-Caveat Lector-
Note: Dr. Ron Paul was the June 2001 commencement speaker at the
University of Texas-Houston Medical School.
The State vs. Doctors
by Congressman Ron Paul, MD
Being invited to address you today is indeed a particular honor for
me. In seeking advice about my speech I was told to observe three
things:
1.) Be brief; no one remembers graduation speeches and too often they
are boring. Being brief is not the easiest request for a politician to
fulfill. But I did decide not to read the 80-page speech I'd written.
2.) Be positive; don't dwell on the problems medicine faces; this is
to be an upbeat event. Now that's a little more difficult for one who
titles his weekly legislative report: "Texas Straight Talk."
3.) Be non-controversial; well, that's just asking too much of a
politician.
My task today is to remark on the relationship of medicine to society
from my perspective as a physician and legislator. To me this is a
very interesting task, but difficult to accomplish in a short period.
Before I begin, let me reassure you that I will try hard not to
offend anyone, but that's probably not completely possible. If I do
offend, I apologize. But you need not worry too much about a
disagreement you might have with what I say, because I'm an advocate
of a political philosophy that believes social and economic problems
should not be solved by passing more laws and using force, but
instead, solutions should come through freedom and persuasion.
The same events that early on motivated me to go to medical school
later motivated me to participate in politics. Clear memories of the
horrors of World War II and the Korean War and the reports of loss of
life of family, friends, and neighbors had an impact on me. I knew
very early on I never wanted to carry a gun in a war and, with the
draft in place, I realized the odds were overwhelming that I would be
called up to serve. I definitely knew at an early age that I preferred
a medical bag to a gun, healing to maiming, life to death.
I'm sure all of your reasons to become physicians vary, but most young
people deciding on the medical profession share the noble goals of
promoting health, healing, and life.
There are two short stories I want to tell, one medical, the other
political and economic.
First, when George Washington got a serious illness, the best
physicians in the country were called in. Three of the best consulted
and agreed that bloodletting was the treatment of choice, and the
leeches were put in place. Washington's weakened condition that was
the result of a serious respiratory infection promptly worsened and he
soon died. (There was no malpractice lawsuit filed.)
Good intentions and conventional wisdom were not helpful in saving the
life of the father of our country. Medical care involves more than
good intentions.
Second, in 1620 the Pilgrims, under the guidance of Governor Radford,
landed at Plymouth Rock. For the first two years the guiding principle
was "from each according to ability, to each according to need - and
by force." Starvation ensued and the colony neared extinction.
However, in the third year, Radford, in consultation with the adults
of the community, agreed on a system of private plots and
self-reliance. Results the next summer were astounding. Productivity
shot up, and a community spirit of voluntary sharing replaced the
harsh laws that guided the first two years.
Freedom solved the problem of starvation.
The second story reminds me of one of my early lectures in medical
school. We were told that Kwashiorkor was the most common illness in
the world, killing more persons than any other. Immediately, with
delusions of grandeur, I dreamed of being the physician to find a cure
for this devastating malady. But later in the lecture I learned that
Kwashiorkor was a different kind of illness - it is the end result of
starvation. Later it dawned on me that the solution to this problem
was more political than medical.
Because we in this country have enjoyed the benefits of the freest
society ever known, true famine has never existed here. But a headline
a few weeks ago read: "Rickets on the rise in the U.S." I wondered at
the time, could this be an early sign that something is wrong? Have we
undergone a reversal back toward the philosophy that nearly destroyed
the Plymouth colony?
Currently the method of distribution of medical care in the United
States is coming under attack by politicians, bureaucrats, hospitals,
labs, service providers, doctors, and patients. More laws and more
money are demanded from all quarters. But could it be possible that
distribution of medical care is now being criticized because of a
return to a system of government similar to the early rules of the
Plymouth colony? Or is it possible that freedom combined with
self-reliance no longer works? A basic understanding of economics
helps one to understand why distribution of medical care today is
becoming more difficult; quality is down while costs are
