Thursday, April 26, 2018

Herd animals

The case of Alfie Evans is rightly getting a lot of attention. Here's a backgrounder:

This case reflects two competing social philosophies: individualism and collectivism. It illustrates the dark side of universal healthcare. 

One perspective values freedom. Suppose you're a chain-smoker. That puts you at elevated risk of dying before a normal lifespan from cancer or emphysema. But unless you're directly harming others, what you do with your life is your own business. 

Same thing with compulsive gambling. It's your money to lose. You can prudent or reckless. I may not approve of your lifestyle. I make different choices. But that's the point. You and I are independent of each other.

Likewise, if you indulge in a high-risk lifestyle that causes a medical condition, and you can afford treatment, then it's a fee-for-service arrangement. Whether or not you seek medical treatment is up to you. You're a free agent. Good or bad, you make your own decisions in life. I'm not responsible for how you live your life. I can give you advice, but ultimately it's up to you. 

In addition, due to the inexorable fact of human mortality, many people take calculated risks–since everyone is going to die sooner or later. If we were immortal, but not indestructible, then we've be fanatically risk-averse since there'd be so much to lose, but since we're all going to die anyway, we all gamble a bit. 

Then there's the alternative perspective. You're a herd animal. That confers collective benefits. A safety net.

But there's a tradeoff. Sick, injured, aging herd animals slow down the herd. In a network of interdependent links, the weak link is a threat to the collective. You're hogging limited resources that the rest of us may need. When we're pooling our collective resources for the common good, we can't afford to let runts and weaklings become a drag factor that endangers the herd. When they're at risk, that puts everyone at risk. The welfare of the collective trumps the welfare of the individual. So the herd needs to be culled. Eliminate the stragglers. Survival of the fittest.  

Of course, humans are social creatures, so we don't want a pure sink-or-swim system, but that's where family and private charity kick in. Moreover, a capitalistic system produces the best medical R&D. And it enlarges the pie for everyone. 


  1. I'd like to add private charity can sometimes come from physician groups or practices. For example, I know cancer doctors (oncologists) who have given entirely free cancer treatment to certain people. Consider certain chemo medications and other therapies can cost as much as $10,000 every other week.

    For example, here is what an oncologist has said:

    "What you can do, however, is find a practice that allows you to provide charity care. For example, in my practice I recently treated a woman for free- $0 charged to her. She received definitive chemoradiation therapy for oral tongue cancer. We treated her for free after she was turned down by every 'academic' center (how they can look themselves in the mirror after refusing charity care is beyond me) and didn't qualify for any other gov't programs. Felt good to be able to care for her when no one else would."

  2. Alfie has died: