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Dec. 12, 2005 - Freedomain Radio - Stefan Molyneux
35:03
10 Putting a man on the moon - the initial successes of state programs

State programs often start well, and then fail in the long run - here are some reasons why

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Hello, and I guess it's time for our afternoon drive.
Actually, it's closer to evening now.
It's 6.15 p.m.
on December the 12th, 2005.
I'm just on my way home.
And I guess the topic for this evening is what happens to government programs After their first, say, decade or two of implementation.
And I think this is pretty important because I think it helps to understand just why it's so difficult to get rid of these programs or to help people to understand just how corrupt they've become.
Because they follow a particular pattern in terms of what happens to the incentives and the rewards and the personalities and so on involved as they continue to age.
And I'll take sort of two examples that I'm a little bit familiar with.
One is, of course, NASA.
And the second is the creation of the Universal Healthcare Misery Scheme in Canada, which occurred in the 1960s.
So let's take a look at what happened in Canada in the 1960s.
Well, Tommy Douglas, one of our premiers, who was, I believe, a minister or a minister's son, was very big on, you know, let's give free health care to everyone because, you know, it's just not a good thing for us to have to pay for it all this way.
So he got all of this chugging along and the then Prime Minister, basically just kept offering more and more money to the Canadian Medical Association until it finally collapsed.
As the Prime Minister famously observed, at least famously to me, he said, when people said, and how on earth did you get the doctors to agree to become indentured serfs?
And he said, I stuffed their mouths with gold, which I think is just a wonderful phrase to describe political power.
Of course, it's not his gold, so stuffing it doesn't cost him anything.
Just, you know, everybody else who has to pay.
So, let's just say that we wake up one morning and, you know, in the 1960s in Canada, and lo and behold, we have socialized medicine.
Well, what does it look like?
Well, I'll tell you, it looks a whole lot different than it looks right now.
And it's not just because debt has increased in the intervening years.
What happens when you socialize an industry, and we're just talking about healthcare right now, is you socialize it and all of the participants in it have habits that have been developed in the free market, which is very very very important.
So when you first socialize medicine, when you first grab power over the medical system and transfer all of that power to the government, you are inheriting a system wherein both the doctors and the patients, and the other practitioners of course, have had their expectations and work ethics shaped Buy the free market.
I couldn't emphasize how important that distinction is.
So, you grow up and you're, you know, a Saskatchewan kid or an Ontario kid in the 1920s, 1930s, 1940s, 1950s, and you don't go to the doctor.
You take care of yourself, because going to the doctor costs you money.
So, you take care of yourself.
You eat your apple a day.
You exercise.
You don't overeat.
You take care of yourself.
Because the financial consequences of getting into long-term or palliative care are just horrendous.
So, generally, you'll take care of yourself.
And, of course, the fascinating thing is, if you look back at movies or... I particularly enjoy newsreel footage of those years in North America.
People were thin!
I mean, you couldn't see a fat man for miles!
You have a look at any sort of freeze frame.
You know, newsreel footage from the 1950s or the 1940s, the 1960s, even the early 1960s, and there's no fat people.
It really is astounding just how different our society has become since this stuff all became sort of sucked into the maw of the government.
So patients are used to taking care of themselves and they are Not used to going to doctors.
They sort of have lifestyles which have been developed with a huge lack of desire to go to a doctor because it's expensive.
So that's on the one side of the equation.
On the other side of the equation you have doctors who have been conditioned to a work ethic and a level of social responsibility that was developed in the free market.
It's all very different.
These are doctors who are used to doing house calls.
These are doctors who are used to working 60 hours a week.
These are doctors who are used to taking deferred payment from people who can't afford it.
These are doctors who will give away free treatment to people who can't afford it.
So their work ethic, their level of responsibility, their level of commitment to the community, their level of charity for these doctors has all been conditioned In the free market.
And these are not habits that you just wake up one day and say, well, now I'm socialized, so my entire approach to medicine is going to change and I'm going to start chiseling the system and whatever.
I mean, these doctors who are 40 or 50 or 60 years old, when they get socialized, don't wake up one day and say, I am now no longer going to try to do the kind of good doctoring that I've done for 20, 30 or 40 years, but I'm going to become some other kind of doctor.
It's really not possible.
If you have a habit of taking care of yourself, of not overeating, of exercising and so on, you don't wake up one morning and say, wow, healthcare is free!
I guess that I can just, you know, let myself go and, you know, let the doctors patch me up.
So that's sort of one example of why it takes 10 or 15 or 20 years for the problems within a socialized system to really show up.
So if you want to find out why it's such a mess in health care throughout the world, but particularly in North America now, you really are looking at the effects of decisions that were made, you know, 15 or 20 years ago.
Because it takes quite a while for doctors to come into the system who have known no other system, no more free or more responsible kind of system.
And so, given that it takes a while for these doctors to come into the system, the lag of more competent and more dedicated and more responsible people whose work ethics and charity and community sensibilities were shaped in the free market, it takes a while
For those people to get out of the system to retire or to leave the system and it takes a while for all of the people who've now grown up within that system and have never been exposed to the free market in health care for those people to come into the system and really change it.
If we look at something like NASA, I think that sort of makes a good deal of sense as well.
I remember I used to listen to, and I still do from time to time, I used to listen to Harry Brown's radio broadcast.
It's harrybrown.org.
Brown with an E on the end of it.
And he's a very good speaker and a very good analyzer of the free market and the effects of government coercion.
One of his shows, I can't remember where or when, was this question and he was like, oh god, NASA has coasted on the moon landing for like 35 or 40 years and can we just let it go and so on.
And he couldn't sort of figure out how they managed to pull off the moon landing.
And then, you know, that everything since then has been, you know, such a disaster.
I mean, everything since the moon landing, pretty much, for NASA has been a complete wash.
You know, they got Apollo 13, so they have to pull it back with a rope almost.
You know, they have space shuttles exploding or failing to take off or crashing.
They have Mars landers that fall over on Mars and don't broadcast.
They've got space probes that just fly into the middle of nowhere and cease transmitting.
I mean, NASA has produced nothing of value for like 30 years, but they've been riding this whole, we put a man on the moon thing.
And if you think about my analysis of the healthcare system and put it in terms of NASA, I think that you'll see that the same thing is going to hold true.
That the people who first entered into the NASA environment when it was put together, and I think this was in the late 50s or early 60s, You know, that you had to be a senior engineer to get into NASA.
You couldn't be just some kid out of grad school, I don't think, anyway.
So you had to have had a pretty significant exposure to the free market and to the discipline and all of that that comes along with working in the free market.
And the discipline and also the lack of politics.
I mean, the free market has its politics, of course.
But, you know, they're blunted or limited by the fact that people still have to make money, right?
I mean, in the public sector, there's no limit to the carnage that politics can wreak.
In the private sector, of course, if politics get out of hand, a company goes out of business, right?
Because people spend more time fussing about status than they do creating goods to be sold.
So, you have a whole bunch of engineers and managers coming into NASA from the free market.
And these guys, these are all guys in their mid to late 40s and up, who've spent 20 years working as engineers in the private sector.
So, of course, they're going to be good.
Of course, they're going to attack the problem of the moon landing with all of the dedication that you would expect from people who are the best that the free market can produce.
So, it makes perfect sense to me that NASA would have an initial success, followed by, you know, a stunningly quick disintegration as these guys retire or get out of an increasingly political organization and go back to the free market, that the initial successes of all socialized institutions make perfect sense to me.
But the fact that they end up in these quagmires and these morasses and these heavily political, heavily wasteful, you know, non-service-oriented bogs of incompetence, I mean, it makes total sense to me, at least.
You know, if you take people from the free market, they're great.
And then if you move them into the public sector, there'll be a short amount of time
Where things look great, but basically you're cannibalizing the past and the system will swamp people pretty quickly and Start to move them into you know political and greedy and predatory and corrupt situations I can say for sure that this is the case in the in the mental health care field and of course I have some knowledge of this just based on
Conversations with my wife and the fact that we've written a book together on life a day in the life of a hospital and Unfortunately because it's pretty critical of socialized health care.
It's having a little bit of trouble getting a publisher but if you look at something like psychoanalysis Psychoanalysis is of course a discipline of the therapeutic discipline.
It's the talking cure wherein You get to the truth about your feelings and you honestly express what is inside of you and you stop trying to live other people's thoughts and other people's emotions.
And you then become authentic and your level of happiness increases.
Your satisfaction from not often existing relationships would fall by the wayside.
But new relationships, you know, gets much deeper and richer.
You can live a more moral life.
All of this kind of stuff.
This is all stuff that was behind the original intent of psychoanalysis.
Well, of course, psychiatrists are doctors first, as everybody knows, and then they go into specialization and into postgraduate work and they become psychiatrists.
So, they are the only people, at least in Canada, I think it's the case in the U.S.
as well, who are allowed to prescribe drugs for people who are suffering from mental ailments.
And, you know, there are a certain small number of situations where this is entirely appropriate.
I mean, if somebody's about to have a psychotic episode or somebody is so depressed that they can't even benefit from therapy until their mood lifts a little, then, you know, a short-term course of antipsychotics or antidepressants is entirely appropriate.
However, when you start to look at things like, you know, a large proportion of children being dosed with Ritalin and other drugs to control their, quote, disorder, this ADHD, attention quote, disorder, this ADHD, attention deficit hyperactivity disorder, which is complete nonsense.
I mean, you know, calling something a disorder does not create a physical marker for it.
I mean, there's absolutely no physical marker which can determine whether a child is suffering from this, quote, disorder or not.
And so you have this thing that has been invented to take the place of, you know, generally absent parents and terrible schools.
And so psychiatry, which was originally a talking cure and to some degree a sort of course on philosophy and morality insofar as, you know, you had to get to the truth of situations rather than just follow your opinions about them.
Now has degenerated into, you know, this mass medical dose bombing of the population as a whole.
So the way it works in Canadian hospitals at least is somebody will be brought in suffering from a mental illness of some kind, depression or paranoia, anxiety, Panic attacks, phobias, you know, this kind of stuff.
Or, you know, they have a full-blown neurological disorder like schizophrenia and so on, but let's not deal with that just now.
So they're brought in and they get assessed by a psychologist and then they get... a psychiatrist will wander in at some point for five or ten minutes, say sort of, hey, how's it going?
What's new?
What are your symptoms?
Blah blah blah.
And after the therapist has done, you know, an hour of work of interviewing them, or 50 minutes at least, writing up what's been going on for them, writing up their case history, phoning people that they visited before, other hospitals and so on, then the psychiatrist sort of bungees in and says, well, you know, looks to me like you need drug X, Y, and Z.
And then prescribes that drug, writes a prescription, and then bills OHIP, you know, some significant sums of money for what is essentially a five or seven or ten minutes chit-chat and a prescription.
So, you know, here you have a situation where psychiatry, and I myself have not taken any advice from a psychiatrist, but I certainly had some conversations with a therapist which I found enormously helpful.
Of course, I took no drugs, and it was basically, you know, trying to find a way to live my values in a more open and clear way, despite the fact that my values, and yours too, if you're listening to this, I suspect, are not exactly copacetic or sympathetic to what most of society believes.
So it's tough to live in opposition to what everybody else believes.
So, I mean, therapy to me is fantastic.
You get the right therapist and you stay off the beds and, you know, you work hard at bringing your life goals and your integrity into clearer focus, then that to me is a wonderful thing to do, right?
I mean, it's something that decent parents should do or, you know, mentor figures should do, but, you know, decent parents are hard to find and mentor figures are... I mean, I guess I was 38 before I met somebody who I could learn something from in business.
So, You know, an original idea behind a profession when it was private was, you know, we have a talking cure.
It's going to make you feel better.
Now you socialize it and what happens?
Well, of course, as I mentioned before, there's a lag and that lag is, well, you have psychiatrists who are well trained in the talking cure, who are well trained in helping people to realize more truth about their lives and to live with more integrity and more authenticity and to stop living with fear.
Based on cliches like you should you should always love your mother no matter what she's like and all this sort of nonsense that people get taught all the time.
So you have a psychiatrist who are competent to do that and who use drugs as a last resort or in specific situations for strong neurological and neuropsychological problems.
All well and good.
But you socialize it and what happens?
Well, you get people who come out of school and into a system wherein they can bill hundreds and hundreds of dollars for five minutes work.
Or, they can bill hundreds and hundreds of dollars for an hour's work.
And look, these people, they're not easy to deal with.
You know, the people who come in, sometimes off the street, into hospitals for mental health issues are not people who, you know, have problems with their mother.
I mean, they are, but that's not exactly how things manifest.
They're not people who generally want to explore their dreams and reach new heights in life.
You know, these are people who are difficult and argumentative and paranoid and borderline and, you know, not pleasant to work with.
So, somebody who was a psychiatrist before socialization has obviously chosen this route and is going to, you know, take on these people and try and save their souls to whatever degree he or she can.
And so when they're socialized, there's some tendency towards shorter visits and higher medication, or shorter time with the patients and more medication, but they still have a work ethic and they've been sort of self-selected as people who are interested in dealing with difficult personalities and helping to cure them.
But when you socialize it, you get doctors who come straight out of grad school as psychiatrists.
And I know they have some mentoring and they have this and that.
So they have had some exposure to people who have had a little bit of exposure to the private free market.
But mostly they're now vaulted into a system where they can either sit down and have very difficult conversations with very difficult people for an hour, which is exhausting.
I mean, or for an hour, like eight times a day.
Or they can have a 5-minute chit-chat with someone, prescribe the medications and see 20, 30, 40 people a day rather than 6, 7 or 8.
And, of course, the other problem is that when you are a psychiatrist, you're supposed to, of course, keep notes about the patient.
And the taking of notes when you're dealing with talking therapy is quite extensive.
The taking of notes when you're just lobbing pills into someone's gullet, really not so extensive.
You know, I saw this person complain to depression, gave them whatever, you know, Xanax or gave them some sort of drug to make them happier.
It's not really that complicated.
So basically you become a pill dispenser, a pill machine.
You're not paying for it.
Your patients aren't paying for it.
The taxpayer doesn't have any clue what's going on and couldn't do anything about it even if he did.
So what is really going to happen to your motivation in the long run?
Which style of treatment are you going to be drawn towards?
The easy and lucrative one Where you see pretty immediate effects like six weeks to eight weeks after the person starts taking the medication, they're going to feel better.
Or the long, unpleasant and difficult process of actually dealing with people and their issues and trying to get them to be more honest about their lives and so on.
I can tell you I know which way I would swing.
I mean, I try and live, of course, with as much integrity as I can, but it would be kind of hard to sort of not feel like a sucker when other people are making three, four, five times as much money as you are, having much more pleasant days, and basically fobbing off all of the actual talking therapy onto people who are salaried rather than those who bill OHIP.
I mean, another small example of this, of course, is that I believe it is at the end of April that doctors cycle their billing times within the Canadian, or at least the Ontario, public health care system.
So, I'll leave one guess open to you, given that doctors have to end their billing cycle At the end of April, and they're only allowed to bill a certain amount to OHIP every year, to the public health care system every year, and they run through that pretty early on.
When do you think most doctors take their vacations?
When do you think most doctors don't come in very much?
And if you guessed sort of February-March, you'd be absolutely correct.
If you're only allowed to to bill up to $300,000 say and as of Christmas you've built about $300,000 then you have a choice.
You can go in and work for nothing and take on all the liability and the risk that goes along with maybe you make a mistake or maybe you just get a hypochondriac loony who just wants to sue you for funsies.
So you go in and you work for free and you expose yourself to all that liability for a couple of months or You kind of scale back and you kind of don't go in so much or you, you know, don't do so much based on the fact that you can't bill for it anyway.
That's sort of one example.
Now, in the free market, I mean, that would be ludicrous, of course.
You could just bill for as much as you wanted.
Another example about how socialism or socialized things really corrupts the common decency among people is the issue of waiting times.
I mean, When there's no competition, a doctor can make you wait.
Right?
I mean, just as if there's nothing but public roads in your area, a traffic jam costs the government precisely nothing.
So, if you have to... My wife, for instance, has to go and see a doctor once in a while.
She likes to show up at 7 o'clock in the morning.
Before he does, so that she can actually see him in some kind of reasonable time.
Because if she gets there at nine o'clock, she's going to be waiting for two, two and a half hours.
Because they'll give an appointment, but there's no particular incentive for them not to stack up patients in the waiting room like cordwood, because it doesn't cost them anything.
There's no competition.
And all doctors do the same thing, because there is no competition.
So, Waiting times is another thing.
I don't have that problem with my dentist because my dentist is private.
I mean, you know, as private as things get in the socialist paradise up north.
So I don't have to wait for two hours to see my dentist because if I did, I would complain and I would say, look, if you make me wait again, I am never coming back to you.
I'm going to go somewhere else.
So that's another reason.
I mean, these are all small examples, but I can guarantee you that these particular habits, these particular breakdowns in things like service and dedication and charity and competence and expertise, these kinds of breakdowns did not occur the day after Socialization took place.
You've got a lot of momentum of competence that comes from the free market which spills over into the public sector and slowly the public sector drag the drag of violence and compulsion and the reversed incentives of the public sector they begin to slow down and drag down the competence and expertise in the newly socialized system until you end up with this complete quagmire where you know doctors are incompetent and
You know, the drug companies basically pay doctors to prescribe pills and, I mean, you have to wait for two hours and the waiting lists are ridiculous and doctors will refer you around so everybody can cash in.
I mean, it's not that the doctors are just innately bad people, it's just that human beings respond to incentives.
Certainly the voters responded to the incentive of free health care, so why wouldn't doctors respond to the incentive of poor health care for more money?
So, I guess what I'm trying to say is, when you're talking to people who are older, and this of course is politicians and people who are older, people in power tend to be people who are older, they'll say, you know, the healthcare system is pretty good, you know, I remember it when it was socialized.
It wasn't really that much of a change.
The system ran really well.
Blah blah blah blah blah.
And they genuinely can't understand why people have so many problems with the healthcare system.
Because when they first experienced the healthcare system after socialization, it was doing great.
And for 10 or 15 or 20 years afterwards, it was doing relatively well.
And now, for these people who are in power, who are older, they're like, yeah, you know, it's getting a bit slower and there are some problems, but they still have this basically good view.
And I sort of believe, or suspect, that it's because they have not understood that the healthcare system that they bequeath to us was very very very different than the health care system that they experienced after socialization.
And because, I mean this is one of the reasons why violence and compulsion are just so dangerous and just so horrendous and just create such an enormous amount of conflict in society.
I mean the older people in society who don't understand what the hell has gone wrong are genuinely bewildered.
And to take them through, step by step, everything that went wrong would take a lifetime of research and communication.
They'd be dead by the time you came up with a good case.
And of course, the people who have only grown up in a socialized healthcare system, they just take it for granted.
They just, yeah, you gotta wait two hours to see a doctor.
Yeah, you know, you get kind of medication maybe you don't always need.
Yeah, you know, it takes a long time to get anything done.
Blah blah blah blah blah.
But they don't really have anything to compare it to.
I remember Harry Brown talking about, you know, that the people who remember what society was like before, you know, recreational drugs became illegal, kind of dying off, you know, kind of getting older.
And, you know, as soon as, it's the 1984 problem, as soon as, you know, people are no longer around, ...who can remember what life was like when things were free, you don't have a benchmark anymore.
Statistical benchmarks don't, you know, don't really mean that much, right?
And then people come up with usually ex-post-facto justifications like, well, of course healthcare is more expensive now because there's technology and blah blah blah blah blah, right?
Forgetting, of course, that technology lowers costs in every other field known to man.
In fact, that's why you invest in technology is it lowers costs.
But no, healthcare is expensive because an MRI machine is expensive and blah blah blah blah blah.
So I would sort of like to submit to you that this problem of the lag, where you still get competent people in the health care system or in NASA or in other government fields, this is true I think particularly in management, and then the decay, the rot, the collapse, the slow collapse of competence in the public health and the public sector fields, begins to set in that by the time the rot is fully evident,
The people who at one point experienced something different are no longer around.
Or, in the case of healthcare, people who can remember what it was like before socialized healthcare are probably in their 60s and 70s now.
And so are completely dependent on socialized healthcare.
And so, you know, this is how the noose tightens around freedom all the time.
That's why, you know, where society ends up with, like how a life ends up, is in the tiny details at the beginning of things.
And that's why it's so important to not argue from statistics and to not argue from the argument from effect, but to use the arguments of consistency and morality, which are available on my blog and on the Lew Rockwell site as well, to use the arguments from principles.
Because if you rely on the argument from effect, most people will say, well, you know, it was pretty good for the first 10 or 15 years, now it needs to be tweaked and so on.
Which is not the case at all.
You don't want to be like the person who never figured out that smoking was bad, who ends up with terminal lung cancer and now quitting smoking doesn't really help.
So you don't want to end up supporting or even allowing people to support a system that its root is founded in violence.
And compulsion, and legislation, and politics, and this and that and the other.
You don't want to oppose that on any other grounds other than violence, because it is the one thing that still people have a tough time supporting.
I mean, you know, you talk violence in Germany in 1932, and people are like, yeah, great, let's, you know, we need living room, let's go kick the heck out of Europe.
But in the West, we still have a certain squeamishness and a sensible squeamishness against violence.
So, what I'm suggesting is that when you go to oppose something like health care or something like, you know, the space program and all that kind of stuff, you're not going to get anywhere by talking about, well, NASA wastes its time and health care is very inefficient and the free market would be more efficient and blah blah blah blah blah.
Because the rot takes so long to really show, and by the time it does show, everybody who could remember what a non-rotten state was is long gone or totally dependent on these handouts.
So, you know, the argument from effect or the argument from, you know, efficiency or whatever, they just don't work.
They don't strike people in their guts.
All they do is they provoke interesting statistical discussions, I guess you could say.
But they're not going to change anybody's mind.
Now, the problem that we're faced with, of course, as libertarians now is that there are so many people who are dependent upon the state for their largesse.
And the largest group of these, of course, is those who are old, for want of a better phrase.
The people who are old vote like crazy.
These days they live forever.
They have all the time in the world to write to their congressman and write to their senator and write to their local representative and they have, you know, these gray power coalitions that are constantly showering advice and opinions and demands and all of this on politicians.
They are in an extraordinarily needy phase of their life, of course, because when you get old and sick, you really can't contribute that much back to society.
And I don't mean to say that all people are useless.
Of course not!
But if you're young, and when you're a baby, of course people invest in your development and then you can provide a lifetime of working and thinking and contributing and loving and All of that to society.
So the resources that are invested into a baby are, you know, investments in the future.
Resources that are invested into old people are not, you know, which is of course not to say that they shouldn't be invested.
I mean, that's of course up to every individual.
But, you know, the fact of the matter is that when you are dependent, especially when you're dependent based on an immoral proposition like You know, I need health care, you young people better pay for it, or I'm going to advocate that the government come and throw you in jail, right?
Then you tend to become kind of entitled, kind of hostile to any sort of new ideas or theories, especially those which say, listen, you old people failed to defend freedom for us, and so now we're not that sympathetic to your requirements for health care and, you know, assisted living.
And that is a particular challenge.
It could be considered one of the greatest challenges, is the dependency of old people and, you know, to some degree, you know, families without fathers and all this kind of stuff.
I guess I'd like to talk about that.
I guess I'll have to do it on Thursday because I'm traveling tomorrow and then on Wednesday I'm actually speaking at a conference, nothing as exciting as libertarianism of course, so I really won't have a chance to do any of these podcasts until Thursday morning, which I will talk about how I think it would be worthwhile approaching the problem of the old people and those who are dependent upon the state and how we can turn that around.
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