Asclepius Shrugged

Asclepius is the Greek god of medicine.  Even in the mythology of the Greeks, healing was a business fraught with danger for the practitioner.  Zeus, legend goes, was angered because Asclepius did his job too well and punished him accordingly.  In some cultures -- China being a good example -- the physician treating a patient was liable if the patient died, no matter what the reason.  American tort lawyers seem to believe that any imperfect medical procedure must be malpractice, and juries seem to nod in agreement.

The practice of medicine has also been a personally dangerous business for healers.  Before inoculation was common and the theory of infection understood, the doctor who tried to save lives often died himself.  New procedures were often feared by ordinary folk, who could not understand that small doses of poison (anesthetic, for example) could allow a patient to have surgery without dying from shock.  Yet men have always gotten sick and died, and those in distress want a good healer to save them or to relieve their pain. 

The historical question in medicine has been this: Who wants to undertake the heavy burdens of healing, and what will we -- society -- do to help ease those burdens?  In parts of rural America, where there may not be a doctor for fifty miles, towns understand doctors' sacrifices, and they pay for the schooling of a doctor who will then practice in the rural community for a certain period of time.  These good folk know much better than Americans in large cities what would happen if doctors did what creative people did in Ayn Rand's class, Atlas Shrugged.  What would happen to us if Asclepius Shrugged?  What if doctors went on strike against a society which sought to hyper-regulate their practice, creating a nightmarish world of malpractice litigation that forced medical offices to spend giant sums on liability insurance, and which through ObamaCare tried to remove medical judgment and independence in the practice and the business of medicine?

It is not a hypothetical question.  The Wall Street Journal in April reported that our nation will already be facing a shortage of 150,000 physicians in fifteen years.  The Heritage Foundation reports that the overwhelming majority of physicians had a negative impression of ObamaCare, the bill rammed down the throats of an angry American public.  A whopping 86% of doctors thought that the bill did not give adequate consideration to the perspective of physicians.  The Physicians Foundation presents even more shocking news: 40% of doctors plan to stop providing patient care within three years, 87% say that they will stop or limit new Medicare patients, and 93% say that they will do the same with Medicaid patients.

These numbers suggest a strike of the gifted and the hardworking, terms that describe the vast majority of physicians, and the impact seems likely to be felt most keenly by the elderly, the disabled, and the poor.  I know a neurosurgeon, a diligent, brilliant, and decent man who could very easily have had a career in physics or chemistry, who did extensive charitable work -- operations for the poor in other countries who could not afford his help.  Now he is out of medicine, forever.  How many more healers are out there who have a passion for medicine, empathy for the sick, and a work ethic which transforms their gifts into little miracles across our land?  What will happen to us when they join John Galt? 

The state, of course, can conscript subjects into some variety of medical care.  The military has doctors.  Student loans could be reconfigured to entice people into the practice of medicine.   Then, of course, we have had a virtual flood of physicians from other nations practice in America.  But that is dubious ground for hope.  Before ObamaCare, there was a flow of Canadian doctors to America.  Since then, however, the flow has slowed, even reversed, perhaps.   Although more than ObamaCare was involved, that is a serious factor.  How many doctors who left their homelands out of frustration with government-run health care are going to come to America now?

Ultimately, the war on the hardworking and talented, of which the war on healers is but one part, will lead to a sort of strike against an ungrateful world.  This will not manifest, as in Rand's classic, in a migration to Galt's Gulch.  It will be more like the walkouts in Poland under Solidarity thirty years ago.  Why produce for those who rob and revile you?  In time, even the best-intentioned of the worker bees in a society of drones gets the message, and when that happens in American medicine, we will see Asclepius Shrug.

Bruce Walker is the author of a new book: Poor Lenin's Almanac: Perverse Leftists Proverbs for Modern Life.

See also: What's Your Doctor Worth?