Regulation | Mark A. Hurt, MD

How do you interpret the meaning of recent health care reform legislation in relation to what you do?

I believe it is too early to understand fully what this means for me or people who do what I do.  My sense of it is that more regulation and more taxation will drain the life blood -- capital -- from me:  professionally and personally.  For what? -- to pay unproductive people, with the power of government behind them, to continue to be unproductive and to pay new people to be unproductive -- sitting in judgment of me, making it more difficult for me to do what I do and more difficult to deliver my services to meet the demands of patients.

These kinds of things usually progress slowly and often with unintended consequences.  When governments attempt to "plan centrally", most of the time it fails, and the failure becomes institutionalized.  Look at Medicare.  It was supposed to be an "insurance" plan for those 65 and older, it being an offshoot from the Social Security Administration, an age chosen arbitrarily by a government bureaucrat named Robert J. Myers, who was an actuary and who worked on the original system.  Why was 65 chosen?  According to Mr. Myers “Age 65 was picked because 60 was too young and 70 was too old,” . . . “So we split the difference.”  This is how it's done when it comes to the government.  Forget facts, forget morality, forget fiscal responsibility -- after all, it's other people's money, and they believe somehow that they are doing good.
 
But they aren't.  The money is stolen, then it's used to prop up unproductive "services" that no one in their right mind -- and perhaps out of their mind -- would attempt.  In the first 3 years of Medicare funding, for instance, instead of rising gradually, the price to fund it became asymptotically high -- and it has never stopped.  The new system passed recently is Medicare on LSD.
 
Oddly enough, sometimes work like I perform is sustained well for a time by these government programs, but over a long period of time the quality erodes because, despite the funding from the government, incentives for production subside - i.e., the drive to keep going for one's own sake -- and one often becomes disillusioned about being told what one must do instead of running a business the way he knows it should be run.
 
As the villan from Ayn Rand's novel, The Fountainhead, stated:
 
Kill man’s sense of values. Kill his capacity to recognize greatness or to achieve it.  Great men can’t be ruled.  We don’t want any great men.  Don’t deny conception of greatness.  Destroy it from within.  The great is the rare, the difficult, the exceptional.  Set up standards of achievement open to all, to the least, to the most inept – and you stop the impetus to effort in all men, great or small.  You stop all incentive to improvement, to excellence, to perfection.  Laugh at Roark [the book's hero] and hold Peter Keating [an incompetent architect in the book] as a great architect.  You’ve destroyed architecture.  Build up Lois Cook [an incompetent writer] and you’ve destroyed literature.  Hail Ike [an incompetent playwrite] and you’ve destroyed the theatre.  Glorify Lancelot Clokey [an incompetent newspaperman] and you’ve destroyed the press. Don’t set out to raze all shrines – you’ll frighten men.  Enshrine mediocrity - and the shrines are razed.
 
Thus, when the government enshrines mediocrity in medicine by this new plan, which it will hold it up as great in whatever incompetent form it takes, what is truly great -- the free market and individual rights applied to the practice of medicine -- will be pushed off the scene altogether, killing whatever is left of authentic medical care.


Insights from Thomas Jefferson

The main body of our citizens . . . remain true to their republican principles; the whole landed interest is republican, and so is a great mass of talents.  Against us are the Executive, the Judiciary, two out three branches of the legislature, all the officers of the government, all who want to be officers, [and] all timid men who prefer the calm of despotism to the boisterous sea of liberty . . .

 
-- Letter to Phillip Mazzei from Thomas Jefferson, Apr 24, 1796

We hold these truths . . . that all men are created equal, that they are endowed . . . with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness. — That to secure these rights, Governments are instituted among Men, deriving their just powers from the consent of the governed, — That whenever any Form of Government becomes destructive of these ends, it is the Right of the People to alter or to abolish it, and to institute new Government, laying its foundation on such principles and organizing its powers in such form, as to them shall seem most likely to effect their Safety and Happiness.

 - Thomas Jefferson
 - 1776