I Do Have a Choice
Written by R.S. Jaggard for The Voluntaryist, June 1991.
I want to be productive. I want to produce goods and services of value to my neighbors, and, I want to deal with them in willing exchange for mutual benefits.
My life-long ambitions, my training and experience, and my present position all add up to the fact that I am best qualified to help others by performing medical services for them. For these reasons, I practice medicine in a situation wherein I offer my services to any and all persons, dealing financially with each individual patient on terms that are mutually acceptable to the two of us.
Granted, I am not able to practice under the free enterprise system, because the state requires that I have a license to practice medicine. This creates a semi-monopolistic system, wherein all prices for all services by all physicians are artificially high because of restricted availability. Also, huge, direct subsidies from government to the vast majority of doctors cause higher medical fees for all.
In my efforts to be of service to others, I do not accept direct subsidy, because I do not accept any payment from government. I do get indirect subsidy because some of my patients pay me with cash which they have received as subsidy (direct or indirect). Government has become so pervasive, invasive, and intrusive that it enters into all sorts of contracts with all sorts of people in all walks of life, and all of us are “subsidized” in various ways.
The most obvious way in which many doctors now get large, direct subsidy payments is by participation in the government programs. Those doctors who provide politically-selected-and-approved care and treatment to politically-selected-and-approved patients, and who push the “right” buttons on the computer, (or use the “right” code numbers), get huge paychecks from government — with strings attached. They try to rationalize their acceptance of government paychecks (and political control over their medical decisions) with the excuse that this is the “practical” way to live in modern times. They object when the political controls are used against them, to their detriment, and suddenly they find that their “rights” are being violated.
Government gets its income by taxation, taxes are collected by force and violence (or the immediate threat of same), and, disbursement of tax money is made in accordance with political rules that give special consideration and special benefits to special people with special political power.
Traditional medical ethical codes clearly say that the physician should serve the best interest of the individual patient. The physician who depends on “somebody else” for income can not remain devoted to the best interest of the individual at all times.
I try to practice in the traditional Hippocratic manner as best I can. I do not accept money from the government medical programs, because I do not want to personally steal from the public treasury, neither do I want to steal by proxy, so I do not give patients any statements or receipts that they can use to get money from government medical programs to give to me in exchange for medical service.
I do not want anybody at any time to steal from the public treasury for any reason, and I certainly do not want them to steal, and then claim that they are doing it for my benefit.
Force, violence, stealing, and political interference on behalf of special interest groups are all destructive actions which are counter-productive. I want to be productive, to be free to act with individual moral responsibility for my actions. I want to build a better way, the voluntary cooperative way, for the benefit of all persons, for all future times.