Politicized Medicine  by Hans F. Sennholz, Editor, The Freeman Classics, Foundation for Economic Education, Inc.  Irvington-on-Hudson, N.Y. 1993, 157 pages.

Review by Del Meyer, MD

Dr. Sennholz has assembled 21 essays into three overall topics.  In the first section, six of the seven essays are written by physicians.

George Yossif, MD, PhD, in the “Economics of Medical Care,” discusses how the patient’s freedom of choice is necessarily complemented by the provider’s freedom to compete.  The patient obtains the best medical care that he is able and willing to pay for, while medical fees, as well as the price of medical technology, tend to drop.  Yossif points out the different expectations of patients (why should those who are happy with less pay for more; and those who demand everything, pay little?) and the variations in practitioners’ medical skill, judgment, reliability, discretion, and other idiosyncratic intangibles).  He takes issue with government subsidies and the National Institutes of Health that does not produce health, but a horrendously expensive technology.  Another impediment to a free medical market is the creation of incentives for patients to buy large amounts of medical care through employee benefits, which causes physicians to push expensive medical care.

John C. Sparks in his essay, “The Best Things in Life Are Not Free,” points out that the original song referred to love, happiness, and other philosophic items as being free.  Now with extension to economic items such as health care, economic freedom is doomed and new medical miracles will no longer occur.

Charles W. Johnson, M.D., in his essay, “Medical Care Is Not Right,” develops the concept of rights vs. privileges.  The former are given by God, nature or one’s own self.  The latter are voluntary exchanges or thefts.  When medicine becomes an involuntary right, it will be stolen from each other and excesses cannot be controlled.

The Part II essays, under the general theme of “The High Price of Experience,” discuss the “British Nationalized Health Service” (no evidence of progress); the “British Way of Withholding Care” (procrustean rationing on the entire population); “Why I Left England” (I had to turn down at least two out of three requests by GPs for emergency admissions.); “Socialized Medicine: The Canadian Experience” (The cost of free public medicine isn’t really free.  What the consumer doesn’t pay, the taxpayer does, and with a vengeance.); “National Health Care:  Medicine in Germany 1918-1945” (Social insurance under Bismarck’s anti-socialist agenda led to a virulent socialism of genetic screening, euthanasia and human medical experimentation.); “Health Planning in Fort Wayne – The Six Million Dollar Fizzle” (Planners gave subsidies, developed control, a power base, micro management, escalation of costs, and waste of money.)

The Part III essays under the general theme of “The Inaptitudes of Politics” discuss “The Coming Push for National Health Care” (Patients make little contribution to the cost of care, leading to exorbitant increase in demand for health services, price controls, rationing, income controls on physicians, shortages of equipment, deterioration of medical facilities and long waiting lists.); “Free Medicine Can Make You Sick” (Government medical care unwittingly prolongs the suffering of those already ill and causes illness to develop by delaying treatment.); “The Price of Free Medicine” (The British NHS spent one million pounds for containers for prescription items and only 27 thousand pounds for research in mental health – medical progress, he states, has ended in Britain); “Third Party Medicine” (The best interest of the patient requires that the individual patient-physician relationship be held inviolate in every area.  All “third parties” are intruders and inhibit the rapport and confidence of the patient in confiding with his/her doctor.)

Most of these essays are reprints from The Freeman.  Some are dated.  But as a primer in what’s happening in health care today, both economic and medical consequences, it should be a valued educational tool.  A copy can be obtained for $3 by calling 914-591-7230.