Degrading Healthcare: How Egalitarian Impulses Destroy Excellence in Medical Practice

We live in an age of entitlements states. Most people, being the descendants of serfs of former ages, look toward government as they once did to the manor house: a source of employment, care/cures, and pension. After all, serfs worked the land and paid rents in exchange for a pension and periodic help from the lords, so it makes sense via genetic memory to extend that expectation to what replaced the aristocratic-feudal society.

The Left began clamoring for socialized medicine in the 1930’s because their goal is egalitarianism, or using government to make us all “equal,” which really means wealth transfer in order to erase the differences between social classes. The Leftist ideal is the “classless society,” meaning a giant herd of identical fools and a few canny manipulators ruling them all. This appeals to the lowest common denominator human mind: The People can do whatever they want, and suffer no judgment from others that reduces their social status, while government acts like a grocery store or bank in providing a service. If anyone does well, they give that back to the group just because, well, in their view it is the right thing to do.

In reality, this penalizes those who rise above the norm, which is mediocrity: most people are simply not that bright, motivated, or morally attentive enough to pay attention to vital details. When we make everyone equal, the average slob gets exactly what he would get anyway, which is eight hours a day at a do-nothing job, but those who are driven to rise above have all of that taken from them. This means that they quickly figure out that they do better just slobbing on through and spending their energy on their own interests instead of working hard to succeed at the day job.

The modern West has fallen into a low standard of competence because all of our intelligent people dropped out years ago. You no longer find the high competence types with important official titles; instead you will find them in easy jobs, taking long lunches, giving not much of a damn about anything and living cheaply. Mostly they have stopped bothering with marriage, since it also transfers wealth from men to women regardless of who is guilty of breaking the marriage contract, and die childless. The West under egalitarianism destroys the intelligent so that the mediocre (but capable of voting) feel safe from judgment.

Socialized medicine has done the same to healthcare. In the name of making it affordable or free for everyone, we have impoverished the middle class and also, by subjecting doctors and nurses to endless paperwork, driven the most promising candidates out of the field. You get free care, yes, but you will wait for it and it will be bad quality. You will be subjected to lots of tests that are unnecessary because that is how your doctor gets paid, since he or she gets paid now by the health insurer or government instead of directly.

If you want to fix healthcare, consider this. Every time humans gather in groups and fear rules the herd, people choose the “safe” option which means appointing a powerful bureaucracy to ensure that everyone gets the same amount of benefits or attention. This is individualism or narcissism in action; the individual fears that someone else will get more, so appoints a third party to do everything “fairly” in a way that ends up penalizing anyone who is not a total disaster. Over time, this leads to incompetence, corruption, and abuse.

American healthcare did well when it was cash in hand. You went to the doctor and paid for services. The doctor, responding to market forces, charged a reasonable rate because otherwise competition would swamp him, unless he was a specialist so good that he could charge a lot more. You bought health insurance for catastrophic events like accident, disability, or life-threatening disease, and the insurance company then paid the hospital bills. This irked insurance, of course, since they wanted to cut those healthcare costs.

Starting in the 1930’s with our entitlements state, insurance began scheming about ways to infiltrate health care. It settled on a simple scam: negotiate bills downward so that it never paid list price, but still charged insurance monthly costs based on those list prices. As with all merchants, the insurers quickly realized that this would work better if they had a monopoly, which they could achieve through government action with socialized medicine.

Since that time, healthcare has become a national obsession. The more laws we pass to ensure that no individual is overlooked, the more expensive and mediocre everything gets. The family doctor has long departed, replaced by the local health center at which quality of care is dubious. You will spent more of your lifetime filling out paperwork to justify necessary procedures than you will have hours of your life saved by this medical care.

In addition, rules like EMTALA mean that anyone who shows up at an emergency room gets free care, so now emergency rooms are useless unless you have twelve hours to wait. You end up buying private healthcare to address the actual emergencies, your funds go to public healthcare, and as usual those with more money get better care. Socialized medicine has completely failed in every objective except strengthening bureaucracy.

The medical town in which I grew up had quite a few specialists, and their rosters were full of people from socialized medicine countries who were here because with private care, they might survive instead of waiting on the NHS or Health Canada to get around to helping them. The emergency rooms looked like they were in downtown Mexico City. Doctors made most of their money off of people who were unwell and would remain unwell, mainly because they were the result of the fascinating genetic experiments of the New World that resulted in a passel of deleterious mutations that guaranteed chronic health issues.

Humanity came around the bend a couple years ago. Two centuries after the Leftist revolutions took over the West, people began to lose faith not simply in specific institutions, but in the entire idea of Leftism. It turns out that trying to save every individual results in bad care for all individuals, not just in health but in education, careers, law, and daily life. Our healthcare question needs a similar solution. Remove Leftism and the fear that it feeds on, and we can have normal lives again.

This requires us to accept a fundamental proposition of reality: we cannot save every person. Some are born doomed, and some suffer by chance. However, we can make life better for everyone else, and they are the vast majority. For too long, our fear has ruled us, especially in healthcare where our armchair bourgeois mentality has us envisioning the worst case scenario for ourselves. As we overcome this fear, we are headed toward an environment without entitlements and regulations where people connect with other people to receive personalized, quality care.