for them, access to state of the art facilities, highly trained – usually Western educated – doctors, availability of the latest Western pharmaceuticals and equipment for their special use, and only for their use. Within the same hospital, as the “common” patients died for lack of equipment, drugs, or simple concern, in the adjoining wards reserved for the governing elite, medical instruments would lay idle. (See Maltsev below).

Those few with the means left the country for treatment in the West. Many of the less fortunate, my patients tell me, terrified of the dangers inherent in official Russian medicine, turned to traditional healers and herbalists, who had somehow managed to keep the wisdom of past generations alive and well, in small isolated pockets safe from the eye of the state.

Perhaps the best article I’ve read on the Soviet health care system under communism was written by someone actually there, Uri N. Maltsev, an economist who served as an advisor to Soviet President Michail Gorbachev in the 1980’s, before defecting to the US. Hardly a Western intellectual evaluating communism from a distance, Mr. Maltsev served at the highest level of government, living the collectivist dream first hand or rather, the collectivist nightmare. In his astute article appearing on the Ludwig von Mises Institute website this past August 21, 2009, Mr. Maltsev certainly takes the glimmer off of President Obama’s rush to government controlled health care.

As Mr. Maltsev writes, the aim of the Russian communist system, in terms of health care, resemble pretty much those ultimate goals of President Obama as he has himself in the past spoken, universal coverage for all at low cost, provided by the government. But as a warning for all time, in the old Soviet Union, the humane ideology and noble intentions quickly tumbled into the morass of all collectivist efforts, into failure and misery for the Russian population:

The system had many decades to work, but widespread apathy and low quality of work paralyzed the health care system. In the depths of the socialist experiment, healthcare institutions in Russia were at least a hundreds years behind the average US level. Moreover, the filth, odors, cats roaming the halls, drunken medical personnel, and absence of soap and clinical supplies added to an overall impression of hopelessness and frustration that paralyzed the system…

Irresponsibility, expressed by the popular Russian saying, “They pretend they are paying us and we pretend we are working,” resulted in appalling quality of service, widespread corruption, and extensive loss of life…

Mr. Meltsev reports only through the payment of bribes could the average Russian obtain even the most basic of care:

In order to receive minimal attention by doctors and nursing personnel, patients had to pay bribes. I even witnessed a case of a “nonpaying” patient who died trying to reach a lavatory at the end of a long corridor after brain surgery. Anesthesia was usually “not available” for abortions or minor ear, nose, throat, and skin surgeries. This was used as a means of extortion by unscrupulous medical bureaucrats. To improve the statistics concerning the numbers of people dying within the system, patients were routinely shoved out the door before taking their last breath…

Being a People’s Deputy in the Moscow region from 1987 to 1989, I received many complaints about criminal negligence, bribes taken by medical apparatchiks, drunken ambulance crews, and food poisoning in hospitals and child-care facilities. I recall the case of a fourteen-year-old girl from my district who died of acute nephritis in a Moscow hospital. She died because a doctor decided that it was better to save “precious” X-ray film (imported by the Soviets for hard currency) instead of double-checking his diagnosis…

Instead, the doctor treated the teenager with a heat compress, which killed her almost instantly. There was no legal remedy for the girl’s parents and grandparents. By definition, a single-payer system cannot allow any such remedy….

At the end of the socialist experiment, the official infant-mortality rate in Russia was more than 2.5 times as high as in the United States and more than five times that of Japan.

As an aside, Mr. Meltsev clarifies the US statistics on the death rate of babies, remarking on the often ignored fact that the US death rate for infants is high only because we – unlike virtually every other country – count all infant deaths, including premature deaths. A nation like Cuba, for example, only catalogues mortality for those babies formally registered into the system, an event that often occurs weeks after birth. Those babies who don’t make it to that point simply aren’t entered into the accounting.

Mr. Meltsev sums up socialist medical care quite dramatically:

After seventy years of socialism, 57 percent of all Russian hospitals did not have running hot water, and 36 percent of hospitals located in rural areas of Russian did not have water or sewage at all…

The appalling quality of service is not simply characteristic of “barbarous” Russian and other Eastern European nations: it is a direct result of the government monopoly on health care and it can happen in any country. In “civilized” England, for example, the waiting list for surgery is nearly 800,000 out of a population of 55 million. State-of-the-art equipment is nonexistent in most British hospitals…

For the ultimate indictment of Russian medical care, one need only turn to the Russian leaders themselves. Though the elite in the old Soviet empire did have access to their own special hospitals, wards, equipment, medicine, and doctors, nonetheless, when they themselves or their family members fell ill with a problem of any seriousness, they still often turned to the West for help. For example, when Boris Yeltsin, the Mayor of Moscow and President of Russian just after the Soviet Union collapsed, suffered a heart attack, he didn’t rely on Russian style medical care, he flew in an entire team from free-market capitalist Boston, to guide his assessment and treatment. His own local doctors then worked under the supervision of these denizens of the horrid capitalist West. When doctors diagnosed the wife of Gorbachev, the last President of the unified Soviet state, and the man responsible for Glasnost, with leukemia, Gorbachev did not turn to the fruit of 70 years of wondrous Marxist-Leninist collectivism. No, instead he brought his wife to the West for treatment, as quickly as possible. Thereafter, the capitalist medical team supervised the treatment of Ms. Gorbachev, which ultimately proved unsuccessful regardless. I remember years ago the stir ensuing when a high ranking government official from Libya , another Marxist style dreamland, fell ill, he very quietly tried to arrange a trip to the US, even as his leader, Kaddafi, railed against Western style democracies.

So the story goes, throughout the communist kingdom. When its leaders fell ill, they turned their back on the great collectivist experiment, even the special care available only to them, and went west, as fast as they could go. In this time honored tradition, I have read that recently the President of North Korea flew in a team from an unidentified Western nation, to treat his secret but serious ailment – pancreatic cancer, one expert claims.

Perhaps I am too simple-minded, as I view the current health care debate, the hysteria over the dangers our current leadership sees in the free-market system, the rally to “reform, reform, reform” to prevent catastrophe. But I feel nonetheless obligated to ask, humbly, if the leaders of the Marxist Soviet nation, the very fruit of 70 years of collectivist ideology had no use for their collectivist medical system even at the highest echelon, why should anyone see anything of value in any similar government regulated, single payer plan for “universal” coverage anywhere else? Tragically, as Mr. Maltsev so eloquently reports, universal health care in Russia proved neither compassionate nor humane, instead creating the nightmare it was suppose to prevent, epidemic disease, misery, and a lifespan of a third world country.

Along with the quality of medical care, in the Soviet Union under the grand Marxist experiment, medical and biological research floundered. The government allocated its dwindling research funds from its devastated collectivist economy for rocketry and national defense, not biological or medical research. The elitist experts distributed what little monies that did remain in ways that suited their collectivist ideology, regulating all aspects of such research and what direction it could take. In biology, for example, ideological driven thinking led to the bizarre acceptance and promotion as a fundamental truth Lysenkoism, the inheritance of acquired characteristics.



Trofim Lysenko (1898-1976), an agronomist by training of most humble achievement, presented the world with the concept that acquired characteristics could be inherited, in direct contradiction to the documented laws of Mendelian genetics. In its simplest sense, Lysenko claimed that if you lost your finger in an accident, there was an increased likelihood your offspring would be born without a finger. This preposterous theory, universally rejected by 20th century biologists in the in the West, appealed to Russian leaders who saw in these fabrications a reflection of their own dream that the collective could control all aspects of human life, even the direction of human evolution – all for the collective good. Stalin appointed Lysenko to the directorship of the Institute of Genetics, and eventually, as overseer of all biological research in the Soviet Union, a position, to say the least, of enormous power. The Russian leadership perceived enemies of Lysenko, whatever their scientific credentials, as enemies of the state, who lost funding, or faced even more draconian punishment.. As the biography appearing in Wikipedia states:

Lysenko’s anti-Mendelian doctrines were further secured in Soviet science and education by the exercise of political influence and power. Scientific dissent from Lysenko’s theories of environmentally acquired inheritance was formally outlawed in 1948, and for the next several years opponents were purged from held positions, and many imprisoned.

As molecular biology, the basis of much contemporary medical research, came into its own in the West during the 1950’s and 1960’s, Russian biologists remained hamstrung by centralist dictates about Lysenkoism that suited a strictly political, not scientific agenda. It wasn’t until 1964 that the Russian leadership finally discredited Lysenko, but the damage had already been done. I would be hard pressed to name a single development over the past fifty years coming out of Russian medical or biological laboratories, while the traditions of invention and discovery flourished in the US. Certainly, the infliction of Lysenkoism on a generation of Russian researchers should serve as a warning to those who think the state should be meddling with science in any way, as so many in the US seem to think it should be.

Health Care Reform, Cuban Style

Still surviving socialist countries have hardly fared better, in terms of health care. Though Mr. Moore in his movie “Sicko” lauded the Communist run system in Cuba, the filmmaker visited the exemplary hospitals reserved for the elite, not the roach and rat infested hellholes serving the beloved masses. Furthermore, as Mr. Meltsev points out, Mr. Moore compared the care given healthy young women giving birth in France and Cuba to that received by the old with incurable diseases in the US. The comparison, of course, is fallacious. And as bad and backward as it is, Cuba’s health care system wouldn’t even exist if it hadn’t been for the largess of the old Soviet Union, which even as it began to collapse due to the economic failure of communism poured two billion dollars a year into Castro’s dream.

Contrary to Mr. Moore’s claims of success, Cuba provides a striking contemporary illustration of the great failures – and dangers – inherent in socialized, government run medicine. During the early 1990’s, tens of thousand of Cubans, mostly adult men – the estimate range from the official Cuban tally of 34,000, to up to 80,000 – developed a mysterious form of blindness. The Cuban medical community, though mobilized by the centralist government, was clueless, unable to find a cause or solution, until aided by an international effort including a team of skilled US physicians, run out of the New York based eye care foundation, Project Orbis. The capitalist free-market doctors quickly diagnosed the problem as not as some esoteric strange infliction, but the result of nutritional deficiencies and malnutrition, apparently epidemic in the Cuba communist paradise. With the diagnosis made, with supplements provided through the generosity of US charity, the perplexing and frightening epidemic came to end, courtesy of Western medical insight, concern, and care.

An article entitled “Baffling Blindness Afflicts Thousands in Cuba” from the Washington Post, June 1, 1993, reported at length on the problem, summing up the findings of the US led international team:

There is a general consensus, some of the scientists said, that widespread malnutrition, caused by Cuba’s deteriorating economy, plays a major role in the illness, as does some toxic agent – possibly in homemade rum – that has not been identified.

Like every aspect of Cuban life, health care serves primarily the dreams of communist ideology first, the “people” second. Even as health care continues its accelerating collapse at home, the current Cuban administration continues to send out, as it has for years, health care teams consisting of hundreds of physicians and support staff, on socialist evangelical “mission” work around Latin American to spread the philosophy of the collective.

However, the doctors participating in the venture seem less enthusiastic about the effort, once away from the homeland. Physicians earn approximately $15 a month in Cuba, putting them essentially in the position of at best indentured servants, at worst, slaves. Not surprisingly, as Castro has enjoyed a luxurious lifestyle with 14 palatial homes spread around his island nation, the hardworking doctors do not appreciate living in abject poverty to serve as Castro’s personnel propaganda tools. Defections of physicians assigned to such health care missions have become rampant, so much so that In August 2006 the US government began a special program to expedite the entry of Cuban health care professions here, the Cuban Medical Professional Parole Program. An article appearing October 10, 2007 in the South Florida Sun-Sentinel, entitled “Hundreds of Cuban medical workers defecting to U.S. while overseas,” details the situation nicely. According to the reporter, by 2006 over 1,000 Cuban physicians had entered the US under the program, gratefully leaving their homeland behind. And interest in the program continues to increase, as exemplified recently when dozens of Cuban doctors on a mission to Colombia sought asylum in foreign embassies.

Health Care Reform in Nazi Germany

If one need still needs convincing of the dangers in collectivist thinking in general, and regarding health care in particular, I could suggest no greater example than Nazi Germany. I have always found it perplexing, rather remarkable to say the least, when Democrats and Liberals, as they so often do, with knee jerk predictability always point to Nazi Germany as an example of “right wing,” conservative thinking in its extreme. In reality, Nazism, in its literal translation National Socialism, was just that, socialism, another system of centralized power. Nazi Germany serves then as no example of conservative small-government ideas run amok, but yet another sterling illustration of centralist planning, government control over every aspect of one’s life, from the smallest issue to the biggest – including one’s medical care.

I suspect Liberals conceive of Nazism as an example of conservative ideology due, perhaps, to their ignorance of history. Hayek, the great Nobel Prize winning Austrian economist, libertarian and free market thinker who emigrated to the West to escape Hitler, wrote long ago in his wonderful 1946 book “Socialism, the Road to Serfdom,” that Nazism represented little more than another version of collectivist, communist government rule in action. As Hayek points out, the Nazi Party itself recruited many of its leaders directly from the German Communist Party, with the Nazi leaders, taking a direct cue from Lenin, referring to their “oppressed” German comrades as the “proletariat.”

Nazism was simply Marxist thinking with a German touch; while in the Soviet Union, the government owned and ran all industry and all businesses, in Nazi Germany, Hitler allowed “private industry” to operate, but only under strict supervision and for only as long as their activities fell into line with the needs of the greater government collectivist Germanic good. For example, the famed Krupp steel conglomerate thrived during the Nazi reign, providing, as it did, the steel needed by Germany’s ever expanding armed forces. But the differences between the Soviet Union and Nazi Germany were slight, since the government under Hitler still ultimately controlled all economic activity – as evidenced in the pre-World War II confiscation of all Jewish businesses, whether small and local, or large and international in scope. Though Hitler continually railed against Soviet “communism” as a danger to civilized life in the West – an ultimate irony, in view of the devastation his own reign would cause – he was really railing against the Soviet Union as a nation, whose people he perceived as subhuman, hardy worthy to be allowed life itself.

As with so many 20th century tyrannical systems, universal, single payer, government controlled health care for all Germans ranked at the top of the list of Hitler’s idealistic visions. Actually, German leaders as far back as Bismarck in the late 19th century already implemented the beginnings of centralized health care planning, partly to appease the growing socialist movement within the country. In an article entitled National Health Care: Medicine in Germany 1918-1945, published in November 1993 in The Freeman, the physician and anthropologist Marc S. Micozzi gives perhaps a most insightful history of health care in Germany, beginning with Bismarck. I have used Dr. Micozzi’s article as a basis for my own analysis of Nazi health care policies.

As Dr. Micozzi reports, the health care crisis brought on by the disasters of World War II prompted the Weimar Republic leaders to create a system of government regulated health care for all German citizens, with a single agency in charge of all decisions and all funds. Concurrent with the rise of such centralized health care planning, the government changed the focus of medical care from treatment of the individual with a disease to public health and disease prevention. That is, the state became more important than any single patient. As Dr. Micozzi writes:

Medical concerns which had largely been in the private domain in the nineteenth century increasingly became a concern of the state. The physician began to be transformed into a functionary of state-initiated laws and policies. Doctors slowly began to see themselves as more responsible for the public health of the nation than for the individual health of the patient. It is one thing to see oneself as responsible for the “nation’s health” and quite another to be responsible for an individual patient’s health. It is one thing to be employed by an individual, another to be employed by the government…

Under the Weimar Republic these reforms resulted in clearly improved public health…but in connection with these reforms, the doctor’s role changed from that of advocate, adviser, and partner of the patient to a partner of the state.

Under the Weimar Republic private charity also became nationalized, along with the entire welfare system.

With the economic crisis of the world-wide Great Depression beginning in 1929 and the collapse of the German economy, the government had to restrict its more idealistic ambitions, but kept in place its control over all aspects of medicine. In a sense, the German citizens lost the benefits, but remained dependent on state dictates for their care. As Dr. Micozzi writes:

What remained of the humanistic goals of reform were state mechanisms for inspection and regulation of public health and medical practice. Economic efficiency became the major concern, and health care became primarily of question of cost-benefit analysis. Under the socialist policies of the period, this analysis was necessarily applied to the selection of strong persons, deemed worth of support, and the elimination of weak and “unproductive” people.

After Hitler’s rise to power, the new German leader expressed considerable personal interest in the role of medicine in the collectivist Nazi state, continuing to develop the preventive agenda originally proclaimed by the Weimar Republic. A long-term vegetarian himself, Hitler was particularly interested in the role of nutrition in promoting health, insisting, for example, that his cherished soldiers be provided with vitamin tablets. In some respects, Hitler was far ahead of many Western countries at the time: some 30 years before the US Surgeon General declared cigarette smoking a hazard in 1964, Hitler railed against the habit as dangerous, to be aggressively discouraged, particularly among his soldiers – even as Western armies were given free cigarettes to help “with their stress.” My father, one of those honorable WWII American GIs, developed a terrible smoking habit in the military – a habit that contributed to his life ending cancers decades later.

Despite such legitimate concerns about prevention, Hitler eventually subverted all German medical practice and certainly medical research to his political agenda, the creation and world domination of the master German race. The Soviets had Lysenkoism, the Nazis gave us eugenics carried to the ultimate insanity, the study of racial “improvement” engineered by science and scientists. Under Hitler, the German medical research community invested considerable effort and considerable monies investigating and cataloguing those physical and physiological characteristics defining the ideal Aryan man and woman – and those biological signs that signaled an inferior biological specimen.

In fact, one of the first laws passed by the Nazi regime mobilized the medical community to work toward the perfection of the German race. As Dr. Micozzi writes:

“The Law for the Prevention of Progeny of Hereditary Disease” intended to “consolidate” social and health policies in the German population and prohibit the right of reproduction for persons defined as “genetically inferior.” After 1933, the connection between the theory and practice of politicized medicine advocated by many in Weimar Germany became actual in Nazi Germany.

Hitler’s government not only funded race-related research within Germany, but sent chosen scientists journeying around the world during the 1930’s to study the characteristics of inferior non-Aryans. I have seen documentary films of German investigators with great seriousness measuring the noses and facial dimensions of alleged “non-Aryan” races such as those living in the Himalayan highlands.

As part of its goal of racial perfection, the Reich also established “Health Courts” charged with determining, through a combination of law and medicine, which of its citizens deserved medical care, and which did not. It’s a bit frightening to think, in view of current Congressional proposals for “health courts,” to realize the Nazis were there 75 years before us:

A “Genetic Health Court” consisting of judges and doctors made decisions about forcible sterilization. As “advocates of the state,” doctors prosecuted those persons charged with being “genetically ill” in sessions lasting generally no more than ten minutes and from which the public was barred. In 1935, an adjunct law allowed forcible abortion in such cases up to the sixth month of pregnancy…

…Following the sterilization laws, the National Socialists next implemented a strategy of euthanasia to solve the remaining problem of those whose conception and birth had preceded these laws. The pediatrician Ernst Wentzler, while developing plans to improve care in the German Children’s Hospitals in Berlin, personally decided (as consultant to Hitler’s Chancellery) on the deaths of thousands of handicapped children. Hans Nachtsheim placed delivery orders for handicapped children for his pressure chamber experiments on epilepsy; Joseph Mengele delivered genetic and anthropological “material” from Auschwitz to the Kaiser Wilhelm Institute and conducted his infamous twin experiments on the child victims of the Holocaust.

Julius Hallervorden at the Kaiser Wilhelm Institute for Brain Research at Berlin-Buch carried out several research projects based on euthanasia programs…

In his article, Dr. Micozzi describes case after case of physicians experimenting on the “unfit” or “undesirable,” who usually ended up dead. I remember reading some years ago that the Nazi medical leadership funded an entire well equipped hospital devoted solely to such endeavors, with its scientific staff eagerly publishing their findings in German medical journals. Hardly a physician or scientist in Germany objected, so total was the medical community’s infatuation with the political agenda off the Reich. Tragically, in its worst and final incarnation, such thinking gave us the death camps, and the murder of millions perceived as inferior. So much for the always noble intentions of government regulated health care.

Why Collectivist-Socialist Visions Always Fail

So, what can be learned from all this? Are the Soviet Union and Nazi Germany anomalies, aberrations, hardly legitimate examples of the socialist-statist philosophy that only government can make the world better, in agriculture, economics, medicine? Hardly. Though I have used these two nations as illustrations, I could just as easily have used China under Mao, whose socialist vision for the betterment of all led to the Cultural Revolution, with its repeated devastating famines, with 25 million Chinese murdered along with the destruction of the universities and the end of scientific and medical innovation. That tragic episode put Chinese civilization, and Chinese medical care, back into some pre-modern dark age, from which it has only slowly recovered with the development of at least a partial free-market economy. I could have referenced North Korean, where centralized socialist planning, centralized control, all for the benefit of the collective, have led to mass poverty, more than a million dead from famine – famine that continues to this day – and a medical system that again that hardly functions. No, Soviet Russian and Nazi Germany are not exceptions to the rule, they are the inevitable result of socialist thinking.

The failures of all collectivist states in the 20th century, including failure of their medical systems, to the chagrin of latter-day hard-line communists contrast completely with the enormous prosperity, high standard of living, and excellent medical care characteristic of the disdained “capitalist,” US influenced countries of the world. One need only compare the GDP’s of North and South Korean, the old East and West Germany, the Soviet Union under communism and the United States to make this point. Marx believed his collectivist dream would usher in an era of unimagined prosperity for all, coupled with personal and psychological fulfillment for its citizens as happy cogs in the benevolent state. Instead, the reality could not be uglier, widespread poverty, catastrophic famines, epidemic physical and psychological disease. Unfortunately, these realities seem forgotten today, particularly in the case of President Obama who seems so ignorant of the history he disdains, in the rush to foist a method of government, with its inevitable centralized health care, that has already proven a failure time and time again.

So, why does the grand collective dream always end in devastating misery for all (except the chosen elite)? The reasons, really not that difficult to phantom, can be easily summed up. Certainly, more learned people than I have written books about the failure of socialism, but I thought it might be valuable to throw in my thoughts about the inevitable demise of socialist endeavors. Here I list the general reasons for socialism’s failure, later I will apply these premises specifically to address why socialist state-run medical care specifically always ends in disaster:

1. As a fundamental flaw, the centralist state, be it the old Soviet Union, Nazi Socialist German, Maoist China, Castro’s Cuba or contemporary North Korea, only attracts supreme leaders driven by a narcissistic opinion of their own superior intelligence, knowledge, values, and worth. Thomas Sowell refers to such as the “anointed”. Without question, hesitation, or doubt, in such governments the leader and the chosen leadership know how all others should live, be they farmers, dock workers, industrialists, doctors, everyone, whoever they might be. This holds true even if the leader and those around him know nothing about farming, the docks, industry, work in general, or medicine in particular. Regardless, socialist-statist leaders always know best, even when they ultimately know nothing. Such thinking invariably leads only to disaster, because agriculture, the docks, economies, and health care systems are each very complex and multi-dimensional, operating in ways far beyond the capacity of the human brain to predict the ultimate outcome of meddling, intervention, and above all, “fixing.” But no worry, knowing what is best, for agriculture, for the docks, for industry, and for medicine, the narcissist plows on unconcerned, blind to the misery sown wherever he treads. Fortunately for narcissists but unfortunate for all others, they never need take responsibility for the disasters they inflict on all. In 1941, Stalin, hardly a military strategist, repeatedly ignored the warnings of his generals that all signs pointed clearly to a looming German Blitzkrieg invasion. He knew better, period. When the inevitable occurred and the Nazi divisions rolled over his unprepared frontier armies, Stalin blamed the very generals who had warned him of the threat, sending many to the firing squad. On the other side of the battlefield, at the start of World War II, Hitler, with no formal military training, had at his disposal the best trained, most effective professional military leadership in the world. But his ignorant meddling precipitated one failure after another, culminating in the epic defeats in Russia at Moscow, Leningrad, and Stalingrad, and the disasters in the West that began at Normandy and continued to the Battle of the Bugle fiasco. True to form, Hitler blamed his generals, firing many, and forcing the very best of the officer corps, Rommel who had served the nation with such loyalty, to commit suicide. Even in his bunker as the Russian armies closed in only blocks away, Hitler blamed everyone but himself for the military defeats.

2. In a less dramatic way, in terms of our current subject of interest, health care, I see our current leader, with no scientific or medical training, absolutely convinced he knows full well how medicine needs to be practiced, and run, certainly better than any mere physician trained in the field. As an aside, I remember so well during the dubious adventure with “Hillarycare” in 1993, the First Lady convened “think tank” meetings on the matter, inviting hundreds of alleged experts – but strangely, no doctors. These meetings, as I recall, were held in secret.

3. To the detriment of society at large, narcissistic statist leaders despise both achievement, and its companion, success – unless it is achievement they have allowed, and success they have themselves granted to those deserving underlings who espouse the leader’s vision and serve it without question. But otherwise, the leaders of statist countries invariably view those who achieve independently of the state, in whatever field, as threats to their own power and authority, threats that need to be undermined, destroyed, even physically wiped out. The Stalinist purges of the 1920 and 1930’s killed 25 million Russians, much of the professional and educated class including 33,000 of the Soviet’s best military officers. And those at the highest were hardly immune. Stalin slaughtered most of his nation’s talented generals, whom he saw only as undermining his pre-eminence and potential threats to his authority. In the days leading up to WW II Russian, Stalin made clear to his military that qualities of independence, initiative, and leadership would not be tolerated; he forbade even the most basic accoutrements of distinction, such as officer insignias and epaulets on their uniforms that might set them apart from their underlings. Inevitably, with his most talented officers either dead or disgraced in Siberia, Stalin himself set the stage for Hitler’s early victories during operation Barbarossa, his unexpected thrust – or at least unexpected to Stalin – into Russia in June 1941. When Hitler attacked with 3.1 million German troops, Russian Generals on the field were so paralyzed with fear of offending Stalin they failed to respond effectively, compounding the disaster. After a series of catastrophic defeats and with the German army marauding through Western Russian, reality apparently lit a light in Stalin’s brain. He removed his Secret Police from oversight of the military, distributed very distinctive uniforms to his officer corps, encouraged and rewarded leadership and initiative instead of punishing success. Eventually his much revived armed forces helped destroy the Third Reich in a series of impressive military victories, including the last triumphant victory in the Battle of Berlin in April of 1945. The Russian military experience in 1941 shows nicely that when you punish achievement, failure will follow.

4. In a similar way, Maoist China experienced the Cultural Revolution, essentially a deadly war against “modernity,” against intellectual and academic pursuits and achievement which Mao claimed to be decadent, but which in reality he saw as a threat to his total control over the nation. Mao wasn’t stupid, he knew that smart, educated people can be – though certainly not always – difficult to manipulate and subdue. In any event, in its wake, this Revolution left 25 million Chinese murdered including most of its academic, scientific and medical leadership. Students paraded university professors around forcing them to wear dunce hats, before they were, if fortunate enough to survive with their lives, sent off to communes to perform the most menial of work as part of their punishment for being smart. This grand expression of communist enthusiasm, this planned destruction of the country’s intellectual and scientific class, pushed China into a dark age of poverty, misery, disease, and epidemic suicide, from which it took decades to escape. Only recently, with Maoist philosophy disgraced and a more free-market system in place that recognizes and reward achievement, has the situation dramatically changed.

5. I am so saddened that in our wonderful country, this America, under the recent rise to power of Obamaism and leftist ideology, we see the same demonization of those who achieve, those who succeed – at the moment, primarily business leaders and doctors. I have been appalled, as have others, by our President’s not subtle and somewhat vile attacks against physicians, without hesitation stating as fact to public forums that surgeons apparently routinely unnecessarily cut off the legs of diabetics, or take out the tonsils of children, to make some big bucks. In all my years of medical practice, though I might question the direction of medicine from a scientific perspective, I know of no doctor who has ever cut off a leg or taken out a tonsil to make extra money. All statist thinkers, it appears, inevitably turn their wrath on the professions, on those who achieve and those who succeed, hoping to marginalize entire groups of intelligent people who might not so easily accept the socialist agenda. I would comment that interestingly enough, in America today trial lawyers escape the general vilification of the professions, understandably, since much of their work involves attacking businesses and doctors, for whom the left has no use. So they operate with a special government granted grace and affection.

6. In addition to such philosophic disdain and often vilification, in America at this time, the government punishes those achieve and succeed in many practical and insidious ways, with extraordinary tax burdens on the so-called “rich”, endless regulations that make achievement and success more difficult to sustain independent of the state, that restrict and impede creativity, innovation, and material progress, whether in business, in the sciences, or in medicine.

7. Yes, socialist-centralized states despise achievement and success, but in general they distrust, demean, and penalize hard work while rewarding or at least until the system collapses, those who lack ambition, motivation, a concern for achievement, and those who don’t particularly care to work that hard. Of course, as others have said more eloquently that I, statists portray those who achieve success independent of the state as victimizers, and those who don’t achieve, the victims whose victimhood needs remedy. This correction invariably involves taking from those who have achieved, rewarding those who have not with money, entitlements, and praise. As a result, little incentive exists for achievement, success, or simple hard work, and much motivation to do as little as possible. I recently heard, on the Glenn Beck Show on Fox News, a quote attributed to Ben Franklin to the effect that the best way to reduce poverty is to make it as uncomfortable as possible. Statist meddlers think differently, as they try to make poverty as rewarding and satisfying as possible, with their generous but ultimately counterproductive entitlements.

8. Tragically, the socialistic-narcissistic leadership can allow for no opinion, however expressed, that dissents from its own vision, whether in the realm of agriculture, business, science, medicine, or the military. Invariably, the state sees such opposition as a deadly threat to its very existence that must be crushed, often brutally and violently, as in Leninist-Stalinist Russian and in Nazi Germany. Often, though not always, the vilification of opponents begins gently – as we currently see in the US, in the organized assaults against such grassroots upheavals as the Tea Party movement, Rush Limbaugh or Fox News.

9. The collectivist state and its leaders invariably rely on, for its planning, dictates and actions, small groups of hand-picked “experts” who have the ear of the cherished leader and leadership, answer to no one but the leader and his cabal, and fall into line without question. Such was the case in the Soviet Union, in Nazi Germany, in Maoist China, and is the case today in Castro’s Cuba and contemporary North Korea. However, the term “expert” is a misnomer, serving as little more than a propaganda tool implying that the leadership astutely depends on skilled intelligent men and women to make its excellent decisions that regulate the lives of everyone else. Inevitably, these experts usually are those whose main quality is not creativity, true intelligence, or originality – qualities which the state and its leadership would see as a threat requiring extinction – but rather unflinching acceptance of the leader’s vision.

10. In the US today, we see, while not yet a collectivist state in full bloom, the creeping ideology that could easily lead down that very tricky path. Our President has surrounded himself with “experts,” in his particular case mostly academics with only book learning experience, but not with real experience in the field for which they profess expertise. We have a man running GM who has never worked in the car industry, for example. And I have read that in Obama’s administration, in charge of what in times past has been the most productive and successful free-market experiment in history, the envy of the world, only 10% of his “experts’ managing our complex economy have actual business experience, fewer than in any previous US administration. Most are academics, who have not worked in the “real world.” The choice of such “experts” to lead us is of course, is an invitation to disaster. When I first read of this statistic, I could only wonder if Obama or someone close to him had a brain tumor, would he chose as a surgeon someone who had read a thousand books on brain surgery, but never once had operated, or someone who might not have read so much, but had completed 1000 actual brain operations. Obama has chosen to run our complex nation and its complicated economy men and women whose book reading has convinced them they know exactly how the nation and its economy in all its aspects, should by run. In my humble opinion, the average bodega owner in the Bronx knows more practical economics, and the dangers of government interference, than our current Secretary of the Treasury, who to my knowledge has not even run a lemonade stand.

11. Inevitably, the collectivist state falls prey, disastrously so, to the rule of unintended consequences, operating in systems far too complex to submit to mere human reasoning. I have seen films of President Lyndon Johnson, in a very impassioned speech given I believe in 1965, lauding his new wide reaching, hundred-billion dollar welfare program, part of his “Great Society,” that would “temporarily” give multiple entitlements to the “poor”, and would “end poverty by 1975.” At that glorious time, the welfare system, no longer needed, would close down. Of course by 1995, twenty years after Johnson predicted the end of poverty and government dependency, some 30 million Americans lived on welfare, some had been living off the state – and the taxpayer – for more than 20 years. As Professor Sowell and others point out, the welfare enactments of the 1960’s actually created poverty, by paying people to sit home and do nothing, by paying them not to work, not to study, not to think, not to think about achieving. The whole system backfired, causing the loss of an entire generation of welfare dependents. Ironically, prior to the enactments of Johnson’s “Great Society,” poverty was actually decreasing to minimal levels but with the onset of mass entitlements, the levels soared.

12. Unfortunately, statist programs and institutions, whether in economics, science, or medicine, do not attract the most talented, original, creative, imaginative workers. Such people could never survive in a bureaucracy that penalizes such qualities.

13. Collectivist state leaders view the competition of ideas, competition in the marketplace of products and services, as fundamentally evil, and certainly anathema to the goals of the state. But without competition to weed out the ineffectual programs and processes, bad ideas frequently stay entrenched, to the detriment of everybody. Competition, in its best sense, allows for good, new ideas to surface, to replace the old and less good. Human progress in all spheres, in improved agricultural production, in the economic realm, in improved standards of living, in creative scientific advances, in improved health care, requires at its core competition, to stimulate the development of the better new way of doing things.

14. Progress requires, always, creativity, and creativity, to the dismay of statists, at its core requires liberty, freedom for the individual citizen to live, and think, and work the way he or she wants, and not in the way the state dictates. Human progress requires that someone like Thomas Edison be allowed to work when he wanted to work, to tinker when he wanted to tinker, and in the ways he wanted to work and tinker, with no interference from bureaucrats with not an iota of his intelligence. Edison was truly an American creation, a man with no more than some high school education, but possessed of that characteristic American drive, love of independence, dedication to hard work, determination to carve his own path, and we’re all the better for it. Bill Gates, a more contemporary example, could have happened only in America. A drop-out from Harvard with no future, he created an entire industry that saved the economy of Seattle, long collapsed into welfare dependency and government mismanagement after the demise of Boeing. Gates did what the bureaucrats could never do, his original ideas created businesses that directly or indirectly employ millions, have made many millionaires, and have made all our lives better with his unique inventions. And along the way, in true American fashion, he’s donated literally billions to charity. In a collectivist state, in any collectivist state, Edison and Gates could never have happened, they would never have been allowed to carve an independent path, to try and fail, to try again and succeed and maybe fail again.

15. Lest you think I exaggerate the dangers to creative thinking inherent in the socialist state, think only of Einstein in Germany before WWII. Hitler despised the Jewish scientist, justifying his hatred of Einstein’s novel and revolutionary theories by portraying them as a threat to the staid and true concepts of 19th century German physics. Had the Professor stayed in Berlin instead of fleeing to the freedom and liberty at the time characteristic of the US, he most likely would have ended up in a gas chamber, like so many other Jewish scientists under the Nazi reign.

16. States fail for many reasons – the oppression of creativity, independence innovation, liberty in general, etc. – but they also fail because in a very practical sense because of their lumbering inefficiency. As the State grows, its bureaucracy becomes a cancer, consuming vast amounts of resources just to maintain itself. I read recently that at the height of the Soviet experiment, thousands of economic “experts” in Moscow set the prices on some 12 million items, from the smallest of screws to a loaf of bread to the price of a tractor. The energy wasted in such trivia explains in part the disastrous GDP at the fall of the Soviet Union. In a lesser way, in the US, with its rapidly disappearing free-market system, for every dollar the government spends for one its various programs, a dollar goes into sustaining the bureaucracy itself. What a waste of time, effort, energy, and money.

A Real Reform: The American Republic

Our blessed founding fathers, what a group indeed, knew all this, more than 200 years ago. They knew the inherent and inevitable dangers of collectivist thinking even then, after all they had seen it in Europe, the enslavement of the masses for the perverse ends – whatever they might be – of the glorious State. They knew the bigger the state, the smaller the individual, the less his or her freedom and liberty, and the less his or her freedom and liberty, the worse our lives as a nation become. They knew the collective meant not only the loss of individual freedom, but ravaged economies, a worsening standard of living, eventually and inevitably universal poverty (except always for the chosen elite), physical, moral, spiritual deterioration.

They also knew that the individual, free from the constraints of the ever vigilant state, free to follow his or her own path, represents the only hope for progress in all spheres, the economic, physical, psychological, spiritual. They knew, fundamentally, that human creativity, and ultimately human progress flourish only with the state kept in check.

In a practical sense, our Founding Fathers recognized the value of competition, the competition of ideas, of products, of services, competition in which the better idea or product or service gains recognition and earns rewards more than the less good idea, or product, or service. They relished the idea of competition, the competition allowing for the new and the better to replace the old and less good. And our founding fathers wished that in this new America, in this meritocracy that today is so often criticized, achievement and accomplishment would be rewarded for the benefit of everybody, and not, as is always the case in the collective, punished and squandered to the detriment of all. We have taken this precept for granted, this reward for achievement, but in the annals of the world, it is quite a unique perspective for a government to take.

I remember sometime ago Hillary Clinton, when she served as First Lady, making a derogatory comment about capitalist competition, expressing a variation of the old Marxist view that the system was “Darwinian” ultimately oppressing the poor and the helpless. Quite the contrary, competition allows for the best to survive and flourish, to everyone’s advantage. And ironically socialism is itself “Darwinian,” by wasting limited resources on vast bureaucracies and programs that fall victim to the rule of unintended consequences.

Our Founding Fathers created the Constitution with one goal in mind, to protect the individual from his and her greatest enemy, the ever encroaching state, to allow the individual to live as he or she wished to live, free from its potentially oppressive weight. The Constitution, now largely with great arrogance ignored by our leaders as a quaint historical document, exists for no other reason than this, the protection of the individual from the state. So our President’s dream, that the State will somehow protect the individual, that only the state can protect the individual properly by regulating as completely as possible all aspects of national life, perverts completely the vision our founders.

John Adams famously predicted the American experiment, as he called it, would collapse within 20 years, because no state ultimately could be contained. Fortunately for us, he erred in his estimate, but one can only hope we survive the current encroachments by the resurgent socialist idealists, and fight once again strongly for the independence we too often have taken for granted. Signs evoking despair are everywhere, right down to the elimination of reward and awards for childhood achievement, or even worse, the rewarding to all regardless of success or failure, passing everyone in elementary school, whether deserved or not, eliminating scores at baseball games, so no one has to lose and no one can win, lowering salaries of those with ambition who work hard and achieve, and rewarding in many ways failure, an unwillingness to work or work hard.

Why US Health Care Reform Will Fail

It is tragic, at least to me, to witness our President and the Democratic leadership in Congress foist a government controlled health care program on us without nary a second thought, as if history didn’t exist, as if the failed government-run health care programs around the world never happened. These failures did happen, they did and still do exist, and we need to learn from them. Government run health care in the US, however restricted at the onset, will grow as malignant bureaucracies always relentlessly grow, as Medicare and Medicaid grew (into bankruptcy of course), as Bush’s prescription drug benefit plan has already grown far beyond its original intended limited scope. Bureaucracies can do no less, they must grow, it is in their biology and genetic make up. And so the proposed government run health care will grow, it will fester, and it will fail, for the same reasons all socialist statist enterprises ultimately fail.

I thought it would be useful to summarize, simply, my predictions as to why government run health care will falter:

1. The various health care bills I have reviewed all make provision for that inevitable draconian centralized group of Washington medical experts who will decide, for each and every condition – in fact, if I read the bill correctly, for each and every patient – what diagnostic tests and what therapy the doctor can prescribe. In a sense, the various drafts of Democratic inspired health care in one way or another seek to put the state between the doctor and the patient. Tom Daschle, the unseated former Senator from South Dakota claims such a system is best for the “collective,” whatever the downside to individual patients and their doctors. As with most centralist experts, despite the lack of any scientific or medical training, Mr. Daschle sees nothing wrong with telling physicians actually in the health care trenches they must stop performing as individuals, stop making individual decisions, stop relying on their own experience, education, intelligence, instincts, but instead blindly the follow the dictates of centralized experts. Once again, such a proposed system, to its final detriment, would prohibit and penalize independent thinking and independent action, the hallmarks of good medicine in general and the hallmarks of American medicine to date.

2. Doctors would not only take their marching orders from the state, but would also work for the state, charged as it would be with doling out payments according to its own system of acceptable medical practice and price controls. This set-up, as it did in the Soviet Union, would further discourage creative thinking, initiative and good old fashioned hard work, since doctors would no longer work for themselves. And those doctors who work harder would not be paid more than those who work less.

3. Historically, whenever government intrudes into science or medicine, science and medicine become twisted into the tools of political agendas, only peripherally devoted to their more honorable responsibilities, i.e., the search for the truth and the service of the sick. We have seen that with Lysenkoism in the Soviet Union, eugenics in Nazi Germany, physicians use as evangelical missionaries for Castro’s Cuba. We see that currently in the United States with the global warming initiative and the various legislative proposals that seek to drastically curb mankind’s allegedly pernicious activity at enormous cost financially, and at enormous cost to our liberty. Global warming appears to suit a particular political agenda, which suits the environmental ends of non-scientists but increasingly – as we freeze through a particularly brutal winter – seems based not in scientific fact. With “health care reform”, inevitably politicians and the scientists they chose to consult will determine what doctors, and their patients can do, based on their ideas of what should be right regardless of the scientific fact or the consequences.

4. I have personally witnessed medical bureaucracy first hand, and trust me, it isn’t pretty. As many of you know, I have spent the past 12 years battling with the various medical bureaucracies at Columbia University, The National Cancer Institute, the National Institutes of health, and the National Center for Complementary and Alternative Medicine, as we tried to force them to run our government funded clinical study properly – to no avail. Although I explain the details more thoroughly on my website and in my upcoming book about this expensive and time consuming fiasco, simply put, we uncovered dishonesty, incompetence, indifference, and good old-fashioned laziness right up into the offices of at least one Director. Our clinical trial, as supervised by entire cadres of bureaucrats from these various institutions, deteriorated into the chaos of careless management and mismanagement, corruption, even fraud, with the lives of patients put at risk with total indifference as far as we can tell. These people shouldn’t be running anything, least of all health care. Bureaucratic scientific institutions seem to select too frequently for the incompetent and the lazy, those happy to do very little of anything for as long as possible and always at taxpayer expense. In our office we call this syndrome “welfare science” and the bureaucratic practitioners “welfare scientists.”

5. The proposed government controlled health care system will prove financially untenable, for the same reasons bureaucratically run, centralistic enterprises of whatever ilk are always financially untenable. The bureaucracy will itself, cancer that it is, consume enormous amounts of resources that go not to medical facilities such as hospitals, or to patient care, or to medical research. I have read that the Senate bill if passed would establish 17 new major government programs, each requiring large staffs, facilities, and expenditures that take money away from the actual purpose of health care reform, that is, health care.

6. Health care reform as currently proposed, will as most government programs punish good behavior, and reward bad – and ironically, will make us sicker. Those of us careful and intelligent about what we eat, those of us who exercise, who avoid noxious habits such as smoking, drug use, and excessive drinking and have little need for medical care will be taxed to pay for the very expensive medical treatments prescribed to those who could care less, who eat recklessly and behave recklessly, who smoke, drink, etc. I read recently that a full course of treatment for lung cancer – a mostly preventable disease – with surgery, radiation, and chemotherapy can cost upwards of a million dollars, though most standard treatments for the problem work poorly. I have read predictions that the cost of treating Americans with Type II diabetes, largely the result of poor dietary and lifestyle choices, will run in the tens of billions annually as its incidence continues to increase yearly. But as long as someone like the government pays the bill, little incentive exists to change habits or take personal responsibility for one’s health. The fallacy persists in the liberal-socialist-Marxist mind that sick people are helpless “victims,” in need of the all powerful State, which parent-like, will be there to take care of you, whatever the problem and regardless of previous self-destructive behavior. No one need change habits, or take responsibility, quite the opposite. Ironically, such an attitude shared by the bureaucrats and populace in the Soviet Union helped speed along the downward spiral of the nation’s health care system, as purely preventable diseases achieved epidemic proportions, straining medical resources to the breaking point.

7. If we all had to pay for our own health care directly, and not indirectly through third parties of whatever ilk, government or private, we would inevitably think twice about our life decisions, and we would be the healthier for it. After witnessing a few families going bankrupt paying for pretty much useless lung cancer treatment, many of us might think twice about lighting up. For most humans, there’s nothing like repercussions for bad decisions, particularly financial repercussions, to make our decision-making process better. I remember during the welfare reform of the mid-1990’s, opponents of the plan paid for television ads warning that if the legislation passed tightening requirements, grandma would end up on the street, or little Timmy would starve to death. Of course, after the reform initiative became law, smartly placing severe entry criteria and time limits on welfare, our grandmothers did not die on the street nor did Timmy or Tommy end up starving to death, as far as I know. Instead, with payments now limited and no longer indefinite, millions of healthy Americans, many of them young, got off their duff, went to work, and experienced the rewards, self-respect, and possibilities for their future only work can bring. The nation, and the former welfare recipients now in the work force, were and are the better for it.

8. If we had to pay for our own health care, we would become intelligent consumers, as intelligent as we are when we purchase a house, or a car, or a lawnmower. First of all, most sane citizens, if they had to pay themselves, would restrict unnecessary visits to the doctor that don’t require any major intervention. In England and in Canada, with their universal “free” health care programs, repeated unnecessary doctor consultations for minor complaints are helping to undermine the entire system. Then, most of us, again if we paid for health care ourselves directly at the point of service, would investigate the options, find out what treatment works best for whatever condition we might experience, which doctor has the best results, which tests give the most valuable information. We would stop being so passive as we are today when someone else foots the bill directly, invariably turning over all the decision-making to the doctor. Intelligent choices and intelligent consumption by the consumer in the marketplace would not only lead to better, not worse care, but as an added benefit, would inevitably bring prices down. For example, PET scans can cost, in New York where I practice, up to $5,000, all directly underwritten of course by the insurance companies, though we all inevitably bear the price. However, if patients themselves had to foot the bill at the point of service, they would balk at such an expense, forcing the radiologists to bring their fees for the test more in line with the actual value – less than $1,000, in fact, less than $500. If a patient with metastatic pancreatic cancer had to pay the $30,000 or more for surgery, the $30,000 or more for chemotherapy, the $20,000 or more for radiation – it certainly adds up – they might question whether the expense was worth it for treatments that in general do little of anything for the disease. Doctors, and drug companies, would have to compete for patients, and bring the costs to a more reasonable level that patients could immediately afford. But as long as it’s “free,” that is, paid for directly by insurance companies and only eventually paid for by all of us in indirect costs, patients don’t think twice about proceeding with an aggressive and outrageously expensive therapeutic plan that might give them a few extra months of life and much discomfort along the way.

9. Perhaps those in Washington believe that this time around “we’ll do it better.” But this argument is nonsensical, since government programs are never “done better,” they always turn out worse. Again, it’s in the inevitable nature of beast.

Health Care Reform and Alternative Medicine

Since the world categorizes what I do as a physician as “alternative” in nature, I thought it might be a productive exercise to discuss the various bills before Congress in terms of the specific dangers they might represent to health care practitioners whose paths diverge from the current standard of care. Since bigger government always means, except for the cherished elite, less freedom and less liberty, including for us doctors, all the bills as they exist represent a potential hazard to alternative medicine. In an earlier brief essay that currently circulates on the Internet, I wrote that I have been in touch with those who have studied the various bills, such as the Liberty Counsel in Washington DC. All the bills, whatever its proponents state about “competition” and “freedom to choose a doctor” have as an ultimate goal single payer, universal government mandated government controlled health care with an end to competition, and government regulation of all medicine and medical science.

All doctors who participate in the government program would be closely monitored by the centralized bureaucracy and its dictates about acceptable care. Possibly – and I say only possibly – physicians such as myself might be able to opt out of the centralized collectivist plan, but no one at present seems sure if this will actually, in practice, be allowed. If doctors can opt out, we would then operate on a cash only basis, with patients aware no insurance would cover the cost of the alternative nutritional therapy. That would be ok, since we would still have the freedom to practice medicine and think as we saw fit. But if the government plan requires all physicians to join the centralized health system, as the Senate version requires all Americans, under threat of jail time, buy insurance, then serious alternative medicine practitioners will need find another America, and another Plymouth rock. Hopefully, the situation won’t reach such a draconian turn, since the lives of so many hundreds of my patients depend on the availability of this therapy.

Yes, I Have a Solution

Do I have a solution? Yes, and it’s quite simple. Keep government where it belongs, completely away from any regulation of, or any involvement with, health care. Government here and everywhere else have shown that whatever the noble intentions at the start, state bureaucrats can regulate and manage nothing effectively or efficiently, including health care. Yes, I know, we already have in this country entitlements that could never be immediately stopped, as unsustainable as they might be, such as Medicare. These programs, already headed into bankruptcy anyway, should gradually be phased out, with current commitments honored. Ideally, as some free-market thinkers suggest, private insurance should be reserved for catastrophic conditions and situations, and not set up to cover a visit to the doctor for a cold, or broken arm. We should return to a pay as you go system, paying the doctor directly.



Such an approach would reduce costs for everyone, since the billions eaten up by the various health care bureaucracies, whether private insurance or public, would be saved. Costs would come down, as they have in the free-market world of Lasik eye surgery, where insurance covers nothing, and patients make agreements directly with doctors. Those patients who overuse and abuse the system of “free” care for minor complaints would think twice before visiting their doctor with a problem that require only time for healing. Billions would be saved as fraud disappears, since there would be no third party, no inefficient government bureaucracy to con.

Patients could chose whatever doctor they want for the treatments they desire without interference, physicians would be free to prescribe and treat as they saw fit based on their education, experience, and instincts. That’s the way it used to be when I was a child in the 1950’s, and I don’t recall millions left to die on the street. For the truly destitute, for those legitimate victims of chance or bad fortune, American charity has always been there, to help those who truly couldn’t help themselves. Americans, as study after study proves, remain a most generous people, the most generous in the world. No, quite the contrary, it is the impersonal bureaucracies of government run health care that leave people to die, in any number of ways.

Fundamentally, I believe Americans should have the same freedoms in choice of medical care as they have in buying a car (though admittedly, even this freedom seems under assault). Should any of us wish to purchase an automobile, we shop around, compare prices and quality, go to a dealer of our choosing, select the car we want, put down the money, or at least a down payment, and ride off into the sunset. It couldn’t be simpler, the wonders of free-market capitalism, you want something, you pay the person who has it and sells it, and it’s yours. And the government – at least not yet – doesn’t directly intervene or interfere.

A system of car purchasing set up like the proposed government run health care would work quite differently. In such a situation, the government would first tax you excessively, whether you wanted a car or not, whether you had any intention of ever buying a car or not, in order to subsidize the centralized car entitlement program and its bureaucracy. Should you actually want a car at some point, you would first have to apply to some office of the government bureaucracy, which would then determine, based on your demographics, marital status, etc, what type of car you could buy. Then you would be given the car of the government’s, not your, choosing, “for free” or for a modest copay. Of course, the quality of the car would necessarily be far inferior to what you would have been able to purchase in the free-market with your own money, since the centralized bureaucracy would eat up so much of the funds collected into the government run auto entitlement system only a percentage would be available to pay for actual high-quality cars. In any event, as ludicrous as such as scenario might seem, government run health care involves exactly this, a third party with a voracious financial appetite eating up resources while eliminating freedom of choice and quality in the marketplace. Remember, when was the last time you heard anyone boasting about their “Russian made” automobile – and remember, all Russian leaders travel around in non-Russian Western-made luxury cars.

Some Final Thoughts

Recently, I read in the weekend edition of the Wall Street Journal (November 28, 2009) the comment of the late, great University of Chicago economist, Professor Milton Friedman, “The great advances of civilization, whether in architecture, or painting, in science, or literature, in industry or agriculture, have never come from centralized government.” Though Professor Friedman did not include medicine specifically in the list of fields that do not thrive under centralized governments, certainly the same rule applies. It is a shame that our current President has an apparent disdain for history, or he would see what is so obvious, and so nicely summarized in this quote from Professor Friedman. And it would end the debate on health care once and for all.

As a final comment, certainly, I believe that there is no good in this, in this “health care reform’ of any sort, not because of some oppositional tendency in my psyche, but because of what history teaches me. Government control of anything leads only to the unintended consequences of greater unexpected and unpredicted problems, problems far worse than those the “fixing” sought to solve in the first place. The hysteria surrounding this need for “reform” to me is an onerous sign of a government ignorant of history, and behaving with the demagoguery of a state relishing the heady sensation of new and unbridled power. With great self-confidence, it blindly marches forward to repeat the same inevitable mistakes that have led to such devastating consequences when other similar visions have been tried in other nations, always to the detriment of those the vision seeks to “help.”



My advice is simple, oppose “health care reform” in all its various incarnations and incantations, oppose it vigorously, oppose the slavery of any state program. If it passes, continue to oppose it, support those candidates who oppose it, until it’s finally gone. This is still America, and our Founding Fathers would expect no less.