An Open Letter to Bill Clinton

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Dear Mr. Clinton:

Like many other Americans, I was sorry to hear of your health misfortunes. While open-heart surgery has become routine in this country, we should never forget that it is a very dangerous and serious operation, and I can only hope that you will have a full recovery.

The purpose of this letter, however, is not to wish you better health. No, I am writing this letter because I can only hope that this experience will help you to understand what a disaster you and your wife almost forced upon this country a decade ago when "HillaryCare" dominated the news. At the time, you claimed that "selfish special interests" were behind the failure of your wife’s plan to ultimately push the country into a Canadian-style health system in which government controls all medical care.

Two months ago, I also found myself in the care of a cardiologist. Like you, I came to the hospital after suffering from severe chest pains and, like you, the doctor found a number of blockages in three of my arteries. However, unlike you, I underwent the less-invasive angioplasty procedure. Nevertheless, it always is a frightening experience to know that one’s circulatory system is not functioning properly and that I surely had been facing a heart attack had my wife not insisted I go to the hospital.

In this politicized age, no doubt someone will say that it is not "fair" that Bill Clinton is able to have surgery paid through his insurance, while large numbers of Americans do not have health coverage at all. Like the "economist" Paul Krugman, they will insist on a "free" government plan that provides "equal care for all" at a fraction of the present cost.

In fact, your former vice president, Al Gore, came out of the closet two years ago and endorsed such a plan, and Hillary has been known to declare privately that she would like to impose such a system on us. "Single payer" systems are the rage of the entire "peace and justice" crowd, along with large numbers of others in the political classes. Thus, I realize it would take some real political courage on your part to stand up against it and be an influence for the good.

Proponents of such a plan declare that if health care services were "free" (that is, no fees for services are charged), then anyone who needs health care can receive it without having to worry about the ability to pay. At least, that is the pretty picture that politicians who champion this system like to paint for us. Reality — and especially economic reality — has a way of reminding us of a few truths, however.

It is obvious that medical care fits the definition of a "scarce good," and since that is the case, people cannot have unlimited amounts of it at a "zero price." Furthermore, by making medical care essentially a government service, those who manage and administer such care will not have a mechanism by which to engage in economic calculation. While these may seem like esoteric terms to you, in reality, they are matters of life and death.

When I saw my cardiologist a couple of weeks ago, we discussed the "Canadian system," and he pointed out just how inhumane this supposedly "humane" and "free" system really is. Remember my timeline: I went to the emergency room on Friday afternoon (July 9), was checked in for the weekend, and was taken to the cath lab early the following Monday (July 12).

Immediately after the procedure in which they put dye in my veins to find the blockages, the doctor said to prepare for angioplasty, and in less than an hour, I was being wheeled back to my room. (I am forever grateful I heard the doctor say "angioplasty" instead of "open heart surgery," but I am even more grateful to be alive.)

A friend of his living in Canada, according to my doctor, suffered a heart attack and went to the hospital. Realizing the trauma, the medical authorities scheduled him for a test — for nine months later. In the interim, he was forced to take blood thinners and other medications, but had to live with the knowledge that he was a step away from another attack — and this one almost surely would be fatal.

After his tests confirmed arterial blockages, he was sent home to wait — and suffer. Despite his having actually had a heart attack, three years passed before he had open-heart surgery to correct his problem. In the interim, he got by as best he could, but was hardly functioning normally.

The story I have related is true — and is quite typical of this system. Yes, there are conscientious doctors and nurses in Canada, and it is not their fault that the lines for care are as long as they are. It is the nature of socialism, which not only forces people to bear costs of the lack of medical care through missed work, worse health, and — all too often — death, but also dehumanizes the care in the process.

There is something quite dehumanizing about forcing a person to wait three years for surgery following a heart attack. Canadians who have suffered or who have had family members suffer under this kind of malpractice have emailed me with their own tales, and the newspapers in Canada are full of horror stories that even the True Believers of the system cannot ignore.

However, I also receive emails from angry (and often abusive) Canadians who declare one of the following: (1) the system is "free" and does not discriminate between rich and poor, or (2) the forced egalitarianism of the system is morally superior to what we have in the United States, so the medical system — as rife with malpractice as it might be — is actually a stairway to a spiritually higher plane of life.

The only problem here is that the system is neither free nor egalitarian. As I pointed out before, a scarce good that is in demand cannot be provided for free, unless one believes that no one in that system, from the lowest orderly to the highest-level surgeon, not to mention everyone who is involved in any way with a medical operation works for no compensation whatsoever. That clearly is not the case, so we should dispense with the fiction that Canada has a "free" medical system. Canadians pay dearly with some of the highest tax rates in the Western Hemisphere.

Second, a medical system that is designed by the political classes is one designed with the interests of the political classes in mind. It is not designed for those who actually must use the system, as no one suffering from a heart attack would impose a three-year wait upon himself for a necessary operation.

No, we can be assured that those who are wealthy enough will opt out for care in another country (like the USA), and that those who are deemed politically important will be taken to the head of the line. From presidents protected by goons from the Secret Service to the local member of the county council, Americans have been propagandized into believing that elected politicians and political appointees, not to mention most government employees, are the most important people in the country. Important people, of course, must be given instant care; everyone else can wait.

Thus, Mr. Clinton, we know that under the system that your wife wants to impose, you never would have been in danger of waiting for surgery. Instead, others would have to bear the costs. Now, you have claimed in all of your recent speeches to be a person who stands for basic fairness in society; perhaps you can see the unfairness of forcing people to wait in line for health care services when other methods exist to give them timely service.

As a loyal American, I hope that your surgery is successful. Having faced the Grim Reaper myself, I do sympathize with people who are vulnerable to heart attacks and heart disease.

But I also would be remiss if I were to fail to urge you not to use this occasion to call for even more government control of medical care. As a former President of the United States, I am not surprised to see doctors act quickly to deal with your health problems. However, I am a nobody compared to you, yet the care I received was as timely and as high-quality as the care you have been receiving. That is because at least some vestiges of a free market system still exist in our system, and we need even more free enterprise there, not less.

I wish you the best as you go under the surgeon’s care this week. But there is even more at stake here than your good health, and I hope you can be persuaded to do the right thing.

Sincerely,
William L. Anderson

September 6, 2004

William L. Anderson, Ph.D. [send him mail], teaches economics at Frostburg State University in Maryland, and is an adjunct scholar of the Ludwig von Mises Institute.

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