Monday, February 4, 2008

Armstrongs On Freedom And Compassion

The February 4, 2008 Grand Junction Free Press has printed the following OpEd by Linn and Ari Armstrong on freedom, compassion, and health care:
Freedom is compassionate ... force is not
By Linn and Ari Armstrong

We've been writing a lot about health policy because it is an extremely important issue that has been at the center of the political table for the past couple of years.

One side of the debate calls for more political control of medicine in the form of more tax spending, more mandates and more political interference. The other side, which we join, points out that existing problems in medicine are the result of just such political force, and the solution is liberty in medicine, a free market that consistently protects individual rights to direct one's resources and interact voluntarily.

In our Jan. 21 column, we argued, among other things, that doctors should not be forced to provide service without compensation. This is hardly a radical claim. For instance, most people don't expect grocery stores to offer "free" food to any comer who claims to need it. However, even though nobody forces them to do so, many grocery stores voluntarily contribute to food banks. We have heard of no proposal to force grocery stores to offer "free" food to whoever demands it, without compensation.

Nor are we unique in thinking that the use of such force would result in widespread abuses. Certainly nobody seriously proposes the nationalization of grocery stores to "solve" the problem of hunger.

Yet some expect us to believe that, while we count on the free market to provide us with other necessities of life, from food to housing to clothing, in health care the proper approach is socialized medicine.

In his Jan. 24 reply, Dr. Michael Pramenko alleges that we are heartless for endorsing a free market in medicine. He offers as examples a man suffering chest pains, an infant born prematurely, and a child with asthma. If these people cannot afford treatment, will they be tossed out in the street? Pramenko is relying upon his readers' sympathy, and the very fact that so many people care about such patients ensures that they will find care in a free market.

A free market means one in which people are free to interact voluntarily. Thus, a free market includes all voluntary charity. For example, as a Shriner, your elder author helps to raise funds for the Shriners Hospitals, which provide care to children at no charge. In a free market, not only would many hospitals and clinics provide services to the poor at no cost or at discounted rates, but many individuals and foundations would provide funds to cover such care.

What is heartless is forcing a doctor to provide care to any person who walks in the door, regardless of the circumstances and without compensation. Such a system invites widespread abuse. Many people who can afford to pay for their care simply skip out on their bills. Some who could afford insurance choose not to buy it; after all, one is guaranteed "free" care by law, at somebody else's expense. Others neglect their health, actively damage their health (as through alcoholism), or ignore lower-cost options because the law grants them "free" yet expensive emergency care.

If Pramenko actually believes that doctors should be forced to offer care, then why stop there? Why not also force grocery stores, clothing stores and so on, to also provide "free" goods to anyone who claims to need them, without compensation?

Why not force private individuals to help others who claim to be in need, without limit? For instance, if somebody knocks on Pramenko's door and claims to need a place to live for a few months, shouldn't Premenko be forced to give the person a home, without compensation, no questions asked? Anybody with common sense can predict the resulting chaos and injustice of any such policy.

In fact, as Lin Zinser and Dr. Paul Hsieh review in an article available at, the law forcing hospitals to offer "free" care has resulted in many emergency rooms shutting down.

Just as all of us have the right to decide whom to help in our own homes and with our own charitable dollars, just as we have the right to offer our labor in return for money, so doctors have the right to decide whom to serve and on what terms, as accepted voluntarily by the patient. No one has the right to demand "free" service from a doctor, or from a grocer, or from anyone. Doctors who wish to provide care at no cost are free to do so, and doctors who wish to work only in exchange for compensation have that right.

But Pramenko is not content merely to leave in place existing unjust laws that harm our health. He wants to impose more such controls. The result will be higher taxes, more political controls placed on doctors, and more rationing for patients. Politically controlled medicine is heartless.

The alternative to Pramenko's heartless, health-harming, politically controlled medicine is a compassionate and just free market in medicine.

Linn is a local political activist and firearms instructor with the Grand Valley Training Club. His son Ari edits from the Denver area.