Like many others, the medical profession has fallen under the domination of those who propound statist ideas. Such professionals are all in favor of more government involvement in society, and disdain our traditions of liberty and voluntarism. To cite some recent examples, the American Medical Association was a strong advocate of the lockdown approach to dealing with COVID, and some state medical societies even threatened members with loss of licensure because they spoke out against the vaccine mandates. The intolerance of “progressivism” for anyone who argues against its coercive nostrums is as bad in the medical profession as it is everywhere else.
There are, however, some doctors who aren’t afraid to make the case for freedom, both in medical care and in all other aspects of our lives. One of them is Dr. Miguel Faria.
Faria escaped from Cuba as a teenager, studied medicine in the US, and became a practicing surgeon. In his 1994 book Vandals at the Gates of Medicine, he argued that the heavy hand of government was undermining the efficacy of America’s great medical system. In 2002, he wrote Cuba in Revolution, where he countered the way Cuba has been depicted by western intellectuals who foolishly trumpet propaganda on behalf of the Castro regime. More recently, in America, Guns, and Freedom, Dr. Faria made the case against the heavily politicized gun control movement and the medical establishment’s role in it.
And now, in Controversies in Medicine and Neuroscience, he revisits some old issues and adds a new one. (Much of the book is outside of my field of knowledge and I’ll only comment on the chapters that I expect will most interest AIER readers.)
I’ll briefly discuss the new issue first.
How did the brutal Soviet dictator Josef Stalin die? The official Soviet line was that he died of natural causes, but there have long been suspicions that he was killed by one of his own henchmen. Dr. Faria has examined the Soviet documents and argues that he was killed by Warfarin secretly mixed into his wine. That, Faria believes, is a convincing explanation for Stalin’s symptoms and lingering death. And whodunit? Most likely, it was Stalin’s vicious enforcer Lavrenti Beria. He, along with others in Stalin’s inner circle feared that the megalomaniac dictator would unleash another purge of those he thought were plotting against him, including them.
There’s a double irony here. First, that Stalin, who had so many millions killed, should himself die at the hand of one of his officials, and second, that Beria would soon himself be arrested and executed by the other Soviet dictators in waiting.
Now, the five chapters that deal with public policy in health care.
In Chapter 21 Faria reviews the Obamacare debacle, which he sees as a giant step toward “corporate socialized medicine in the US” He recounts the political legerdemain it took to pass the misnamed Affordable Care Act, and makes the sound legal argument that nothing in the Constitution authorizes the federal government to take control over health care. But that did not matter in the slightest to President Obama and his political allies, who thought this massive governmental intrusion would buy lots of votes for the Democratic Party.
In Chapter 22, Faria argues for a truly free market in health care and insurance. We had exactly that for a long time and enjoyed great medical progress as a result, but starting in the 1960s with Medicare and Medicaid, the government started pushing the country in the direction of socialism. Writes Faria, “If we truly had an unfettered free market in healthcare in the US, medical care would be competitive, more efficient, less expensive, and still humanitarian.” Alas, the false compassion of the statists is moving us rapidly in the opposite direction in each of those elements.
The great flaw that Faria identifies is the third-party payer system. For most Americans, the actual cost of procedures and treatments is irrelevant and unknown because someone else will pay. That induces terrible distortions in the incentives of patients and providers, driving up costs and lowering the quality of care. That great mistake predated Obamacare, which made matters worse. Faria writes, “Reforms are needed, but with the passage of Obamacare, US medical care will be further disrupted and what is left of the free market will be further distorted.” He points to the areas where Americans still have fee-for-service arrangements such as cosmetic surgery, dentistry, and even veterinary care to show how much better people fare when they have market competition working in their favor.
Faria next devotes two chapters to refuting false claims that we often hear from the statists about the supposed need for government activism in medical care. For one thing, leftist politicians and their media allies like to claim that government must intervene to bring down the high cost of medical care so that it will be “affordable.” Faria counters that it’s government meddling that has made healthcare so unaffordable, and observes that we have enormous administrative costs in the system that are wholly attributable to government interference in the market.
He also decries the financial self-interest of the public health officials who continually agitate for more power and bigger budgets. They may be medical doctors, but Faria thinks that they are not following the precepts of the Hippocratic Oath in pushing the country steadily away from free markets and patient-oriented care.
In his final chapter, Faria surveys the current health care debate in the United States. The great problem he sees is that the forces of socialism hold the high ground and the system they have forced on us is a very poor one. He states,
“Where the supreme medical ethic once dictated that physicians, hospitals, and other medical entities place the interest of the patient first, in the spirit of compassion and charity, today’s ethic of corporate socialized medicine propounds that all health entities place cost considerations and the interest of third party payers, including the government, above that of the patient.”
He’s correct, and no matter how much lip service politicians and bureaucrats pay to caring about individuals, the inescapable fact is that socialized medicine means long waits for impersonal, often substandard treatment. It hurts sick people.
Dr. Faria has retired from practice. He’s therefore beyond the control of those in the medical establishment who would rather not have any apostates arguing that America made a terrible blunder in turning toward socialized medicine. He has not, however, retired from speaking out on the harms that leviathan government is causing us. I hope we’ll have more of his eye-opening writing.
Made available by the American Institute for Economic Research.