G. Keith Smith, M.D.

“Socialism, like the ancient ideas from which it springs, confuses the distinction between government and society.  As a result of this, every time we object to a thing being done by government, the socialists conclude that we object to its being done at all.”  

More wisdom from Bastiat.  I think when muddy-headed folks say that health care is a “right” they are making the mistake of blurring the distinction between government and society.  A desire to make health care available to the most vulnerable and poor is, after all, distinctly different from inviting government corruption to the task.    

The socialist would say,” charity won’t adequately provide for the poor!”  This is the primary justification and argument of the socialist for the compassion of collectivism, the barbarity of entitlements and the widespread violation of property rights.  Here are three ways to respond to this argument.  

First, “I don’t care what you do with money stolen from me.  All I care about is that I’ve been mugged.”  After all, the government doesn’t have any money to pass out that it didn’t first take from someone at gunpoint.  This argument is sufficient in itself.  Nothing more really needs to be said.  That someone else should claim a “right” to your property, means it was never your property to begin with, as no right can exist, the exercise of which violates another’s rights, property or otherwise.

Second, government handouts consist of the value of the handout plus the overhead of administering the bureaucracy in charge of theft and distribution of the loot.  This is very inefficient and is not what any economist would call an ideal or maximal utilization of resources.

Third, we will never know if charity would have sufficiently provided  for the poor, as denied the use of money through confiscatory taxation, many are denied their opportunity to be charitable.  The great libertarian Leonard Read wrote angrily about this, seeing this denial of the “right to be charitable” as an incredibly destructive influence on communities and society, distancing and depersonalizing the plight of the unfortunate in need of help.

Expand Medicaid?  Government health care for all?  Just because liberty-minded folks are opposed to government involvement in health care, doesn’t mean that they are opposed to the poor having access to health care.  In fact, it is the innovation of individuals in a free market that brings prices down to levels that more and more people can reach, levels that in other industries like cell phones and computers would have been unimaginable 20 years ago.  It is the involvement of government that guarantees limited access, skyrocketing prices, fraud, corruption and death.  

How much more of the carnage of socialism must we endure before we abandon this way of thinking?  Free markets in health care will help us to avoid the rationing and death that has characterized government health systems all over the world.  Our model is a free market one.  There are many others in the works dedicated to price transparent, high quality, reasonably priced health care.  No economic system known to man makes better use of scarce resources than a free market.  To maintain otherwise, particularly with a service as important as heath care, is either ignorant or duplicitous.  

G. Keith Smith, M.D.

If you’re looking for a break from the belched platitudes and promises during this campaign season, check this out.  This is what most readers of this blog would like to hear from the candidates (assuming that if they said it, they meant it!).

Leonard Read and many of his writings ( “Anything That’s Peaceful,” for instance) were transforming for me.  His philosophy of liberty led him to believe that patent and copyright laws were an unjust use of state power, hence all of his writings are available online and free. 

Perhaps his most devastating piece on central “state” planning was “I, Pencil.”  The futility of “planning” the production of a mere pencil is demonstrated in contrast to its spontaneous appearance due to “uncoordinated” market forces.  How one could read this clever piece then subsequently claim government has anything but the most limited role is beyond me.  To rely on central state planners for the provision of something as complicated as health care after reading “I Pencil,” seems clearly more evil than stupid.  

I still remember the dismay I had reading Read’s works.  ”Why didn’t someone tell me about this guy when I was in school,”  was basically what I was thinking.  If you haven’t read this giant of liberty, you are in for a treat.  

G. Keith Smith, M.D.

I’ve come to the conclusion that everyone is a libertarian.  For themselves.  A small subset are libertarians for folks other than themselves.  Human freedom and liberty are qualities that bind all of us, common goals of every human being on the planet.  Any restriction of one’s freedom is instinctively met with anxiety or anger, an acknowledgement that something has been or is soon to be taken away that shouldn’t have been.  Denial of your freedom seems and feels wrong to you.  Denying another’s freedom doesn’t bother most folks as much.  

“Don’t touch my Medicare,” a frequent threat from many otherwise libertarians is balanced by many physicians crying, “don’t touch my Medicare payments!”  ”I’m all for smaller government as long as no one touches farm payments, medical research or the department of defense.”  I’ve heard this countless times and so have many of you reading this.  Sometimes statements like this are veiled so that the ulterior motive of “screw you as long as I get mine” isn’t so obvious.  Sometimes these statements are made with the promise of “jobs” running shotgun for the crony advocating his brand of theft.  

Sometimes  the promise of a $200,000,000 “economic impact” is used to justify a $20,000,000 robbery.  Many times the recipients of the $20,000,000 foist themselves on society as freedom lovers, making their fraud complete.  

Harry Browne’s book “How I Found Freedom in an Unfree World,” challenges us to examine ourselves first for these inconsistencies before we hurl insults at others, in the same way that Leonard Read challenged everyone.  What arrangements or deals are we all involved in that are not mutually beneficial?  That is the question that leads many from the self-libertarianism to a form more generalized that extends to everyone, I think.  

Was charging a patient $83,000 for a drug for which a hospital paid $7500 represent a mutually beneficial exchange?  Or was it a “gotcha,” hit and run sort of proposition?  What would be the public reaction to a business operating in an open and free market that engaged in these tactics?  The state has enabled this hospital to act in this manner and has even moved to shut down or prevent competitors from entering the market to compete with this outfit, all with the argument that we must protect our vital health providers.  

While the Solyndra robbery and bank and auto bailouts are criminal acts, the takeover of health care by the same crony “capitalists” is dangerous to all of us in a more personal way.  Watch for the “health entrepreneurs” who benefit from government largesse all the while claiming to be small government freedom lovers.  While they may value their freedom, it is clear they do not value yours or mine.

G. Keith Smith, M.D.

A few years ago, with the help and encouragement of my older brother, I ran the Chicago marathon.  It was hard.  The training was hard.  The hardest part of the training was the mental part, that part where I had to overcome the anxiety and disbelief that having completed a 10 mile run on a Saturday, there would come a day when I could do a training run of 12, then 15, then 20.  Once the 12 mile run was done, 10 miles didn’t seem like such a big deal.  I couldn’t even remember thinking that 10 miles was a big deal.  I just knew that I had real anxiety about the upcoming 14 miler.  What I hadn’t accomplished yet seemed unreachable, yet once the next goal was reached, I discounted my prior uncertainty. You get the idea.  

I think that our socialist tendencies are like this.  Almost everyone is a socialist if you push them far enough.  On the contrary, almost every socialist respects property rights if you push them far enough. Let me show you what I mean, and as you read this, you can be thinking about when you start feeling like a socialist.  Even the most ardent socialist would protest the violation of his property rights were a mugger to take his watch and wallet.  Most of us don’t like to have our wages taken from us and given to someone else who isn’t working who could be working.  You may be one of these resentful folks but all the while advocate that tax dollars should be used for public broadcasting or the arts.  Realize that what you are saying, in effect, is that “I know best how someone else’s money should be spent.”  You are also saying “..and I condone whatever force is necessary to take the property of my neighbor to effect that end.”  Perhaps you are having difficulty distinguishing between this theft and that of the mugger.  

Now understand that I’m making the case that we all have this tendency (to know what’s best) in us to some extent.  This is one reason that liberty is so fragile and unusual.  Freedom and liberty require a systematic and regular review of what is done by government with an eye toward which, if not all, of its functions can be eliminated, that is, which government activities can be accomplished by the private sector.  Thomas Sowell once said that..”..there is no such thing as community service, for if there were a demand for it, someone in the private sector would have already found a way to provide the service and profit from it.”

You might fancy yourself a true freedom lover,  but not when it comes to medical research or health care.  In your opinion, it might make sense for the robbery to occur to make sure that these services are part of the social safety net as the market can’t be trusted to be as wise as certain brilliant individuals directing the traffic of tax dollars.    You might have difficulty envisioning education as voluntary and separate from government.  You might see the role of government in commerce or energy or old age pensions or the regulation of the environment or food and drugs or roads and bridges  as legitimate and sufficiently justifiable to warrant the confiscation of the property of people who don’t.  

Where do you draw the line?  I’ve always found it interesting that these are very emotional issues and topics for people to discuss.  Often times there is so much emotion anchored to these ideas that you can risk a friendship with a discussion.  Many lovers of liberty have difficulty discussing their own new liberty frontiers without getting angry themselves, not unlike the marathon trainee, who, now running 16 mile runs has forgotten what their mindset was at 8 miles.  Many are frustrated to condescend to discuss issues long since dealt with by them and it shows.  

So here’s my point.  Be patient with those who harbor more faith in government (socialism).  They might have just finished their first 3 mile run and are doing all they can.  Take Leonard Read’s advice and work on yourself: test and master your own thoughts and arguments and don’t go looking for trouble; just because you can’t wrap your mind around a new and seemingly radical freedom proposal doesn’t mean that someone else hasn’t thought through this long ago; find the borders of your own frontiers and challenge those.  I think that this approach can bring the peace of mind that true liberty can grant, as we question at every step the legitimacy of the violence of state action.  

G. Keith Smith, M.D.

Years ago I joined a partnership that was “eat what you kill.”  In other words, if you earned it, it was yours.  No sharing.  No blending of production or money.  Things changed.  The group “voted” that they wanted to start sharing everyone’s income.  I said that those that wanted to get together and share should do so, that I had no problem with that.  That wasn’t the idea, you see.  As a high producer they needed my income in the pot for it to make sense.  One of the partners actually said this in a partnership meeting.

I think of this often.  Liberty is good on its own.  Socialism must include even those who don’t want any part of it.  Socialism is by definition then not a mutually beneficial arrangement for all parties.  Forceful property confiscation is part of socialism.  Liberty lovers are ok with what they have.  They are ok without other people’s stuff.  Liberty lovers just want to be left alone.  Socialists can’t stand to leave others alone.  Liberty lovers are ok with socialists as long as the socialists aren’t empowered to steal from them.  Socialists are not ok with liberty lovers keeping their stuff.  Socialists think they know best how other folks money should be spent.  The more education one has, the more smart they think they are, the more likely one is to succumb to this “fatal conceit,” as Hayek called it.

One of these groups (the socialists) represents a violent thief and the other is self-sufficient.  I think that’s why Leonard Read named his famous book, “Anything That’s Peaceful.”  The libertarian says “leave me alone…I’ll be alright..if not it’s not your problem.”  The socialist says, “those of you who have some stuff need to throw it in the pot in case someone else needs it.”  Everyone’s problems are shared.  Everyone’s successes are shared.  This philosophy of government is what nearly killed the Pilgrims with starvation.  What is fascinating to me (and the really hard part that socialists cannot come to grips with) is that the free market, better than any central economic planner, sees that this very sharing of successes and failures occurs in the most efficient and accountable way possible.  Failures are isolated, not institutionalized.  Successes float all boats higher.  Amazing that people continue to have this discussion.

The destructive power of the socialist’s wealth confiscation and its history of disaster, poverty and death seems to have little effect on those zealots who continue to propose this insanity.   The prosperity and improvement in the quality of life for all segments of society associated with the principles of liberty are so easily forgotten.  

The application of free market principles in medicine at The Surgery Center of Oklahoma has resulted in what the guys in suits call a serious “value proposition.”  The quality of care delivered for the price charged is simply unmatched.  This is a nightmare for our competitors.  Their only hope is the state legislator who would be bribed and bought off or the U.S. congressman who would promote hamstringing legislation to thwart our success.  These disgusting moves by our big hospital competitors are more and more obvious and meeting increasingly hostile receptions.  

Murray Rothbard wrote that the purpose of laws was ultimately to confer an advantage on those who proposed a particular law.  Conversely, a law was meant to confer a disadvantage on those competitors of those who proposed a law.  Watch for legislation that makes it increasingly difficult for newcomers to enter the scene of medical care.  Those legislators proposing these laws and regulations are basically hired thugs.  You are just as likely to see this on one side of the aisle as the other.  Watch for laws that tighten the already tight cartel of the insurance and corporate hospital groups.  Watch for more “certificates of need.”  Behind every one of these efforts is a smoke-filled room with the usual crony capitalist suspects, fascists by any definition of the word.  While complaining about access to care, our wonderful federal government, for instance, has limited the extent to which physician-owned hospitals can expand and has virtually shut down any further entrance of new facilities.  Think a little money changed hands on this deal?  Nothing but violence-loving goons, this lot.  Notice at the end of the article, a government study revealed that the effect of the specialty hospitals so feared, has never materialized.

If the peaceful market prevails and folks leave each other to their own devices without involving the violence of government, we will all be better off.  We should welcome the apologies of those “useful idiots,” as Lenin called them, when they finally realize they’ve been duped by the insanity of socialism.

G. Keith Smith, M.D.