My buddy Laura sent me this article yesterday, along with her thoughts about it. Pretty interesting; I had no idea it was so easy for doctors in some states to (semi-)legally approve dozens—or hundreds—of prescriptions a day based on the most cursory sort of online “interaction” with the patient. Pretty scary.

Laura’s chief observation was a good one, one that I imagine many of you might share. Namely, how stupid do you have to be to think filling out a brief online questionnaire is sufficient basis upon which some anonymous medical “professional” decides to issue you prescription medication? Isn’t the mere fact that the guy featured in the article was enough of an idiot to put anything he got from a spammer’s Web site in his mouth just an indication that Mother Gaia was trying to snip this particular thread out of the fabric of the biosphere? The answer is, of course: yeah, sure, probably. I mean, sheesh.

But the article brought up some larger issues for me, that dovetailed neatly with my thoughts on a recent treatise by well-known science fiction author Newt Gingrich. I had the pleasure of hearing him wax polemic on one of his favorite fictional themes in a commentary on the December 6th edition of Marketplace called “Health Care Needs 300-Million-Payer System”. All his most far-flung and far-fetched visions were invoked: the Magical Healing Power Of Free Enterprise, How Personal Responsibility Will Save America, and of course his long-standing chart-topper, Government Can’t Do Anything Right. (I just love hearing how inefficient and wasteful the federal government is from someone who spent every femtosecond of his time in office trying to hinder, hamstring and/or outright dismantle it. Every femtosecond, that is, except the ones he spent banging House aides. Okay, okay, just that one. So far as we know.)

Yes, fine, I happen to favor the C*O*N*C*E*P*T of free enterprise, of the power of the marketplace, allathatgoodshit. In its pure form, capitalism would seem to be an ideal model for maximizing prosperity amongst all the hard-working, good folk out there. On the other hand, the basic premise of Communism sounds pretty sensible as well, until you release it in the wild.

Among other real-world complications, the basic framework of these ideas were formed at a time in history when tools of mass communication and information dissemination—not to mention disinformation dissemination—were still in their infancy. Free-market aficionados like Adam Smith had yet to see the awesome power of a mature advertising industry insinuate its shiny, self-esteem-sapping, hot-chick-purporting-to-attracting fingers under the rim of the collective subconscious of the public, and pry that sucker up, exposing the tender, vulnerable insides.

Let’s be honest: is there really anybody out there, short of the most die-hard Social Darwinist, who believes that a consumer like Mister Spammy McXanax from the article should be given freer, less-government-supervised access to prescription medication?

I am reminded of another experience I had with a free-market type, at (of all things) a gingerbread-house-decorating party a few years back. The topic of Social Security privatization—oh, excuse me, that’s “creation of an Ownership Society”—came up. I was voicing the opinion that the average American had neither the time nor the knowledge to make all of their own decisions regarding the investment of the funds in the Social Security Trust, particularly when faced with the inevitable and virulent advertising pitches and public relations campaigns initiated by companies dying to get their hands on the billions in potential commissions at stake.

At that point, a wiry fellow with a truly hideous smirk on his face ambled over, patted me condescendingly on the shoulder and said, “Yeah, right, don’t worry, the government is gonna take care of all your money for you, no need to have to think about it.”

I stared over my shoulder at him until he pulled his hand back and scuttled away. I wasn’t actually trying to stare him down; I was trying to come up with a witty, slightly more civilized way of saying, “that’s the dumbest goddamn thing I’ve heard today, and I don’t think you’re actually stupid enough to believe it.” Here’s a quick and easy way to test the validity of the premise behind his snotty comment, in the comfort of your own home: if you think that private enterprise is more capable of competently (and ethically) handling your money than the feds, just replace the word “government” in his little diatribe with the name of your favorite financial megacorporation. Feeling safer?

Some of you—heck, maybe a lot of you—okay, maybe just Gavin—are saying, “oh, you bet I feel safer! Give me control over my own money, and if I end up getting hosed it’ll be my own fault. But at least I will have had the opportunity to manage my own destiny, myself.” That may work for many of us. Certainly the dude who talked down to me at the party was a clever chap, a technology worker if I’m not mistaken, probably carrying a couple of college degrees and a lively compensation package. I imagine that he could, in fact, manage his investment portfolio better (that is to say, with a higher rate of return) than the government could. Intelligent, motivated individuals will tend to react more quickly to market conditions than will a giant entity like—well, like anything, really, investment houses included.

But that’s not the point of Social Security. Intelligent, motivated individuals with extra cash have always been capable of investing their disposable income to their preference and their advantage. It is not the function of a social safety net to make sure that everyone supported by it has the opportunity to buy a superyacht. It is there to establish a minimum standard of living for everyone, up to and including the savvy Microserf with a burgeoning portfolio, down to and including an overworked salesman confused and gullible enough to buy brain-chemistry-altering drugs online.

To me, health care is even more critical a resource than retirement income. In fact, I would say that health care for the citizenry is a governmental function of a priority on par with that of national defense. The very fabric of society is informed by the question of the level of health care Americans—all Americans—receive.

Simply put, this issue is too essential to the stability and prosperity of the country as a whole to be put in the hands of the for-profit private sector. There is an essentially infinite number of techniques which unscrupulous individuals and companies can develop to separate people from their money, and nothing breeds innovation like imperative. If a sudden, massive influx of cash-like medical insurance vouchers were to suffuse the American populace, an almost instantaneous fine-screen mesh would coalesce to filter the cash back out.

Jumping back to the plight of Spammy McXanax: having ready access to free health care—including prescriptions—through his family doctor may not have stopped this guy from taking too much Xanax and nearly offing himself. However, it seems pretty clear to me that such facilities would have gone a long way towards discouraging such an unfortunate event. Particularly given the fact that, had he faced the choice of free scripts from his doctor or 400-dollar scripts from an online pharmacy, he would have almost certainly chosen the former over the latter. See, you don’t even need to pass a law making it illegal to sell drugs online for this to work; just make going to your doctor the obvious financial as well as ethical and not-batshit-crazy-al choice. The mail-order Cialis businesses would continue to exist to fill the market for folks with the scratch who don’t want to fill in their doctor on their weenie problems, just as the high-end medical clinics and specialty centers would continue to exist to feed the need of those with the income to afford them. Not that there would be anything necessary missing from the free facilities. Call me a red-blooded, flag-loving patriot if you must, but I believe that America has the money, the skills and the compassion to make high-quality free health care available to all its citizens. Hell, I bet we could even throw the illegal aliens on there without breaking the bank. Still be cheaper than preemptive war in the Middle East.

I’m not by any means saying that the federal government is as honest, as streamlined, and as efficient as it might be (though I hardly think it’s the hive of incompetence that many anti-government types purport it to be, particularly in comparison to the private sector). Politicians are as fallible as any other human being, and the potential for nepotism, graft and dishonesty is a serious concern. That’s why we as consumers of government services need to be be vigilant, and through the media, public awareness and our franchise act to minimize the benefits and maximize the risks to our elected officials of going astray. Surely the American electoral process is as viable a method for influencing the actions of government as consumer spending is for influencing the actions of industry. (Please note that the phrase I used was “as viable as consumer spending”; the inherent viability of our electoral process as it stands today is another question entirely. I just think it’s easily as transparent, effective and accessible a form of influence as consumer spending at this point in time.)

Instead of voting with our dollar as Mr. Gingrich suggests, we could vote with—well, gee, our vote.

Additionally, putting the control and dispensation of health care services in the hands of the government would actually streamline the oversight process. Think about it: right now, government regulators monitor and enforce laws on the health-care insurance industry, lest it take advantage of the consumer. In turn, the People keep an eye on the government, lest its officers succumb to the temptations of bribery and influence-peddling on the part of the organizations it is charged with regulating.

If the government were directly in charge of health care, it would eliminate the need for an entire redundant layer of oversight.

If you won’t think of the children, think of the savings! 😉