When Sarah Palin suggested that Obama’s health care plan will give bureaucrats the right to decide who lives and dies, she raised a legitimate concern. After all, a health care system that is limited by meager financial resources must ultimately decide who gets to benefit from it and who doesn’t.
However, the debate over life and death issues has obscured a more fundamental concern. The system will not only have to make decisions over who is allowed to die, but the government will be faced with the God-like responsibility of telling the rest of us how to live.
At least, that is the precedent that has been set by those countries already providing national health care, particularly the United Kingdom. If the example of Britain teaches us anything it is that when there is a direct link between the physical health of a populace and the nation’s fiscal integrity (which there obviously is when government promises to pick up the tab on everyone’s medical expenses), the state cannot help but develop an inordinate interest in keeping its citizens healthy.
In short, a government that promises to provide health care for its citizens begins to take a deep interest in the minutia of their personal lives. At first, this manifests itself in mildly intrusive ways, such as the UK’s campaign to get citizens to exercise while waiting for the bus. But it quickly accelerates into a full-scale policing of individual health.
Consider that British parents are routinely threatened with having their children removed if they are too fat, while the “health and safety” cult increasingly restricts the range of legitimate activities Brits may or may not perform. Any behavior that might lead to disease or injury – from tree climbing to eating shellfish – becomes a matter, not merely of private health, but of public “health and safety.” The reason these things are a concern is because preventative action is seen as the most effective way to reduce the costs of an over-stretched health care system.
Because every aspect of our lives can, in a general and indirect sense, be connected to our health, universal healthcare quickly becomes a blueprint for government to micromanage the minutia of our personal lives. In the end a state that has an economic interest in keeping its citizens healthy is a state that begins to be deeply interested in matters that ought to remain none of its business.
If President Obama succeeds in bringing in his health care plan, America will go down a similar road, leading to an institutionalized hysteria about health, lifestyle and all the social and intellectual decisions we make which may affect the health of ourselves and others. In the end, there is literally nothing that will fall outside the concern of a government that has taken upon itself the mantel of public health. Even the books we let our children read and the movies we let them watch become the concern of the health-conscious state. (Let’s not forget that in 2004 Hillary Clinton urged us to think about children’s entertainment “from a public health perspective.” She suggested that, “exposing our children to so much of this unchecked media is a kind of contagion,” a “silent epidemic” that threatens “long-term public health damage to many, many children and therefore to society.”)
A government that provides nationalized health care also cannot help but change the way we view each other. There is a very real sense in which we all begin to compete for the limited resources that government has promised to provide. This can easily change how we think of each other. Consider that the funds being allocated to treat your lung cancer and heart disease are funds not available for my grandfather’s surgery. Therefore, the person who puts cigarettes and red meat into his mouth is not merely unhealthy: he is being selfish. He is a parasite, acting against the common good since every meal and every cigarette unnecessarily sets him up to draw on resources that might otherwise be allocated to someone more worthy. My health and your health cease to be private matters, because the limits of economics ensure that all of our health is related in a web of connecting implications. The end result is what Faith Fitzgerald, professor at the University of California at Davis Medical Center, suggested in The New England Journal of Medicine when he wrote that
"Both health care providers and the commonweal now have a vested interest in certain forms of behavior, previously considered a person's private business, if the behavior impairs a person's 'health.' Certain failures of self-care have become, in a sense, crimes against society, because society has to pay for their consequences."
Eventually, the demand for responsible “self-care” will extend beyond the matters most of us associate with “health.” The template for this has already been set when The World Health Organization defined “health” as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” It is hard to imagine any area of physical and even intellectual life that would fall outside the scope of this broad definition of health. In the end, we reach a state of affairs that was anticipated by Robert Meenan, professor at the University of California School of Medicine in San Francisco, when he noted in 1976 that, “virtually all aspects of life style could be said to have an effect on the health or well-being of society, and the decision reached that personal health choices should be closely regulated.” (Italics mine).
At best, universal health care invites citizens to be meddlesome and deeply interested in the lives of their neighbors. At worst, it speeds up the progression from utopian ideals to totalitarian policy, culminating in the type of Mussolinian totalitarianism where everything is inside the state and nothing outside. I have argued elsewhere that there is historic precedent for expecting the later result. By giving government the responsibility to provide for our health, we are handing the state authority over our health and, by extension, our very lives. We are asking the state to function like as a meddlesome mother (a tendency I have complained about elsewhere).
So what could be worse than Sarah Palin’s fears of a “death panel” making decisions about who has access to life-saving treatment and who is left to die? I’ll tell you what could be worse: a state that has become a de facto “life panel” – making decisions, under the auspice of “public health” , on how we can and cannot live our lives.
Read articles by Robin Phillips
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Health Care as a Tool For Social Engineering
Population control as a solution to global warming
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From Rousseau to the swine flu vaccine
What to expect if Tony Blair is made president of Europe
Swine flu creates 'national emergency' of a different sort
What the Treasury Department is not telling Americans about the national debt
Ebenezer Scrooge and global warming
Social engineering and the dark side of the American Left
The temptation of caring totalitarianism
Totalitarianism in Nationalized Health
The old American tradition of redistribution
Comments
The government has been on the hook for seniors' health care costs since Medicare was created in 1965. So it seems like if the scenario you outlined was going to happen, it would have started happening 44 years ago.
hog wash the ins co are doing worse things now
Complete and utter trash
It seems pretty obvious that "managing the minutiae" is already with us and has been for a goodly while--certainly more than 44 years. What business (not just healthcare) cannot be shut down tomorrow, on some regulatory infraction that does not even have to relate to what the business actually does? The state already controls the very existence of ALL "legal" businesses in this way. (Claims that "capitalism has failed" broadcast a class of ignorance that is hard to manage even on purpose.)
And to the hand-wringing whine that the literal word "death panels" appears nowhere in the proposed healthcare diktat, I would observe that nowhere in the Constitution nor Bill of Rights is there any mention of a government power to regulate health care, either...and yet here we are.
Besides, anyone paying attention already knows from the War on (Some) Drugs that government control over health care decisions has already caused American deaths, and will continue to do so as long as individual people are forcibly stripped of the right to make decisions about their own lives.
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