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        Date: Fri, 25 Mar 94 02:01:34 EST
        From: freematt@aol.com
        Subject: HEALTH CARE IS NOT A RIGHT by Leonard Peikoff, Ph.D.
        To: libernet@Dartmouth.EDU
        
        FWD> By Matthew Gaylor <freematt@aol.com>
        
        Notice:  The following article is Copyright 1993 by
        Leonard Peikoff and is being distributed by permission.
        This article may be distributed electronically provided
        that it not be altered in any manner whatsoever. All
        notices including this notice must remain affixed to
        this article.
        
        
                       HEALTH CARE IS NOT A RIGHT
                       by Leonard Peikoff, Ph.D.
        
                    Delivered at a Town Hall Meeting
                       on the Clinton Health Plan
                     Red Lion Hotel, Costa Mesa CA
                           December 11, 1993
        
        Good morning, ladies and gentlemen:
        
        Most people who oppose socialized medicine do so on the
        grounds that it is moral and well-intentioned, but
        impractical; i.e., it is a noble idea -- which just
        somehow does not work.  I do not agree that socialized
        medicine is moral and well-intentioned, but
        impractical.  Of course, it *is* impractical -- it does
        *not* work -- but I hold that it is impractical
        *because* it is immoral.  This is not a case of noble
        in theory but a failure in practice; it is a case of
        vicious in theory and *therefore* a disaster in
        practice.  So I'm going to leave it to other speakers
        to concentrate on the practical flaws in the Clinton
        health plan.  I want to focus on the moral issue at
        stake.  So long as people believe that socialized
        medicine is a noble plan, there is no way to fight it.
        You cannot stop a noble plan -- not if it really is
        noble. The only way you can defeat it is to unmask it -
        - to show that it is the very opposite of noble.  Then
        at least you have a fighting chance.
        
        What is morality in this context?  The American concept
        of it is officially stated in the Declaration of
        Independence.  It upholds man's unalienable, individual
        *rights.*  The term "rights," note, is a moral (not
        just a political) term; it tells us that a certain
        course of behavior is right, sanctioned, proper, a
        prerogative to be respected by others, not interfered
        with -- and that anyone who violates a man's rights is:
        wrong, morally wrong, unsanctioned, evil.
        
        Now our only rights, the American viewpoint continues,
        are the rights to life, liberty, property, and the
        pursuit of happiness.   That's all. According to the
        Founding Fathers, we are not born with a right to a
        trip to Disneyland, or a meal at Mcdonald's, or a
        kidney dialysis (nor with the 18th-century equivalent
        of these things).  We have certain specific rights --
        and only these.
        
        Why *only* these?  Observe that all legitimate rights
        have one thing in common:  they are rights to action,
        not to rewards from other people. The American rights
        impose no obligations on other people, merely the
        negative obligation to leave you alone.  The system
        guarantees you the chance to work for what you want --
        not to be given it without effort by somebody else.
        
        The right to life, e.g., does not mean that your
        neighbors have to feed and clothe you; it means you
        have the right to earn your food and clothes yourself,
        if necessary by a hard struggle, and that no one can
        forcibly stop your struggle for these things or steal
        them from you if and when you have achieved them.  In
        other words: you have the right to act, and to keep the
        results of your actions, the products you make, to keep
        them or to trade them with others, if you wish.  But
        you have no right to the actions or products of others,
        except on terms to which they voluntarily agree.
        
        To take one more example: the right to the pursuit of
        happiness is precisely that: the right to the *pursuit*
        -- to a certain type of action on your part and its
        result -- not to any guarantee that other people will
        make you happy or even try to do so.  Otherwise, there
        would be no liberty in the country: if your mere desire
        for something, anything, imposes a duty on other people
        to satisfy you, then they have no choice in their
        lives, no say in what they do, they have no liberty,
        they cannot pursue *their* happiness.  Your "right" to
        happiness at their expense means that they become
        rightless serfs, i.e., your slaves. Your right to
        *anything* at others' expense means that they become
        rightless.
        
        That is why the U.S. system defines rights as it does,
        strictly as the rights to action.  This was the
        approach that made the U.S. the first truly free
        country in all world history -- and, soon afterwards,
        as a result, the greatest country in history, the
        richest and the most powerful.  It became the most
        powerful because its view of rights made it the most
        moral.  It was the country of individualism and
        personal independence.
        
        Today, however, we are seeing the rise of principled
        *immorality* in this country.  We are seeing a total
        abandonment by the intellectuals and the politicians of
        the moral principles on which the U.S. was founded.  We
        are seeing the complete destruction of the concept of
        rights.  The original American idea has been virtually
        wiped out, ignored as if it had never existed.  The
        rule now is for politicians to ignore and violate men's
        actual rights, while arguing about a whole list of
        rights never dreamed of in this country's founding
        documents --rights which require no earning, no effort,
        no action at all on the part of the recipient.
        
        You are entitled to something, the politicians say,
        simply because it exists and you want or need it --
        period.  You are entitled to be given it by the
        government.  Where does the government get it from?
        What does the government have to do to private citizens
        -- to their individual rights -- to their *real* rights
        -- in order to carry out the promise of showering free
        services on the people?
        
        The answers are obvious.  The newfangled rights wipe
        out real rights -- and turn the people who actually
        create the goods and services involved into servants of
        the state.  The Russians tried this exact system for
        many decades.  Unfortunately, we have not learned from
        their experience.  Yet the meaning of socialism (this
        is the right name for Clinton's medical plan) is
        clearly evident in any field at all -- you don't need
        to think of health care as a special case; it is just
        as apparent if the government were to proclaim a
        universal right to food, or to a vacation, or to a
        haircut.  I mean: a right in the new sense: not that
        you are free to earn these things by your own effort
        and trade, but that you have a moral claim to be given
        these things free of charge, with no action on your
        part, simply as handouts from a benevolent government.
        
        How would these alleged new rights be fulfilled?  Take
        the simplest case: you are born with a moral right to
        hair care, let us say, provided by a loving government
        free of charge to all who want or need it.  What would
        happen under such a moral theory?
        
        Haircuts are free, like the air we breathe, so some
        people show up every day for an expensive new styling,
        the government pays out more and more, barbers revel in
        their huge new incomes, and the profession starts to
        grow ravenously, bald men start to come in droves for
        free hair implantations, a school of fancy, specialized
        eyebrow pluckers develops -- it's all free, the
        government pays.  The dishonest barbers are having a
        field day, of course -- but so are the honest ones;
        they are working and spending like mad, trying to give
        every customer his heart's desire, which is a
        millionaire's worth of special hair care and services -
        - the government starts to scream, the budget is out of
        control. Suddenly directives erupt:  we must limit the
        number of barbers, we must limit the time spent on
        haircuts, we must limit the permissible type of hair
        styles; bureaucrats begin to split hairs about how many
        hairs a barber should be allowed to split.  A new
        computerized office of records filled with inspectors
        and red tape shoots up; some barbers, it seems, are
        still getting too rich, they must be getting more than
        their fair share of the national hair, so barbers have
        to start applying for Certificates of Need in order to
        buy razors, while peer review boards are established to
        assess every stylist's work, both the dishonest and the
        overly honest alike, to make sure that no one is too
        bad or too good or too busy or too unbusy.  Etc.  In
        the end, there are lines of wretched customers waiting
        for their chance to be routinely scalped by bored, hog-
        tied haircutters some of whom remember dreamily the old
        days when somehow everything was so much better.
        
        Do you think the situation would be improved by having
        hair-care cooperatives organized by the government? --
        having them engage in managed competition, managed by
        the government, in order to buy haircut insurance from
        companies controlled by the government?
        
        If this is what would happen under government-managed
        hair care, what else can possibly happen -- it is
        already starting to happen -- under the idea of
        *health* care as a right?  Health care in the modern
        world is a complex, scientific, technological service.
        How can anybody be born with a right to such a thing?
        
        Under the American system you have a right to health
        care if you can pay for it, i.e., if you can earn it by
        your own action and effort.  But nobody has the right
        to the services of any professional individual or group
        simply because he wants them and desperately needs
        them.  The very fact that he needs these services so
        desperately is the proof that he had better respect the
        freedom, the integrity, and the rights of the people
        who provide them.
        
        You have a right to work, not to rob others of the
        fruits of their work, not to turn others into
        sacrificial, rightless animals laboring to fulfill your
        needs.
        
        Some of you may ask here:  But can people afford health
        care on their own?  Even leaving aside the present
        government-inflated medical prices, the answer is:
        Certainly people can afford it.  Where do you think the
        money is coming from *right now* to pay for it all --
        where does the government get its fabled unlimited
        money?  Government is not a productive organization; it
        has no source of wealth other than confiscation of the
        citizens' wealth, through taxation, deficit financing
        or the like.
        
        But, you may say, isn't it the "rich" who are really
        paying the costs of medical care now -- the rich, not
        the broad bulk of the people?  As has been proved time
        and again, there are not enough rich anywhere to make a
        dent in the government's costs; it is the vast middle
        class in the U.S. that is the only source of the kind
        of money that national programs like government health
        care require.  A simple example of this is the fact
        that the Clinton Administration's new program rests
        squarely on the backs not of Big Business, but of small
        businessmen who are struggling in today's economy
        merely to stay alive and in existence. Under any
        socialized program, it is the "little people" who do
        most of the paying for it -- under the senseless
        pretext that "the people" can't afford such and such,
        so the government must take over.  If the people of a
        country *truly* couldn't afford a certain service -- as
        e.g. in Somalia -- neither, for that very reason, could
        any government in that country afford it, either.
        
        *Some* people can't afford medical care in the U.S.
        But they are necessarily a small minority in a free or
        even semi-free country.  If they were the majority, the
        country would be an utter bankrupt and could not even
        think of a national medical program.  As to this small
        minority, in a free country they have to rely solely on
        private, voluntary charity.  Yes, charity, the kindness
        of the doctors or of the better off -- charity, not
        right, i.e. not their right to the lives or work of
        others.  And such charity, I may say, was always
        forthcoming in the past in America.  The advocates of
        Medicaid and Medicare under LBJ did not claim that the
        poor or old in the '60's got bad care; they claimed
        that it was an affront for anyone to have to depend on
        charity.
        
        But the fact is:  You don't abolish charity by calling
        it something else.  If a person is getting health care
        for *nothing*, simply because he is breathing, he is
        still getting charity, whether or not President Clinton
        calls it a "right."  To call it a Right when the
        recipient did not earn it is merely to compound the
        evil.  It is charity still --though now extorted by
        criminal tactics of force, while hiding under a
        dishonest name.
        
        As with any good or service that is provided by some
        specific group of men, if you try to make its
        possession by all a right, you thereby enslave the
        providers of the service, wreck the service, and end up
        depriving the very consumers you are supposed to be
        helping.  To call "medical care" a right will merely
        enslave the doctors and thus destroy the quality of
        medical care in this country, as socialized medicine
        has done around the world, wherever it has been tried,
        including Canada (I was born in Canada and I know a bit
        about that system first hand).
        
        I would like to clarify the point about socialized
        medicine enslaving the doctors.  Let me quote here from
        an article I wrote a few years ago: "Medicine: The
        Death of a Profession." [*The Voice of Reason: Essays
        in Objectivist Thought,* NAL Books, c 1988 by the
        Estate of Ayn Rand and Leonard Peikoff.]
        
        "In medicine, above all, the mind must be left free.
        Medical treatment involves countless variables and
        options that must be taken into account, weighed, and
        summed up by the doctor's mind and subconscious.  Your
        life depends on the private, inner essence of the
        doctor's function: it depends on the input that enters
        his brain, and on the processing such input receives
        from him.  What is being thrust now into the equation?
        It is not only objective medical facts any longer.
        Today, in one form or another, the following also has
        to enter that brain: 'The DRG administrator [in effect,
        the hospital or HMO man trying to control costs] will
        raise hell if I operate, but the malpractice attorney
        will have a field day if I don't -- and my rival down
        the street, who heads the local PRO [Peer Review
        Organization], favors a CAT scan in these cases, I
        can't afford to antagonize him, but the CON boys
        disagree and they won't authorize a CAT scanner for our
        hospital -- and besides the FDA prohibits the drug I
        should be prescribing, even though it is widely used in
        Europe, and the IRS might not allow the patient a tax
        deduction for it, anyhow, and I can't get a
        specialist's advice because the latest Medicare rules
        prohibit a consultation with this diagnosis, and maybe
        I shouldn't even take this patient, he's so sick --
        after all, some doctors are manipulating their slate of
        patients, they accept only the healthiest ones, so
        their average costs are coming in lower than mine, and
        it looks bad for my staff privileges.'  Would you like
        your case to be treated this way -- by a doctor who
        takes into account your objective medical needs *and*
        the contradictory, unintelligible demands of some
        ninety different state and Federal government agencies?
        If you were a doctor could you comply with all of it?
        Could you plan or work around or deal with the
        unknowable?  But how could you not?  Those agencies are
        real and they are rapidly gaining total power over you
        and your mind and your patients.  In this kind of
        nightmare world, if and when it takes hold fully,
        thought is helpless; no one can decide by rational
        means what to do.  A doctor either obeys the loudest
        authority -- *or* he tries to sneak by unnoticed,
        bootlegging some good health care occasionally *or,* as
        so many are doing now, he simply gives up and quits the
        field."
        
        The Clinton plan will finish off quality medicine in
        this country --because it will finish off the medical
        profession.  It will deliver doctors bound hands and
        feet to the mercies of the bureaucracy.
        
        The only hope -- for the doctors, for their patients,
        for all of us -- is for the doctors to assert a *moral*
        principle.  I mean: to assert their own personal
        individual rights -- their real rights in this issue --
        their right to their lives, their liberty, their
        property, *their* pursuit of happiness.  The
        Declaration of Independence applies to the medical
        profession too.  We must reject the idea that doctors
        are slaves destined to serve others at the behest of
        the state.
        
        I'd like to conclude with a sentence from Ayn Rand.
        Doctors, she wrote, are not servants of their patients.
        They are "traders, like everyone else in a free
        society, and they should bear that title proudly,
        considering the crucial importance of the services they
        offer."
        
        The battle against the Clinton plan, in my opinion,
        depends on the doctors speaking out against the plan --
        but not only on practical grounds -- rather, first of
        all, on *moral* grounds.  The doctors must defend
        themselves and their own interests as a matter of
        solemn justice, upholding a moral principle, the first
        moral principle: self-preservation.  If they can do it,
        all of us will still have a chance.  I hope it is not
        already too late.  Thank you.
        
        --------------
        
        Copies of this address in pamphlet form are available
        for $15 per 100 copies or $125 per 1000 copies from:
        Americans for Free Choice in Medicine, 1525 Superior
        Ave., Suite 100, Newport Beach, CA 92663, Phone (714)
        645-2622, Fax (714) 645-4624.  Copies of Dr. Peikoff's
        lecture, "Medicine: The Death of a Profession" may be
        purchased in pamphlet form for $2.50 each (catalog
        number LP04E) from: Second Renaissance Books, 110
        Copperwood Way, P.O. Box 4625, Oceanside, CA 92052,
        Phone (800) 729-6149.  (Quantity discounts are also
        available: $1.85 each for 10-99 copies, catalog number
        LP66E, $1.50 each for 100-499 copies, LP77E; $1.25 each
        for 500-999 copies, LP88E; and $1 each for 1000 copies
        and over, LP99E.)
        
        Also available from Second Renaissance is the pamphlet
        "The Forgotten Man of Socialized Medicine: The Doctor,"
        containing articles by Ayn Rand and Leonard Peikoff.
        (Catalog number AR10E, $2.95)
        
        Additional information on why national health care
        programs don't work is available from:  Objectivist
        Health Care Professionals Network, P.O. Box 4315, South
        Colby, WA 98384-0315, Phone (206) 876-5868, FAX (206)
        876-2902.  This organization publishes a newsletter on
        health care and distributes a copy of it in their
        health care information package.
        
        --------------
        
        Almost ten years ago, Leonard Peikoff predicted that
        our medical system would be dismantled.  Looking at the
        young people in the crowd, he remarked:
        
           "If  you are looking for a crusade,  there is none
            that is more idealistic or more practical.  This
            one  is  devoted  to  protecting some of the
            greatest [men] in the history of this country.  And
            it is also, literally, a matter of life and death--
            -YOUR LIFE, and that of anyone you love.  Don't let
            it go without a fight!"
        
           From "Medicine: The Death of a Profession" by
           Leonard Peikoff from concluding remarks from 1985
           presentation with Dr. Michael Peikoff.
        
        --------------
        
        Dr. Leonard Peikoff, author of *The Ominous Parallels*
        and *Objectivism: The Philosophy of Ayn Rand* was a
        long-time (30 year) associate of the
        novelist/philosopher Ayn Rand and upon her death in
        1982 was designated as her intellectual and legal heir.
        He received his Ph.D. from New York University in 1984
        and taught at Hunter College.  Over the years, he has
        served in the capacity of professor of philosophy,
        lecturer and chairman of the board of the Ayn Rand
        Institute and is currently one of the principal
        lecturers and instructors of the Objectivist Graduate
        Center. He has lectured extensively at such prestigious
        speakers' forums as Ford Hall Forum in Boston on
        several topics including philosophy and current events.
        Additionally, outside of academia, he has taught
        courses on  philosophy, rhetoric, logic and Objectivism
        audio version of which are available from Second
        Renaissance Books listed above.
        
                                ###
        
