Confessions of a lad born in government-owned health care
By Daniel M. Ryan
web posted August 18, 2008
I arrived in the word shortly after government-owned health care was enacted for Canada. Although Bertrand Russell had died shortly after I was born, the influence of his "permissive society" still lingered in the childhood phase of my life. Casualness was at a premium; "little prigs" were not welcome, as I found out once when six and full of a (thankfully clipped) nascent self-righteousness.
What was considered normalcy at the time would shock many youngsters today. One of my early memories of regular road trips was what was done when my bladder was full and my father didn't want to (or couldn't) pull over. I would be handed an empty beer bottle and told to relieve myself using it. That bottle of beer didn't come from the luggage section of the car – it came from the front seat, handed over by my non-drinking mother.
In and of itself, my dad's ‘70s choice of driver's refreshment isn't the shocking element. The shocking element is that he, in my living memory, was never involved in a car accident. Not one.
The kind of casualness I'm providing a glimpse of is a mélange, featuring a fellow who was raised in a private health-care regime that changed into government-owned health care when he was a responsible adult. Myself, I was born in it.
The difference shows in a bout of childish irresponsibility on my part, at the age of eleven. I had discovered that faking illness was a way to get out of school and soak up daytime TV. Becoming used to this new regime was something I took to quite easily, to the point where my parents seriously worried. They worried enough to pack me into a children's hospital for about a week.
This change of venue, I need hardly say, was not what I had planned for. The hospital wasn't an unfriendly place, and I even absorbed a little moral lesson about my own relative good fortune while "sick." One of the inhabitants of the four-bed room I was ensconced in was a young boy with cancer.
Needless to say, I was discharged and nothing was found to be definitely wrong with me. Back to school I went; if my parents suspected I was faking it, they never let on. I never received a single scolding word from either of them about this incident. There certainly was no pecuniary reason for my parents to land on me, and the mores of the time chuckled at any non-pecuniary reason for doing so. I had, to use the standard phrase, gotten away with it scot-free.
There are some who would think, as a result of this youthful shenanigan, that I'd grow up to be a health-care-system abuser of the rankest sort. Actually, anyone who did so would be flat-out wrong. I don't know what veered me away from health-care abuser to health-care avoider: it could have been an impromptu welcome-back party for me at school, which (given what I pulled) seemed leaden to me. On the other hand, it could simply have been growing up.
The latter was certainly the case with alcohol. I wasn't the wildest teen-age drunk in my neck of the woods: in fact, I was rather moderate. Alcohol tended to make me owlish, rather than extra-casual, so I didn't become a hard-core tippler. The one incident that got me into formal trouble, shortly after I discovered the joys of raiding my father's liquor cabinet, seems like something out of a buffoonish teen movie – one that would have featured yours truly as one of the (second-string) buffoons. Thanks to a short series of doctor's appointments, for the purpose of replacing my unusually thick glasses with contact lenses, I had discovered that a couple of shots of whatever hard stuff was in the cabinet made the rest of the school day more pleasant. This experience encouraged me to up the drinkie count a little, until the last time when I got caught. Because I was still too young to drive a car, I had trundled to school on a bike after several whistlers. The fact that I was driving down a quiet-residential route that was hardly traveled in the middle of the day, and one that I had driven to school for more than two years prior like clockwork, meant that I was lucky enough to get there while becoming more and more plotzed. Like the inexperienced fifteen-year-old incipient drunkard I was becoming, I didn't know that alcohol took some time to work its magic. Suffice it to say that I didn't anticipate running into the vice-principal, as the school was post-exam empty at the time. I had gone there to (believe it or not) attend a meeting for an experimental class for enriched English studies.
My drinking "career" only lasted a few years. Although I never drove a car after drinking, I did briefly fall in to the habit of driving an all-terrain vehicle after nights of tippling in a rural area. Along that route and at that time of night, I was the only one on the road. Once again, I avoided any kind of an accident thanks to previous habituation to the route while sober. At the age of seventeen, I managed to drive myself home to find that I had mistimed the timing. The next morning, I woke up hung over with the impression that I had done some kind of a bad thing: I vaguely remembered being scolded, but I couldn't be sure if I had been or had dreamed it. As it turned out, I had caught hell but couldn't remember it.
The last serious bout I had with alcohol was at eighteen, right after I had matriculated in college. I was visiting Queen's University for a debate tournament, and a post-debate drinking party gave me the opportunity to unveil my competitive streak. I became one of the contenders in a "power drinking" contest, in which the goal was to gulp down beer directly from the keg hose for as long as possible before having to spit it out. My perhaps-biased memory informs me that I had scored the longest time; the aftereffects, though, were somewhat predictable given my earlier experiences. Two juxtaposed memories stick in my mind from that night, where I ended up blundering around (on foot) because the residence I was guesting in had been locked for the night. The first was me wandering into another to ask for help, only to have the night attendant ask me to leave with a bug-eyed look on his face. I politely assented, and docilely walked out. The other was realizing the next morning that the lowest segment of my right pinky hurt for some strange reason; when going home, I wondered if I had greensticked the thing. Wondering was all I did, as I ignored it subsequently.
Although this October 1987 incident could justly be called "the bender to end all benders," the reason why I shifted from "teen-age alky" to largely non-drinking adult was more quotidian: hitting the books began consuming too much time. In both the area of health-care abuse and push-the-envelope boozing, I found myself acting more purposefully without even knowing it. A bookend of sorts was reached when I broke my arm in September 2005. Instead of taking advantage of the resultant hospital stay, I actually asked to be discharged (against medical advice) with only the pre-operation cast that was put on me. My parents talked me out of it through treating my request as foolish.
Given this change of inclination, I would be a fellow who could actually be bandwagon-worthy by the pro-government-owned-health-care-system crowd. An irresponsible child, turned reckless adolescent, turned to responsible adult in using health-care services. Had it not been for parents' behests, I would have had only one (training-related) physical in the last ten years. After that operation for my broken arm, I removed a suture by myself rather than go to the hospital yet again to have it removed for me. A visit to the walk-in clinic to remove a cotton ear swab, which had come loose from its stick, had me resolving never to use them again. (I haven't since.) Once, when genuinely ill, I was taken to the hospital for an examination over my objections. I would have rather recuperated at home.
Candidate Obama has made government-owned heath care one of his platform planks. The pro-government-opened-health-care circuit in America is pushing the idea yet again, with the Canadian health-care system being held up as "proof" that an analogous American system will be cheaper overall. Since the idea is once again "hot" in the American-liberal circuit, I might as well disclose what cultural controls are needed to produce "socially responsible" – or parsimonious – users of government-owned health care services:
- A culture where childish, adolescent and even youthful irresponsibilities are seen as precisely those. In other words, a culture where the immature show due deference, if only in the breach, to the mature. What got me out of health-care abuser mode and into health-care-parsimonious mode was, quite simply, growing out of it. Had there not been respected adult role models around, displaying such parsimony, I would not have. Ironically, this culture is a small-"c"-conservative one, where freedom and experimentality tend to be seen as jejunery and fecklessness. If this predominant culture of maturity is lacking, then it's only a matter of time before special laws are imposed as ersatzes.
- Another irony: A government-owned health-care system that works on the cheap is aided by tolerating "right wing" critiques of it. Reading and agreeing with economists' critiques of government-owned health care, such as the ones found here, result in internalizing parsimonious (or "socially responsible") behavioral norms.
- In a verbally assertive culture, tolerating the "save the government" busybody. That type of person cannot be seen as insufferable.
- A culture where deference to the government is engrained, to the point where normal cost-benefit calculations are stifled: one where taxpayers are mere taxpayers. This norm may have to be reinforced at the legal level through making it impossible to sue the government over procedures gone wrong, as said lawsuits do require cost/benefit analyses for establishing tort levels.
With the exception of norm #2, which is appropriate for a nation with a libertarianistic past, all of those norms are necessary for a relatively low-cost government-owned health care system – because they have the effect of sitting on normal economizing behavior. They're the informal analog to the only formal measure that can ever guarantee the lower-cost outcome for a government-owned health care system: strict rationing. 
Daniel M. Ryan is a regular columnist for LewRockwell.com, and has an undamaged mail address here.