BRITISH readers will find this book an engaging, if perturbing, curiosity.
Insisting that there are key lessons to learn from 鈥渢he wisdom recorded on the
pages of history鈥�, Miguel Faria, a professor of medical history in Georgia,
paints a panorama of the origins of civilisation in Greece and the rise and
fall of the Roman Empire. He then draws parallels between the line of cruel
emperors from Nero onwards and US presidents from Lyndon B. Johnson to Bill
Clinton. In Faria鈥檚 view, recent presidents have been destroying the Union
with taxes and bureaucracy, while buying votes through the 鈥渂read and
circuses鈥� of healthcare reform.
Who then are his 鈥渧andals鈥�? They are the American masses, who, deluded by
鈥渕edia liberals鈥�, entertain unreasonable expectations of doctors, and when
these are not met, resort to litigation and the lucrative ploy of
victimhood.
History thus dictates, proclaims Faria that the siren strains of healthcare
reform must be resisted. Proper medical practice is private practice, and
market competition also keeps medical costs down, not least because the
informed patient can choose cost-effective procedures. Of course, he admits,
some of the sick won鈥檛 be able to afford free-market medicine, but they need
not fear because 鈥渇or those who cannot afford their service, physicians have
always been happy to provide charity medicine care鈥�. In any case, he argues,
America鈥檚 40 million uninsured largely have themselves to blame, since most
have opted to put health low on their list of budget priorities.
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Whether Henry Ford was right to say that history is bunk, Faria鈥檚 history
certainly is, and his prescriptions are pie in the sky. His biased account
never even begins to explain why free-market America presently spends roughly
twice the percentage of its gross national product on medicine as does NHS
Britain.
What will amuse the British reader of Faria鈥檚 diatribe is how closely it
echoes the polemics that were being trumpeted around 1946 by the British
Medical Association in opposition to Aneurin Bevan鈥檚 plans for the provision
of a national health service available to all and free at the point of
delivery. The BMA likewise predicted that the NHS would spell medical
totalitarianism. If one truly wants to learn from history, the fundamental
fact is that state intervention in 1948 gave general practice a new lease of
life (why else did the BMA become the NHS鈥檚 most fervent supporter against the
Thatcher reforms?).
It is truly bizarre that the likes of Faria should believe that a
profession鈥檚 best defence lies in extolling the virtues of the free market.
But then I suppose one of the lessons of history is how little people ever
learn from the past.