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L. Neil Smith's
Number 607, February 13, 2011

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March of the MedicaL Marxists
by L. Neil Smith

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Attribute to The Libertarian Enterprise and
(This is a new chapter for Where We Stand)

Prolonging life is an admirable and desirable goal. Prolonging death is not. Unfortunately, medicine doesn't seem to know the difference just now.
—L. Neil Smith

I'm just like everybody else. For months I listened to and watched "town meetings", originally cobbled together in the home districts of senators and representatives, simply and transparently for the purpose of rubberstamping Barack Obama's obsessive Marxist lust (an obsessive lust he shares with Hillary Clinton and many another tired, threadbare old collectivist) to nationalize an institution that they refer to as "healthcare".

"Healthcare". I dislike the expression intensely. Somehow it makes me think of a bowl of room-temperature softboiled eggs delivered by some idiot wearing a Winnie-the-Pooh suit. I'm a 60-something diabetic with high blood pressure and a history of heart failure. My life has been saved—which is to say, extended—time and again by a legion of straight-edged, robust doctors and nurses, along with their ever- improving technology, the hardware and chemistry, that backs their play.

"Healthcare"? We should be calling it "death prevention". That's certainly the way it's worked out for me. But the leftist UN-hugging, countryside-clearing, arcology-building nomenklatura don't dare call it that. Thanks to brave souls like Sarah Palin, however, we can now see that death is the most desirable element in our would-be masters' agenda.

Somehow, astonishingly, those town meetings didn't go quite the way our elected representatives (and I use both terms loosely) had expected they would. People showed up by the tens of thousands to deliver a message the politicians didn't want to hear, and it quickly became clear that a vast majority of individuals in this country don't want the government to have anything to do with where, how, or from whom they get medical attention or anything else, a message that the other side ignored, causing an historically unpreceented electoral upset.

It would seem even more astonishing if observers and commentators on both sides of the issue recalled that public speaking and personal confrontation invariably show up on surveys as items that the average individual fears more than death. The citizens who spoke out had to overcome both fears to face the politicians and tell them where to get off.

Frankly, I didn't know we still had it in us, as a people.

And yet—because the politicians invariably pay less attention to historians than they do to politically trendy scientists, and even less attention to the voters who placed them in office and pay their salaries—despite widespread vocal opposition, despite a century of embarrassing miserable failure, despite immeasurable human suffering and conspicuously needless death everywhere else on this glorified mudball, like it or not, America is going to try medicine socialist style.

"But why would anybody want to do an idiotic thing like that?" I pretend to hear you asking. Well, partly because there's mountains of cash—uncountable trillions, potentially—and job security in it for properly-connected accomplices to this gangster government who can afford to fly themselves and their families somewhere else for medical treatment.

Somewhere that doesn't have medicine socialist style.

One evening, as I was channel surfing, I happened to click past an Oprah Winfrey rerun featuring a guy with a funny accent, defending government control over all things medical. I paused in my search to listen.

"Let'z ztop usink ze term 'zocialized meditzine'". The sap was trying to substitute what he thought might be a more politically palatable euphemism for it—the same way "liberals", having ruined that fine old appellation, have switched to the word "progressive", instead.

The guy clearly wasn't very bright, since he offered, as precedent for the long-discredited idea he was pushing, the fact that governors of states afflicted by Hurricane Katrina had begged the feds for help. He called it "zocial inzuranze". What he didn't mention was that what the governors got was Soviet Bulgaria's best—little or no real help, massive, messy interference that will slow the area's actual recovery for decades to come, and wholesale, blatant violations of certain fundamental, unalienable, individual, civil, Constitutional, and human rights of flood victims who were already close to their last legs.

Oprah and her "progressive" political buddies like Barack Obama, Hillary Clinton, Harry Reid, and Nancy Pelosi can't wait for every American to live like that, every day. And it may surprise you to learn, though, that to a point, I agree with their TV talkshow advocate.

Let's stop saying "socialized medicine".

Let's be more specific.

Let's be more accurate.

Let's be more precise.

Let's be more truthful.

Let's call the thing exactly what it is.

What is it? Well, back when she was Queen, Hillary Clinton wanted to jail you for paying your doctor privately. That's right, part of her marvelously "humane" healthcare plan was to have you kidnapped by uniformed thugs if you made your own arrangements with a physician. If we'd made her Empress, she assured us, you wouldn't be allowed to work—when the flaming hell did we start needing goverment permission to work?—if you couldn't produce documents proving you were legally insured.

Obamacare, of course, will be completely different. It will be the warmly beloved IRS who leans on those miscreants who are willfully non-compliant.

So let's not call it socialized medicine. Instead, let's call it beat-you-up-and-kill-you-if-you-won't-go-along, coercive medicine. (Although how anybody can call it "medicine"—if they beat you up and kill you if you won't go along—I haven't quite figured out. And apparently neither have they.) Let's agree to call it medicalized Marxism.

History will someday record that the American system of democratic governance eventually devolved to a point where nobody with even the faintest trace of sanity, decency, or intelligence could expect to get elected. Americans are ruled by those among their number who are the most stupid, the most evil, and the most crazy. The system selects for them.

A city councilman once asked me—it was clear that he sincerely wanted to understand—whether I didn't feel unduly restrained, too limited, by having principles. (Note: he was a Republican.) Those who "represent" us know exactly who and what they are, and not one in a hundred gives a damn about what their constituents want. They don't give a damn about the Constitution. They don't give a damn about the Bill of Rights. They don't give a damn about right and wrong. The only thing they really fear is not getting reelected—being deprived of their absurd overpayment for the "service" of destroying their culture—and missing their shot at the next rung up the ladder to absolute power.

For decades I had been saying that there's huge and terrible anger simmering just below the surface of American life. Year after year, decade after decade, century after century, the Productive Class have labored to supply everything necessary and good in our society—from diesel fuel to lemon meringue pie, from the wheels that take us from one place to another, to our homes where we find refuge and comfort—only to have the rewards of their labor snatched away by rapacious parasites intent on controlling every moment and aspect of their lives.

Yet it is the same Productive Class who are the first to be blamed—by elements of a Non-Productive Class that couldn't tell a cotter pin from cottage cheese—for everything, real and imagined, that is said to be wrong with that society, from bad taste in color, cars, and clothing, to acid rain, air pollution, depleted ozone, and global warming.

To the average politician, newspaper columnist, hairsprayed TV commentator, or Hollywood airhead, suburbia is a kind of despicable, disgusting, fetid swamp to be crawled out of, rather than as close to Utopia as humankind has ever come, the locus of all the wishes, hopes, and aspirations of a people whose only wish is to be left the hell alone.

And all these idiots—congressthings and others of the so-called "dominant culture" who believe they own us—can think of is how to suppress that anger for another year, another decade, another century. They desperately want to deny that their opposition is significant and serious. They want to dismiss it as stupidity, right-wing racism, and childish ingratitude. Or the result of having attended all the wrong schools. It never occurs to them to consider what that anger might really be about, or that it might be justified. They simply want it managed.

It's probably too late for that, but they'll be the last to know.

During a period I've otherwise been enjoying immensely, my glee has been marred by various radio pundits. Not those, mind you, who favor medical Marxism and, acting either as propagandists for their side, or, at least, useful idiots, have been calling their opponents "brownshirts" or "Nazis". No, by presumed conservatives who started evaluating the town meetings not in terms of the principles painfully enunciated there by nervous but valiant individuals, or the utter imbecility, insanity, or villainy of established power, but in terms of restrained decorum—or its absence—demonstrated by those who don't wish to become human sacrifices, slaughtered on the altar of collectivism.

This, I maintain, is obscene.

Haven't you noticed, all you conservative radio pundits who were as surprised as I was at the revolt, that they never paid attention until we started yelling? Get yourselves a spine, radio pundits. Get yourselves some cojones. Get yourselves some guts. And above all, get yourselves a sense of historical proportion. Compared to the life and death issues before us, "decorum" is of microscopically less than no concern.

As I've also been saying for more than 40 years, as frequently and loudly as I can, America's Productive Class has always been compelled to suffer for its excessive—and suicidally self-destructive—politeness.

Perhaps that era is at long last ending.

I admit that I worry, having attended my last town meeting more than 20 years ago (the one in which the city councilman asked me about principles) that it might be arrogant including myself among the "we". Except that I've been there before, and I'm there in spirit, now. It's my job to write essays like this one and fling them out as far as I can into the world. I stand proudly beside the young military man who overcame his nervousness to curtly order a congressman to leave his children alone, and who demanded, having kept his own oath and been disabled for it, whether the politician had ever intended to keep the oath he took. If I had one to give, I'd give him a medal just for that.

I've listened to conservative talk radio every day since Barack Obama was elected, not just to Rush Limbaugh, but some of the others, as well. Along the way, I've noticed one element astonishingly absent from their arguments against Obama and his Marxist cohorts trying to regiment medical practice—and, through that, everything else—in America.

That element is individualism.

The arguments I hear from them are utilitarian and collectivist in character: socialized medicine is bad for the economy; socialized medicine is bad for society; socialized medicine is bad for families; socialized medicine is bad for doctors and nurses; socialized medicine is bad for small business; socialized medicine is bad for hypothetical Grandma in her steam punk iron lung, and for poor old Cousin Wilbur, whose intellectual elevator never quite made it to the top of the building.

I guess it shouldn't surprise me. Thanks to Robert LeFevre, I've been calling conservatives by their proper name—right-wing socialists—for decades. But it does surprise me, and makes me a bit sad.

The first mistake that they make (and they always make it) is that they accept the enemy's premises and vocabulary, giving up half the battle before it's even fought. It is not "socialized medicine" that we're up against here—to many a misguided individual, ignorant of history, that makes it sound kind of warm and fuzzy—but government control, through brute force and the threat of brute force, of those ultimately personal, private acts of seeking and delivering medical attention.

Your doctor often knows things about you that you wouldn't want anybody else—possibly including your own family—to know. But for nasty, perverted reasons all their own, having mostly to do with their psychopathological desire to control every aspect of everybody's life, the Obamas, Reids, and Pelosis of this world are eager to stick their noses in your intimate orifices and learn everything your doctor knows about you. As a human being, you are entitled to more privacy than that.

But mostly, as many pundits have been saying, it's about power at the lowest, minutest zit-squeezing level conceivable. It might be difficult for a normal individual to understand why somebody would yearn for complete control over every aspect of another human being's life, but there you are: sooner or later, a lens behind every bathroom mirror.

Make no mistake about it, this heartfelt yearning for absolute control is psychosexual in character, and about as sick and perverted as it can be. Every stuttering, broken-voiced pencil-neck who ever got turned down by a cute cheerleader, every pimply-faced fat girl who ever imagined she was being laughed at by the captain and his whole football team, these are the mental midgets and moral cripples who are looking forward, from under the rocks they currently inhabit, to ruling us tomorrow. You've seen plenty of their species already, down at the Department of Motor Vehicles. Get ready to see a lot more of them.

They want to rule.

They need to rule.

And to rule lives they perceive as better than their own.

Conservatives are in a poor position to comprehend, let alone to enunciate this point. After all, it was their guy, Robert Bork, who informed us that there's no guarantee of privacy in the Bill of Rights.

These specimens can be simply defined as Republicans who, like their glorious leader George W. Bush, dismiss the Bill of Rights as "just a piece of paper". Their advertised willingness, as a bargaining chip, to force insurance companies to cover "pre-existing conditions" (the exact equivalent of forcing them to offer you fire insurance after your house has burned down) is all the proof required that they just don't get it. Given a choice between left wing socialists like Obama and right wing socialists like Bush, just say "None of the Above".

To his credit, Limbaugh made the point (over and over, which I don't hold against him; repetition is the soul of education) that there's no significant difference between what Obama wants and what Hitler, whom he correctly identified as a socialist, "a man of the left", established in Nazi Germany. I even heard the formerly fat flumpus say "statist" several times. I often wonder what he thinks he is.

All political jargon to one side, however, medicalized Marxism is unsatisfactory if for no other reason than this: I don't want it. It violates my unalienable individual, civil, Constitutional, and human rights.

It's going to be hard to keep extending our lives, to live long enough to enjoy the future of our choice if Obama and his minions are allowed to reduce the practice of medicine in this country to stone knives and bear skins—rationed stone knives and bear skins, at that. They don't want people to live longer. Various of them have confessed that they'd like to see the human population reduced by 90 percent, and that what the Earth really needs most is "another good plague".

Don't let them overcomplicate it. Above all, don't fall for the common leftist tactic of burying the argument in the details. Whether it works or not (it doesn't), whether it's better than free market medicine or not (it isn't), are secondary issues. Medicalized Marxism is wrong because it forces me to do what I don't want to do. It keeps me from doing what I do want to do. It imposes duties on me that I don't want imposed. It denies me (and you, and everybody else, too) the uncountable advantages of acts of capitalism between consenting adults.

Get it?

If you take nothing else from this discussion, take this: left wing socialists hate you because they hate themselves even worse, and they project their self-loathing and self-contempt onto everything and everybody else around them. Every day, they scrabble desperately for control of the world and everybody in it because they can't control themselves. They will never advocate anything that benefits you in any way.

The "euthanize Aunt Tilly" death panel section may have been taken out, but the first thing they did after passing the law was to put it back in. The history of socialism demonstrates beyond doubt that it's an absolutely necessary and essential feature of anything supplied by government.

What's more, it's desirable. The Obamas and Reids and Pelosis of the world don't give a rusty fuck about your wellbeing. The last thing they want is for you to be happy and healthy for as long a lifetime as possible. What they want above all is for you and me and Grandma and Cousin Wilbur and Aunt Tilly to have to beg them for our lives every day.

Above all, they want the power to say no.

Stem cells may not represent a real Fountain of Youth, but you may be assured that whatever the Fountain of Youth turns out to be, it will be forbidden by any government run by men of faith (as opposed to reason), a category that includes Marxists of all denominations and environmentalists, who believe it's better to live a mere Biblical (meaning, neolithic) span and go to Heaven, more responsible to stop collecting Social Security from a system they can't fix but don't dare abandon, and kinder to Mother Gaia to get old, die, and get out of the way.

That's what it's all about, not medicine, not healing, power. The refusal of medical help (later, of food, clothing, or shelter) to anybody over 65—unless they have a long record of "distinguished government service"—or to individuals suspected of dangerous individualistic or "reclusive" tendencies. It will be a major feature of their brave new future. I'd bet my last farthing that they yearn even now to withhold medical attention to "Constitutionalists", global warming "deniers", Tea Party participants, anti-tax activists, gun owners, "birthers", evangelical Christians, and other "antisocial" dissenters. This is almost certainly the one thing they want from it most.

It's not enough just to stop an idea like that—it will just come back again, before you know it—it must be eradicated, root and branch from our very culture. The babystep programs that exist today—Medicare and Medicaid—programs that the right wing socialists who call themselves Republicans or conservatives, in their vile, cowardly laziness, have long since reconciled themselves to, must be abolished.

Anything less, the tiniest bit of government interference with medicine at the national, state, or local level will simply end us up right back where we are, since that's what caused the mess to begin with.

These are the same sociopathic scumbags, after all, who hate the private automobile, not because it fails to take you from exactly where you are to exactly where you want to be, in privacy and comfort, but because it succeeds. No matter how slickly they're advertised, the cars they plan to force you into won't be the cars you want to drive because that—and that alone—would spoil the entire exercise for them.

These are the same moral and ethical cripples who persecute smokers because that's one more group they can safely vilify and terrorize.

Their real object is to control you and deny you joy.

These are the same antiConstitutional oath-breaking criminals who have fought for a century to stamp out the Second Amendment, partly because they are frightened by people with guns (rightly so; people with guns are much harder to control), partly because they know they can't trust themselves with guns, and they project that uncertainty onto everybody else, but most of all, because they can see that people derive enjoyment from their guns and that must be stopped at any cost.

These are the specimens, for the most part, who not only dislike red meat themselves, but demand the power—employing any of a dozen transparently phony excuses—to make everybody else stop eating it, too. They hate the proper celebration of American independence. And now these rapidly devolving simpletons have decided that they must hate the greatest gift ever bestowed upon humankind, the incandescent lightbulb.

The oddest fact is that most of what so-called "progressives" hate—and they are a bunch of haters, after all—and soulfully desire to deprive the rest us of, appears to involve fire, as if they were a mob of retarded Neanderthals who had only just heard of the stuff, were absolutely terrified by it, and who had decided to disapprove of it.

What are we to make of recent efforts by the Centers for Disease Control to find out who owns guns in Vermont? To start, you have to understand that there's no Constitutional provision (see Article I, Section 8 for allowable government activities; it's a short list) for anything remotely like the CDC. Like many another federal bureaucracy, Every aspect of its existence—every activity it undertakes—is illegal. Everyone who works for the CDC, in any capacity, is a criminal.

But I have digressed.

The important thing to understand is that medicine is a trade, a business like any other. Trying to make it special—a tendency since the 19th century—has only made it a mess. Nor can there be any denying that—aside from its scientific and technological excellence—the administration of medicine in America is a disaster, which is what made the abomination of medicalized Marxism seem preferable to some.

Nine tenths of the problem is that it's no longer the patient who is the doctor's customer, but the patient's health insurance company. Having an insurance company stand between you and your doctor is no better than having a government committee—a "death panel"—in its place. Insurance companies must have absolutely no say whatever in the patient's choice of doctor or the doctor's choice of treatment. These matters must be left to the doctor and the patient. If we wish to live longer, healthier lives, this is something that must be changed, and soon.

There is nothing to be gained, here, by regulating or punishing health insurance companies. That's probably what caused the problem in the first place. Instead, since there are too few insurance companies, and, therefore, too little competition, laws that make it harder to enter the market, or to do business—a good example is the law forbidding health insurance companies from operating interstate while car insurance companies, for example, are free to do so—must be repealed.

There's nothing wrong with medicine that can be fixed by "single payer" healthcare and I don't know anyone I respect who wants it. Let's make a better start, calling it by its right name: compulsory, collectivist, going-through-the-motions medicine. I've seen how it "works" in other countries, and in the US military. It is an evil and deceptive program the real objective of which is to give very bad people complete, minute control over every moment and detail of our lives.

There are psychopathological personalities among us to whom such a prospect is almost better than sex—for whom, in fact, it is sex. And if Annie Lennox's "Sweet Dreams" is correct, just as there are people who get off on doing it, there are other people who get off on having it done to them, people who are stupid, evil, or insane. Which is why the left have to force medical Marxism on the rest of us at bayonet-point.

They want to live their lives through ours, beginning with the splendid and absolutely limitless excuses that medical Marxism provides.

Only I don't plan to let them.

Believe me, I grew up with it in the American military, and I've seen it in full flower in England, as well. It isn't about providing you with services, it's about denying you services, since that's the cheesy little thrill that is all many bureaucrats ever get out of life. People want power over the lives of others not because they believe themselves uniquely capable of directing those lives, but because they know they're incapable of directing their own lives and find it easier in this culture to try directing the lives of others, instead.

And soon, the murderous battle will be called "single-payer" medicine.

And then, as Tom DiLorenzo points out, "single-payer" groceries.

I have a counter-proposal. Instead of death-threat doctoring, how about pushing through a long-overdue Constitutional amendment that will call for exactly the same kind of formal separation of science—especially medicine—and state that the First Amendment wisely mandates (sorry, conservatives, wrong again) between religion and the state?

A Constitutional amendment mandating separation of medicine and state.

Of course we'll still need another amendment, one that puts teeth in the highest law of the land, one that would impose a lifelong prison term on any politician, bureaucrat, or cop who violates the Bill of Rights and require, should that violation cost the life of any individual, even one of the perpetrators, a death sentence by public hanging.

It isn't that I'm all that much of a Constitutionalist (although many of my readers believe I am), but these are the badguys' rules—especially the Bill of Rights, which was their concession to lovers of liberty in exchange for the power they hungered after so insanely—and by God (or Whoever's on duty), I mean to see that they stick by them.

A Constitutional amendment mandating separation of medicine and state.

In one stroke (well, actually, two), we can eliminate the threat of medical Marxism forever and put an end to shabby, threadbare pseudoscientific hoaxes like global warming. In addition, it will end any prohibitions against research involving such things as stem cells—although it will also prevent the government from funding it, as well.

Clearly, it's a win-win kind of thing.

Allow me to repeat myself, so there can be no mistaking what I've said. There is one—and only one—solution to the mess our medical system finds itself in. That is to remove the real cause of the mess, not drive the system further into ruin and collapse. America needs—meaning it cannot long survive without—a Constitutional amendment mandating separation of medicine and state. The word "mandating" means "making mandatory", giving it the full force of law. A Constitutional amendment formally mandating the complete separation of medicine and state.

One more time: a Constitutional amendment, analogous to the First Amendment, formally separating science—especially medicine—and state?

Anything less, the tiniest bit of government interference with medicine at the national, state, or local level will simply end us up right back where we are, since that's what caused the mess to begin with.

A Constitutional amendment mandating separation of medicine and state.

Along the way, we'll reinstate confidentiality between doctor and patient as it once existed—an unshakable and sacred confidentiality like that between lawyer and client or priest and parishoner. We'll also adopt a "loser pays" legal system, making it much riskier to bring frivolous lawsuits, or lawsuits for profit, against competent doctors.

A Constitutional amendment mandating separation of medicine and state.

For more than a century, the American Medical Association, acting through state legislatures and the federal government, has striven to limit the number of medical schools in America—they started by closing all such facilities for black medical students—which keeps the supply of doctors artificially low and their income artificially high.

A Constitutional amendment mandating separation of medicine and state.

During the same period, by insisting on lengthy, repetitive, expensive, and often wildly inappropriate testing procedures for new drugs and other treatments, the federal Food and Drug Admnistration has obstructed medical progress and cost hundreds of thousands of lives.

A Constitutional amendment mandating separation of medicine and state.

It's time to change things now. Write to Congress. Write to local newspapers. Write to every web and blogsite. Call radio talk shows. Go to townhall meetings. Tell everybidy that you know, everyone within the reach of whatever kind of voice you may command, that America needs a Constitutional amendment mandating separation of medicine and state.

A Constitutional amendment mandating separation of medicine and state.

The urge to power is down there, deep within each of us. We fight it every day whether we realize it or not. What we do with that urge, how we choose to fight it, is one of the surest measures of our character.

And our potential for survival.

Four-time Prometheus Award-winner L. Neil Smith has been called one of the world's foremost authorities on the ethics of self-defense. He is the author of more than 25 books, including The American Zone, Forge of the Elders, Pallas, The Probability Broach, Hope (with Aaron Zelman), and his collected articles and speeches, Lever Action, all of which may be purchased through his website "The Webley Page" at

Ceres, an exciting sequel to Neil's 1993 Ngu family novel Pallas is currently running as a free weekly serial at

Neil is presently at work on Ares, the middle volume of the epic Ngu Family Cycle, and on Where We Stand: Libertarian Policy in a Time of Crisis with his daughter, Rylla.

See stunning full-color graphic-novelizations of The Probability Broach and Roswell, Texas which feature the art of Scott Bieser at Dead-tree versions may be had through the publisher, or at where you will also find Phoenix Pick editions of some of Neil's earlier novels. Links to Neil's books at are on his website


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