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  Dr. Leviathan’s Bitter Pill is a Hayekian Warning Come True
by Matt Tordoff
22 June 2003

We should take heed from the lessons of Britain's universal healthcare system: there is a vicious battle going on between each self-interest group - smokers, the obese, drinkers - clamoring why their lifestyle ills should be the one paid for by the taxpayers.

The debate over who gets what from Britain’s state run National Health Service continues with an increasing amount of bitterness. The system is chronically overburdened and unable to meet the needs of the British public. It suffers from a severe shortage of beds and long waiting lists for treatment. As part of a plan to address this, it was announced last week that obese patients and smokers might be denied treatment for ill health. In effect, health care would be rationed to those who only live healthy lifestyles.

Being fat, smoking, or drinking heavily are perhaps foolish choices. When you are responsible for paying for your own health care such actions are self regarding, and nobody else’s business. However, when one seeks security under the umbrella of state run health care, those choices affect the limited resources available to all. That a government should put restrictions on those who choose to use its services should be no surprise to anyone- trust Leviathan to provide you with your security, and Leviathan will deny your right to make your own choices. That is the problem with government run heath care.

The debate over whether obese persons and smokers should receive state health care is being pursued with an ever increasing bitterness. If you listen to the tone of the debate on the national radio call in programmes or read the letters to editor section of British newspapers, you see that the debate constantly being played out with each side crying injustice. Non smokers are point fingers at fat people, fat people point fingers at the smokers, and smokers point their fingers at drinkers. Each group states with a shrill tone of moral indignation that their own health lifestyle is the only morally acceptable one and the other group has no right whatsoever to use health care resources which should rightfully be theirs.

Friedrich Hayek predicted this fifty years ago in his eloquent tract on the failures of state planning, The Road to Serfdom. Hayek wrote that “ there will always be injustices which appear unjust to those who suffer them …But when these things occur in a society which is consciously directed, the way in which people react will be radically different from what it is when they are nobody’s conscious choice.” He goes on describe the bitterness which people begin to feel when a system of government control allocates something which they think rightfully their own to someone else. Hayek was writing about overall systems of government planning, but his warning well applies to the situation the British National Health Service finds itself in.

Is there a lesson for the United States in this? In a year which has seen the Democratic presidential candidates cozy up to statist plans for health care reform and Congress debate Medicare and prescription drug reform, we should be warned of the dangers of increasing state control over the health care. Not only might it lead to a lesser standard of health care, it may well be a prescription with bitter side effects.

Matt Tordoff is an American living in Britain, and writes commentary on both UK and US affairs.

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