I am also an MD, and I find you embarrassing. The core of medicine is service to others. Granted, we could do a better job of advocating for ourselves, but you are doing it wrong.
Its not clear how anyone can make someone else embarrassed for views they don't share. I'd have more respect for you if you called me an idiot for my views but your embarrassment at my claims makes me think that you actually know the truth, but lack the courage to rethink it.
> we [doctors] could do a better job advocating for ourselves...
Its all just negotiating the terms of your slavery if you agree that people have the "right" to health care.
If you are British enough you can be embarrassed for anyone. I find you embarrassing because your point of view ignores the fiduciary nature of a doctor-patient relationship. That relationship is both sacred and humbling, and the most amazing thing in my otherwise paperwork-laden clinical life. For patients to trust me enough to tell me everything is a duty to be met with respect.
Putting patients first is the part that seems "right." That's not a coincidence, it's the job.
> Putting patients first is the part that seems "right." That's not a coincidence, it's the job.
You claim a responsibility for the trust between the doctor-client relationship but with govt control of medicine its now a three-way and one of the parties is holding a gun to your head. You can't put your client first under govt controlled medical system. The doctors are very unhappy, as 2mur expressed "There is no chance I would do it again" and I have heard from many doctors. Following the regulations or the bureaucrats comes first and you know this because I have yet to hear of a doctor not complain about this.
Also, if you are British you should realize the Empire died a long time ago when they stopped calling the uncivilized peoples savages. Your embarrassment on my behalf is quaint but no longer necessary.
Its all just negotiating the terms of your slavery if you agree that people have the "right" to health care.
Slavery is, by definition, not negotiated. It is a condition imposed upon someone without their choice. There are still actual slaves in this world, and none of them negotiated the terms of their slavery.
> I'd have more respect for you if you called me an idiot for my views
Well, since you're inviting personal criticism, then, and suggesting it might engender more respect for critics and their opposing points than a doctor weighing in on your position...
It'd seem that you suffer from all-or-nothing, black-and-white thinking -- that when confronted with tension between two ideals you don't know what to do except pick a single winner and declare that any attempt to balance tension between the two as an unacceptable compromise against the value you've judged higher.
I'd also guess that if you think that government services are theft, you might have built a philosophy around property rights without ever having thought much about property itself, which is about a real, universal, and solid as the cartesian plane at best.
Finally (and perhaps most specifically and pertinently), while I'd be willing to believe that you may be familiar with the regulatory aspects that directly affect your professional life (and invite you to express your confidence about this by drawing attention to the specific market vacuum you've left behind in case someone else doesn't share your opinion), your summary doesn't seem to me to be a particularly accurate description of the state of values/laws when it comes to health care in the US.
For example, if you're talking about EMTALA as the decades-old invocation of care rights (and I'm not sure what else you would be talking about), there a number of key caveats that I'd think would prevent any sensible person from characterizing it as slavery, perhaps most notably that (a) there's only obligation incurred for institutions that choose to accept medicare payments AND (b) it doesn't compel anyone to into going into providing emergency service in the first place, it compels those who choose to provide emergency service (and accepting medicare) to provide emergency service without regard to ability to pay.
If someone can choose to avoid providing a specific service (or stop when they like), and only incurs obligations by making an agreement with a specific payor, they're not a slave, and it's possibly more disingenuous to invoke the term in this context than it is to invoke the term "theft" when discussing taxes and government services.
> Its all just negotiating the terms of your slavery if you agree that people have the "right" to health care.
People do sometimes speak of the struggle many face for access to health care in terms of rights. Mostly what I think they're trying to express (sometimes poorly) is that they feel the value of giving every member of a society some minimum level of access to health care services is a good on par with the value of property rights, possibly higher. And as such it's worth some limited abridgment of the later.
There are some good arguments for this, even when starting with personal liberty/property rights as a high value: liberty and property don't mean much in a context where life and health aren't protected, and the related risk management and insurance is an area where incentives are screwy enough markets aren't great at the job, which is one reason you see people like Hayek support at least the idea of social insurance.
As smart as they are, the doctors are most clueless regarding the moral issues involved. There is another MD in this thread claiming the essence of medicine is service to others but I think 5 minutes of thought can dismiss that non-sense, even from a doctor.
> It'd seem that you suffer from all-or-nothing, black-and-white thinking --
I don't consider this a flaw in my position. Its called Aristotelian logic either/or, maybe you have heard of it. There is no gray in reality it is in your head.
> that when confronted with tension between two ideals you don't know what to do except pick a single winner and declare that any attempt to balance tension between the two as an unacceptable compromise against the value you've judged higher.
Name those ideals, please. If you boil it down it is not a conflict between two good principle or ideals (this does happen but not in this case) but between a bad one and a good one. Are the doctors free to withdraw their service? Its a simple question. If you believe that medical service is a right doesn't that mean that medical service is an obligation of the doctors to provide? Who, other than a slave, has an obligation to provide service? If you force the doctors to follow the Code of Federal Regulations and limit their salaries are they still really doctors in the proper meaning or are they bureaucrats? Do the good doctors stay under such a system or do they move on? Don't be fooled by nomenclature.
> Finally (and perhaps most specifically and pertinently), while I'd be willing to believe that you may be familiar with the regulatory aspects that directly affect your professional life (and invite you to express your confidence about this by drawing attention to the specific market vacuum you've left behind in case someone else doesn't share your opinion), your summary doesn't seem to me to be a particularly accurate description of the state of values/laws when it comes to health care in the US.
> People do sometimes speak of the struggle many face for access to health care in terms of rights.
Words have real meaning and aren't rubber terms to justify anything people need or want. So where do you draw the line? You and I need food, is that a right too? Your concepts are so confused that I doubt you could even answer that without equivocating and hedging your position but that is a serious question. Every argument you made for health care being a right applies more so to food. So tell me what is different between food and healthcare, shall we enslave the farmers now too? And what about electricity or the internet? I have heard people argue that these are rights too and based on your soft thinking you have no argument against them. If you were consistent, as in my black and white world, you would have to join the hoards demanding these "rights" -- provided by whom?
As you have invited personal criticism: You are naive and your thinking is simplistic. You have managed to get away from complete naivete, you think using abstract concepts, which allows you to look through the superficial appearance of things, and thus cut through a lot of bullshit. But you haven't noticed yet that your abstractions are way too abstract to give a reliable representation of the real world by themselves, that abstractions are just helpful thinking tools, but not the full truth - and that because of that your way of thinking produces about as much bullshit as it cuts through, just of a different kind.
In particular, it's seldom helpful to cling to specific terms and their supposed definitions rather than look at the actual facts. Who cares whether doctors are slaves? Is there anyone who has any actual disadvantages due to how the system works or not? If everyone, including the doctors, is better off with how the system works, who cares whether they are slaves by some definition? If they have some disadvantages, then that should be addressed, who cares whether it fulfills the criteria for being a slave?
Also, you always have to consider the wider societal context. There might be indirect benefits outside the immediate transactions that arise from how a society is constructed. Where I live, for example, if you see someone in distress and there is no significant danger to you if you were to rescue them, and you are able to, it is a criminal offense not to help. I guess by your standards that would mean we are all slaves - but I think the democracy that created the law is perfectly sufficient to justify this obligation, which as a side effect presumably generates higher safety and a higher sense of safety for everyone.
If you seriously believe that, you are indeed being an idiot.
Your logic reasoning skills may be pretty good, which is a component of reason that many people lack. What you seem to lack is a useful mapping between reality and propositions. And from false premises, unfortunately, even flawless logical derivation cannot produce any useful information about the world.
When wwweston critizes your black-and-white thinking, he is not suggesting (I think) that there is some kinda-maybe-not-quite-true-or-false truth value. Rather, he suggests that the choices you are implying actually have more than two mutually exclusive possibilities. In particular, words don't actually have "real meaning", words routinely have tons of meanings, heavily depending on context, which is why you cannot make a simple binary decision as to whether something is or is not an X. It's somewhat unfortunate, as that leads to lots of confusion, but there is nothing logically wrong with it, it's simply a matter of fact that one has to consider when one wants to construct sound arguments, so as to never equivocate any two different meanings of the same word. The binary determination is only possible either for cases which evaluate to the same truth value with every conceivable definition of a word, or once you pin down the exact meaning that is intended in a given context.
Part of the problem with your arguments indeed seems to be equivocation. There is a definition of slaves that hinges on complete unfreedom, which is roughly what most people think of if you don't specify any specific definition - let's name that a slave1 for the purposes of this discussion. Then, there are definitions based on certain philosophical arguments that try to show how, for example, socialism produces similar power structures to "traditional" slavery in certain regards, we'll call that a slave2. (Similar arguments exist for capitalism, and many other power structures.) Now, you come along and say "requiring doctors to provide a service is making them a slave2", which is actually a perfectly reasonable statement to make - except you obviously imply "which is the same as a slave1, and everyone knows that being a slave1 is bad, therefore, requiring doctors to provide a service is bad", and that's just an equivocation fallacy that you employ to avoid having to justify why one is as bad as the other, where that is not the slightest bit obvious if you look at the actual circumstances that slave1s lived in and that doctors live in nowadays.
> even flawless logical derivation cannot produce any useful information about the world.
This is the analytic-synthetic dichotomy that derives from Kant's false theory of concepts and I reject it. I won't argue the point as my comments are for the Aristotelians in the audience not the Kantians.
In most western civilizations government food assistance and other nutritional aid are available for those who would otherwise starve to death. Given that the only estimate I found of actual starvation deaths in the United States was 140 in 2004, I think we can say that people in the United States have a right to basic amounts of food.
They are slaves if it is considered that people have a "right" to their services... in other words, policemen and soldiers are legally and morally required to do their jobs even if there isn't money to pay them, which would be the case if there was such a right.
The same is true for health care. If you actually had an inalienable right to health care, then you could require a doctor to provide you service whether he wanted to or not. That's slavery, and why it is absolutely illogical that there can be a "right" to something that is material and finite. This isn't politics, it's simple logic.
