A Source of Wonder

The persistence of government is truly worthy of study and contemplation. In all places, and at all times, government has been, on the whole, more baleful than beneficial to the people laboring under its yoke. Yet it persists — even thrives. An unappreciated phenomenon!

I suppose the commonest method used by the rulers to perpetuate their dominance is to convince various groups of people that they are living at the expense of everyone else. The lower economic classes, for example, have myriad welfare programs that, after a few generations, they accept as their inherent right and due. They regard with antipathy any effort to reduce taxes, which they don’t pay anyway, or the size and power of government. Of course, the benefits to the target group — the handicapped, let’s say, or the elderly, or the unemployable — are always kept before them, while the cost, spread among the rest of society, is not remarked upon. Anyone foolish enough to question these programs is easily and automatically dismissed as heartless and unfeeling for the less fortunate.

For those a few rungs higher on the economic ladder, the techniques are different. One popular method is licensure. Grant special privileges to a group of people who have no need of a dole, and they will, in short order, become as addicted to that privileged status as their economic inferiors are to the monthly welfare check.

This first became apparent to me many decades ago, when I established my ophthalmology practice. It was a tedious chore to gain attending-physician privileges at the local hospitals, requiring, among other things, furnishing copies of my medical license. It isn’t easy to make a copy of a license that’s framed, and behind glass! I was grumbling about this to a colleague at a medial meeting, and said that licensure was more trouble than it was worth, or something to that effect. His reaction startled me. "Don’t knock licensure! Without it, the paperboy on the corner might start removing cataracts. Would you want that?" The inanity of the remark left me speechless.

Recently, I heard almost exactly the same sentiments expressed on television. The program host, a lawyer, was discussing the tragic case of eight-year-old Terrance Cottrell, an autistic child, who died in the course of an "exorcism." The exorcist — a large man — had lain upon the child for approximately two hours, whispering imprecations in his ear at Satan, who apparently paid little heed to the threats. What the lawyer/host was discussing with his psychiatrist guest was the lawsuit, for child abuse, that had been brought against the preacher. He remarked that, except for the ritual of exorcism in the Catholic Church, most exorcisms are a sort of seat-of-the pants affair, with no set protocol or standards. To my amazement, he declared "we see this sort of thing all the time," and asked the psychiatrist if he wouldn’t agree that there should be some sort of standards for exorcisms! The psychiatrist agreed, and went to far as to declare that exorcists ought to be licensed — by the state, of course. Then — déjà vu — he endorsed the concept of licensure by pointing out that without it, anyone could declare himself a surgeon, and start operating in his garage. Holy smokes!! First the paperboy abandons the sale of the evening edition for cataract surgery, and now a used-car salesman — or anybody — cleans out his garage to make room for his operating table. Are these people serious?

A few questions arise, just off the top of my head. Would these prospective neo-surgeons know what instruments to buy, where to buy them, or even what to call them? Who would give the anesthetic, and where would they get an anesthesia machine? How would they obtain the drugs needed before and during surgery, as well as post-op? Assuming they weren’t actually going to operate on the street corner, or in the garage, where would they perform their surgical procedures? Is any hospital going to make its operating suite available to "surgeons" that only yesterday were hawking newspapers, or second-hand cars?

The doctors making these "arguments" had spent many years in school, and these were the best arguments they could offer in support of licensure? But indeed, what other arguments are there? It could be phrased in more elegant language, but basically, it boils down to "protecting" the idiot patient, who couldn’t be expected to know that the paper boy doesn’t know a cataract from a cucumber, or that yesterday’s car salesman isn’t quite up to removing his gall bladder. (If, by some miracle, the paper boy could remove cataracts better than I did, patients would be foolish not to flock to him, as he would no doubt operate for less, having no medical license to pay for, hospital staff dues to pay, and, of course, no malpractice insurance. With their oft-expressed concern about medical costs, doctors should welcome unlicensed practitioners for providing inexpensive care!) Of course, if the ultimate purpose of licensure is to create still another dependant class, you’ll seldom, if ever, hear that mentioned.

Such is the power of government. Give any group a privilege, and watch them debase themselves to justify it, and attack those who question it. If you feel the need for an exorcism, better make sure the exorcist of your choice is licensed. You can’t be too careful. While you’re at it, have the paperboy remove your cataracts.

Dr. Hein [send him mail] is a retired ophthalmologist in St. Louis, and the author of All Work & No Pay.