Week of March 22, 1999





What happens to the helpless in a free society?

This question, in essence, was posed to me by a reader in the form of two, hypothetical events:

"Suppose we have a gunshot victim who is bleeding and unconscious.   Paramedics rush him to the hospital and perform a long and complicated surgery that saves his life but ends up costing $50,000.  When he comes to, he tells them he has $500 in the bank and no insurance.  Who will pay?

Let's say that on the way to the hospital, the man regains consciousness and tells the emergency dudes he can't afford to pay for the trip, let alone an operation.  They stop the vehicle, move him out, prop him against the nearest wall and drive off.   What's wrong with that?  After all, the doctors simply refused to sell their services to someone who can't pay for them."

The matter of what happens to the truly helpless—who literally cannot survive without assistance—is not an issue, as some will claim, only of concern to altruists.  Quite the contrary, it is a proper concern for any individual, including and especially those who look out for their self-interest.  The reason for this is simple: each one of us is vulnerable to suddenly, without warning, being made helpless, as the result of an accident, a medical emergency or some other misfortune.

To answer the specifics of my reader’s imaginary, medical emergencies, consider the nature of a free society.  In such a society, the sovereignty of your own life is scrupulously protected.  Culturally, a free society places the highest value on the sanctity of individual life.  And, if nothing else, self-interest motivates an individual to be concerned about others in an emergency situation, since the plight of such persons may very well be his own plight in the future.

All of the foregoing leads to the development, in a free society, of mechanisms that assist those suffering some disaster.  It leads to the creation of a safety net, but one that is voluntary, not coercive.  Charitable organizations come to the rescue of victims of some medical problem, as well as others.

In a free society, medical personnel take care of an individual, even without knowing if they are going to be paid for doing so.  They do for others what they hope would be done for them. Further, in a free society, medical professionals have a personal interest in saving lives.  Their reputations and livelihoods depend upon saving lives, even in cases when they likely will not be paid.

Now, consider the example of my reader: the ambulance crew stops, after they discover the individual has no insurance, and props him against a wall, leaving him to die.  For all of the reasons I have cited, this would never happen in a free society.  Yet it is the very fear of something like this occurring in a free society that leads so many to embrace, at least partially, statism.  But this is a cruel joke on the nave because it is only in statist societies, such as the former Soviet Union or in the Balkans, that such a callous disregard for human life occurs.

It is in statist societies that we see the slaughter of unarmed individuals for religious or racial reasons.  It is in statist societies that individuals walk by the sick and the helpless lying in the streets, not lifting a finger to help them.  And this happens in a statist society precisely because statism rests on the premise that individual life is unimportant, that your life is not your own, that you are unimportant.

As to the first question raised by my reader, who pays for the medical care you receive, the answer is simple: you are responsible for paying for your own medical bills.  However, if you are unable to do so, then you have to rely on your friends, relatives, neighbors and/or charitable organizations to assist you.

I will end on a personal note in order to illustrate further how a free society works.  Today, America is a semi-free country that is becoming increasingly statist.   But even in a semi-free society such as we now have, everything I have said about a free society is still at play, although that will eventually change if America is transformed into the total state.

Last year, my wife suffered a life-threatening medical problem.  Emergency crews arrived within minutes and in their rush to get her to the hospital, they failed to get her name: she was checked in as "Jane Doe."  By the time I arrived at the hospital, the physicians at the hospital had already taken some expensive steps to save her life and they didn’t have a clue if I could afford to pay them.  She was evacuated by helicopter to our world-class hospital, Barnes-Jewish, in St. Louis, received the surgery that saved her life and was provided some very expensive intensive care in the ensuing days.

About three days after she was in intensive care, someone at the hospital finally got around to inquiring about whether she had insurance.

This is how things really work in a free society. 

Fulton Huxtable
March 22, 1999

Copyright 1999 Fulton Huxtable




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