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December 2002

Living and Dying in Socialist Britain

by John Clark

Ronald Reagan once said that socialism works in only two places: heaven, where they don’t need it, and hell, where they’ve already got it. In his day the world’s socialist exemplar was the Soviet Union, founded on the principle of abolishing private property by all means, at any cost. This experiment was a fair success according to its own purpose. Whether Soviet citizens got a decent fife out of it is another question, and not a difficult one to answer. When that regime collapsed in about its 74th year, there was nothing of value to show for such continuous, massive poverty, pollution, famine, torture, and death.

British socialism had the less extreme and noblersounding goal of providing for the bodily needs of all its subjects. In this ideal society, no one would have to worry about going hungry or homeless or untended. According to Theodore Dalrymple, in Life at the Bottom, this socialism has been quite a success according to its purpose. There is today, he notes, almost nothing that a British resident can do to relieve the state of its obligation to feed, house, entertain, and care for him.

As a physician in a British inner-city hospital and prison, Dr. Dalrymple has observed as much of the socialist reality as any person can—not just at his workplaces but also in many homes, streets, public areas, and from interviewing some 10,000 patients over the years. What is this reality like? When the state provides for everyone’s needs regardless of effort or conduct on their part, far too many people see no need to learn about the past, use their time well in the present, or plan for the future. “A system of welfare that makes no moral judgments in allocating economic rewards promotes anti-social egotism.” This is what we see—an ignorant, coarse, slovenly, filthy, lawless caste of socialist “beneficiaries” and others who suffer their abuse and harm.

There is always a danger that a policy of insurance will promote the behavior or condition that it insures against; this is what economists call “moral hazard.” It is much in evidence in all aspects of British society today. Those socialists either were blind to the moral hazard or regarded themselves as exempt from, or even the authors of, the law of nature. Egotism begets egotism and, per Dalrymple, misery increases to meet the means available for its alleviation.”

The more health care is viewed as a “right,” to be consumed by oneself and paid for by others, the more widespread, inevitably, become smoking, gorging, boozing, doping, snorting, and other unhealthy behaviors. Typically, several patients a day are admitted to Dr. Dalrymple’s hospital having “attempted” suicide by sub-lethal overdose for, among other reasons, the benefit of a free hospital stay. Far from appreciating this care, many such patients are abusive and threatening to the physicians, nurses, and staff who provide it. Visiting physicians from India and the Philippines who at first admire the socialist ideal are soon appalled by the reality. “On the whole,” says one, “life is preferable in the slums of Manila.”

A less obvious result of the moral hazard of health care as a “right” is increased violence in general. Why should one refrain from punching, clubbing, stabbing, or shooting another person when the system is always there to put the damage right? Combined with other incentives to lawlessness such as the dole, a worthless school system, and lax policing, Britain has some of the world’s highest rates of theft, robbery, and assault—and even the highest rates of such crimes with firearms, despite (“despite”) strict gun-control laws.

In a recent column, April 8, Molly Ivins denounced America’s health-care system as “stupid” and “falling apart.” Her solution, of course, is to replace it with a socialized system like Britain’s. Fine—Dalrymple gives her and like-minded people a chance, if they’ll be so honest with themselves, to learn how their ideal functions in reality. Americans have no experience with socialized medicine, so they are mostly pretty ignorant about it. Its advocates are ignorant even of their ignorance.

Britain’s knowledge dates from the founding of their National Health Service in 1948. Thirty years later, economist Milton Friedman noted that while the population had grown since then, the total number of hospital beds had declined. Health-care bureaucrats have said at times that the lost capacity for treating the sick and injured was not needed anyway. Yet it’s hard to believe that growing numbers of elderly require less health care year by year, while on the other hand so much is expended on drunks, junkies, and brawlers who regard hospital care as their “right.”

As sure as any natural law, this incentive to neglect and abuse one’s own health will lead many people to do so, in every way possible. Inevitably these derelicts will require income support and subsidized housing and jail and prison cells as well. That is one lesson of Dalrymple’s book. Why, in America, suppose that our bumbling amateurs can avoid all of the experts’ mistakes?

We have better options than to grant power over our lives to amateurs, experts, or whomever. One is to take primary charge of our own health. This means following the rules of nutrition, fitness, and hygiene that any 6th grader or the surgeon general can learn. It may mean paying directly for routine services that we want and buying our own insurance policies for services that we hope we’ll never need (e.g., surgeries and hospital stays). And instead of relying on the government to tax us to pay for our health care, we can offer to share our own wealth with the poor and those who serve them.

The more we can learn from others’ experience, the less time and money we will waste and the less misery we will suffer. Dalrymple has done an invaluable service by telling the stark truth about socialized medicine. So compelling is Life at the Bottom that I read it cover to cover in a day’s time—and later reread it twice.

©2002 Liberty



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