Twenty years ago, I used to stop at a lakeside bar after work for a beer and a little conversation. It was what you might call a workingman’s bar, with pool tables, smoke, and lots of noise. There I met a retired gentleman who liked to tell stories, gamble for drinks, and generally have a good time. I noticed the gold watch, gold jewelry, and the gold caps on his teeth right away, but that wasn’t so unusual, and I gave it no thought. Later I noticed that he drove a late model Mercedes, not a pickup truck, and I thought that was a little odd. We got to know each other after a while, and I learned that he owned a small house on the waterfront, a condo in Tahoe, a villa in the Caribbean, and two fine yachts. The guy was a millionaire. How did he make his money? Selling cars.
Let’s think of some of the richest people we’ve ever heard about. There’s Bill Gates at the top of the list, then Oprah, maybe the richest woman on Earth, then the Kennedy family, the Bush family, the Cheney family, then the legion of sports figures, talking heads, and media giants, all multi-millionaires. We can’t easily think of plain old millionaires, by which I mean people who actually own that much in assets, not debts, because there are so many of them from so many different endeavors, like lawyers, real estate developers, car dealers, corporate managers, software contractors, top civil servants, congressmen, orthodontists, engineers, veterinarians, insurance brokers, some doctors, and a handful of novelists.
American consumers don’t seem to grumble much about the millions earned by baseball players and the rest, but when it comes to medical providers earning that kind of money they scream bloody murder. I don’t understand why.
Email response to my last two articles on LRC, "Government Malpractice" and "M.D.," has been 50/50, with medical providers in support, and medical consumers in rejection of my twin observations that doctors are victims of State oppression, and that the medical industry has been bankrupted by State interference. I might conclude that medical providers understand the problem because they are forced to cope with it, while medical consumers presume that all is well in the business because they never heard otherwise elsewhere, but I suspect there is more to it than that. Consumers of medical services seem to deeply believe that providers of medical services are their servants, and that medical services should be free. The old socialist mantra comes to mind: From each according to ability, to each according to need. Never mind that it never worked.
But is that all there is to it? Why do we cheer for the multi-millionaire quarterback, who couldn’t cut our fingernails for us, and excoriate the millionaire heart surgeon, who can save our life? I don’t understand it.
The latest outrage afoot comes endorsed by the AMA itself, a single-party payer scheme; in English, that means the State pays all the medical bills, or not, and that all medical providers work for the State. That’s called socialized medicine. American consumers of medical services who tell me how wonderful socialized medicine works in Europe must feel encouraged by the prospect, though from what I’ve seen, socialized anything (energy, railroads, urban infrastructures, national security, education) doesn’t work at all after a while. The AMA? I don’t know whose tune they’re dancing to this time; we’ll have to wait to see who winds up with the thirty pieces of silver.
Medical students who realize their peril in time may wish to do a cost/benefit analysis of switching to large-animal veterinary medicine or orthodontic dentistry, both of which services are largely cash-only to customers who are happy to pay for it.
One exceptional doctor I knew years ago had been raised and educated in Germany. He moved to the US for medical school, and he did his residency in NYC. I was there for his fortieth birthday party, and he was joking about his forty-thousand dollar debt in school loans. His cousin the same age, he said, was a Mercedes dealer in Germany, and he had just celebrated becoming a millionaire. "Isn’t it funny," he laughed, "I passed up the chance to do the same thing." No, I thought, that’s not funny at all.
Personally, I’d rather have a happy millionaire for a doctor than an unhappy slave to the State.
A final word: People have accused me of shilling for doctors, hospitals, or the pharmaceutical industry. I’m not working for anybody. Nobody pays me. I do not work for Lew Rockwell, and he does not pay me. I am not a millionaire; my assets are near nothing, and I have lived as I wished on a gross annual income under fourteen thousand dollars for years, and I still do.