Paul Arveson comments

Kenneth Feucht (
Sat, 25 May 96 21:14:20 UT

I can appreciate your feelings regarding universal health care, as many people
have been persuaded that health care is a moral right, and that it is a moral
right to health care givers to provide that health care. In your brief
discussion, you address several issues, but confuse rendering health care with
other things such as public health issues. Let me step through your points to
explain what I mean.
Point 1 - Why does everyone have a standing right to emergency care? Have you
ever worked in an emergency room? Do you realize the real crisis that
physicians face in emergency rooms. Since ER rights have been simply assumed
by many Americans, emergency rooms have been glutted by non-emergent problems.
Many of the emergent problems have origins that suggest horrible life-issue
problems such as auto accidents from drunken driving, suicide attempts, so on
and so forth. Should this care also be given for free? How do you hold a
person responsible for his actions? How do you define "emergency"? What has
happened in societies where ER care has truly become "free"? To answer the
last question, free medical care develops zero economic value, and thus
becomes non-care.
Point 2 - Everyone also should have access to other exigencies in life, such
as groceries, a free apartment, free entertainment, free church, and so on.
You are getting picky asking for medical data that is locally maintained and
secured. I was a "professor" of Surgical Oncology for two years in one of the
bastions of free medical care--a large USAF medical hospital. I learned very
quickly that the only way free charts could be maintained is to have patients
physically keep the charts themselves. Otherwise, no one really cared if they
were lost or filed correctly, as their work was a gratuity to the patient who
really didn't appreciate it anyway. I still encourage patients to keep many
of their own records in private practice, encouraging patients to keep their
own records of tests, operations, etc. Patients tend to care more about their
data than anyone else. Unfortunately, the greatest use of medical records
nowdays are to serve lawyers. Much of what is found in any hospital or clinic
chart is totally useless information. I guess you want to make it a patient
right that we keep that useless information for the lawyers to sue us if God
ordains something go wrong in the care of a patient.
Point 3 - public health issue. Polio was in decline before the polio vaccine
ever came out. Most (all?) public health issues have been solved more owing to
attention to sanitation rather than vaccinations or individual medical care.
To prevent many contagious diseases is to ask people to make life-style
changes (such as with AIDS) and not to offer them more medical care. Some
diseases will very unlikely be eliminated, such as malaria. Pollution is only
a small etiologic factor in the cause of cancer. Cancer is more a problem of
increased life span than anything else, and we are suffering from our own
medical success.
Point 4 - You are a very good Communist. To each according to their need, from
each according to their ability? Have you looked at MSA's (medical savings
accounts)? Does health care include chiropractic, naturopathy, Reiki, witch
craft, etc.? It should, under your scheme. Why can people afford billions of
personal dollars spent each year in alternative care schemes with no proven
efficacy, yet are unable to afford a vaccination or a mammogram, which costs
less and actually might do something? I do not understand why an employer
should be held responsible for providing health care for an employee. Have you
ever had or run a small business? If you were a small business owner, would
there be someone who is responsible for your health care? Why should employee
insurance premiums be non-taxable, yet if I want to pay my own insurance, it
is taxable? Why do you obligate government to provide for health care?
Government then should provide for all of our needs and wants in life. In
situations were government (through taxation) has been so kind and benevolent,
health care became non-existent. Just visit a hospital, or talk to a physician
in Russia and other Soviet block countries - you'd rather sit home and die
than let them care for you. And yet, that is what you are now requesting.
Point 5 - (not numbered) - you are also utopian. We will never have a
pollution and disease free environment. Don't pretend that with just the right
circumstances that a disease and pollution free world will happen because it
Point 6 - (your final point) - you say "if that free access is lost..." , free
access to what? Please clarify what you mean, exactly.
Other point -- I am not my brother's keeper. I am my brother's brother. The
Bible gives me no obligations to keep and provide free care to my brother. The
principle that holds is that "He that does not work shall not eat" (IIThes
3:10). This is true compassion.
Kenneth A. Feucht, MD., PhD, FACS

hics/Jim Behnke Comments"