At KevinMD.com, one aspiring neurosurgeon wrote up a detailed description of a typical day of residency. The countless number of crucial decisions he has to make each day is staggering. I highly recommend reading the full text of his post, "A neurosurgical resident's typical day".
(My own residency in radiology was not as grueling as his, but still pretty damned busy. I saw how hard the neurosurgery residents worked at Washington University of St. Louis during their 7-year program, and I had tremendous respect for them.)
Some day, if you ever have a serious head injury (or develop a brain tumor), your life may lay in the hands of a well-trained neurosurgeon like this one, practicing according to his best independent rational judgment. Yet this the kind of person whom the government wishes to regulate via "universal health care" and "cost effectiveness guidelines". When your life is on the line, who should decide what's best for you -- your neurosurgeon or the government bureaucrat?
In Ayn Rand's classic novel Atlas Shrugged, one of the characters is physician Thomas Hendricks who put the issue into essential terms:
..."I quit when medicine was placed under State control some years ago," said Dr. Hendricks. "Do you know what it takes to perform a brain operation? Do you know the kind of skill it demands, and the years of passionate, merciless, excruciating devotion that go to acquire that skill? That was what I could not place at the disposal of men whose sole qualification to rule me was their capacity to spout the fraudulent generalities that got them elected to the privilege of enforcing their wishes at the point of a gun. I would not let them dictate the purpose for which my years of study had been spent, or the conditions of my work, or my choice of patients, or the amount of my reward.We have been warned.
"I observed that in all the discussions that preceded the enslavement of medicine, men discussed everything -- except the desires of the doctors. Men considered only the 'welfare' of the patients, with no thought for those who were to provide it. That a doctor should have any right, desire or choice in the matter, was regarded as irrelevant selfishness; his is not to choose, they said, but 'to serve.' That a man's willing to work under compulsion is too dangerous a brute to entrust with a job in the stockyards -- never occurred to those who proposed to help the sick by making life impossible for the healthy.
"I have often wondered at the smugness at which people assert their right to enslave me, to control my work, to force my will, to violate my conscience, to stifle my mind -- yet what is it they expect to depend on, when they lie on an operating table under my hands? Their moral code has taught them to believe that it is safe to rely on the virtue of their victims. Well, that is the virtue I have withdrawn.
"Let them discover the kind of doctors that their system will now produce. Let them discover, in the operating rooms and hospital wards, that it is not safe to place their lives in the hands of a man they have throttled. It is not safe, if he is the sort of man who resents it -- and still less safe, if he is the sort who doesn't."