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A Modest Health-Care Proposal

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Enough dithering! President Obama says it’s time to act on health care. I agree.

But act how? Are we really going to be happy with the pussy-footing proposals floating around Congress? All the so-called reformers want to do is tinker with insurance regulations. But how effective would that be, considering that the insurance companies themselves support the changes?

We have taken our eyes off the ball, people. Let’s get back to first principles. Obama’s premise is that we have a right to health care. A right.

America was founded on the idea of rights — inalienable rights. No one can take them away. I assume that when people say that health care is a right, they mean that health care is an inalienable right. Obama apparently agrees. In his speech before Congress he called for free services, such as physical exams, colonoscopies, and mammograms. Free! You have a right to those things.

Well, okay. But why stop at free preventive services? Why not free treatments, free surgery, free drugs, and so on? We need those things as much as a physical exam. If we have a right to health care and if we are unable to obtain those services, our rights have been denied or violated. That is something the advocates of health-care “reform” say we must not tolerate.

Okay, let’s not tolerate it. Let’s make sure no one’s right to health care is violated. Let’s get serious for a change.

But how? I can think of only one efficient way to accomplish this. Let’s enslave the providers of medical services — doctors, nurses, paramedics, dentists, chiropractors, acupuncturists, psychiatrists, and the rest. My proposal may shock people, but I am confident that this feeling will wear off as we think about how logically it flows from the principle that we have a right to health care.

First, let me point out that there is no other good alternative. Any other system designed to deliver health care as a matter of right will have gaps through which the least fortunate inevitably will slip. Isn’t that the problem we’re trying to fix? Obama’s approach isn’t much better. He wants to force the insurance companies, with taxpayer subsidies if necessary, to insure everyone — healthy or sick, young or old — at the same price. He might even like a government insurance option, though he can’t make up his mind whether or not that is an essential feature of his plan.

Regardless, it’s a bad plan. Requiring insurance companies to pay for our medical care misses the point. Where do you think insurance companies get their money? From us! What kind of right to health care is it if we end up paying for it anyway? Obama means well, but his plan is a shell game.

On the other hand, enslaving the doctors and other providers would have none of the defects of the current system or the leading reform plans. It goes right to the source. We have a right to health care? Fine. Force the doctors to provide it.

Of course, this wouldn’t be free. I’m no pie-in-the-sky utopian. The doctors and the others would have to be fed, clothed, and housed. They’d need certain comforts. That’s understood. But it would be far easier to keep a lid on costs by enslaving the providers than by the patchwork system we have now, or would have under Obama’s plan.

The biggest problem I can see is that if doctors are going to be our slaves, no one will want to be a doctor. Most people don’t relish the idea of being slaves even in the national interest. They’re selfish that way.

We certainly can’t be a world-class country without doctors and nurses, so I have a solution to this problem: conscription. President Obama should direct the nation’s schools to look out for students with an aptitude for biology and direct them into medical studies. Then at the appropriate time, the government should draft those young people into the newly created U.S. Medical Service Corps.

I know what you’re thinking: As word of this got around, the best students will play dumb. If that happens, we’ll have no other choice than to pick our doctors by lottery.

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    Sheldon Richman is vice president of The Future of Freedom Foundation and editor of FFF's monthly journal, Future of Freedom. For 15 years he was editor of The Freeman, published by the Foundation for Economic Education in Irvington, New York. He is the author of FFF's award-winning book Separating School & State: How to Liberate America's Families; Your Money or Your Life: Why We Must Abolish the Income Tax; and Tethered Citizens: Time to Repeal the Welfare State. Calling for the abolition, not the reform, of public schooling. Separating School & State has become a landmark book in both libertarian and educational circles. In his column in the Financial Times, Michael Prowse wrote: "I recommend a subversive tract, Separating School & State by Sheldon Richman of the Cato Institute, a Washington think tank... . I also think that Mr. Richman is right to fear that state education undermines personal responsibility..." Sheldon's articles on economic policy, education, civil liberties, American history, foreign policy, and the Middle East have appeared in the Washington Post, Wall Street Journal, American Scholar, Chicago Tribune, USA Today, Washington Times, The American Conservative, Insight, Cato Policy Report, Journal of Economic Development, The Freeman, The World & I, Reason, Washington Report on Middle East Affairs, Middle East Policy, Liberty magazine, and other publications. He is a contributor to the The Concise Encyclopedia of Economics. A former newspaper reporter and senior editor at the Cato Institute and the Institute for Humane Studies, Sheldon is a graduate of Temple University in Philadelphia. He blogs at Free Association. Send him e-mail.