Letters to the Editor

LETTERS TO THE EDITOR Dear Sir: Whether Canadian doctors and patients are happier under their more progressively statist system than are their counterparts in the United States I cannot know, but some of T. R. Marmor's assumptions in reply to Dr. Jane Orient's letter (Perspect. Biol. Med. 31:614-617, 1988) are invidious. Why, for example, would anyone, except as an attempt to resurrect the quivering corpse of socialism, or at least engraft some of its diseased parts onto our comparatively free and prosperous society, describe as "free" government services of any kind, when in actuality they are dearly bought with taxes, minus generous commissions to bureaucrats and to politicians attempting to buy votes from the permanent client underclass, using welfare state goodies as currency? And while one may distinguish the price of a service from the timing of its receipt, delay may diminish, unto and past zero, the value of anything. Consider a delayed airline flight, obstetrical service 10 minutes late for a placental abruption, or hip surgery delayed for 6 painful months out of work, a case where the most unimaginative accountant, and perhaps even Marmor, would concede that lost wages and productivity cost the patient and society something. Progressives do not like to account the cost ofdelay and inconvenience implicit in "free" government services. The USSR has claimed for decades to have negligible inflation, obfuscating the cost of constant queuing, where goods and services are available at all. When, as appears inevitable, virtually all of American medicine has degenerated into the ward of some trisomie brontosaurian—but officially benevolent —offspring of the V.A., Medicare, and whatever they have done to Canada, with our altruistic insurance industry standing by as a kindly uncle, then everyone —perhaps even Marmor—will understand well, from sad experience, the true cost of medicine as a free, but politically and bureaucratically rationed, welfare state lunch. But too late. B. T. McQuitty 1502 Greenbriar Road, Lafayette, Louisiana 70503 Permission to reprint a letter printed in this section may be obtained only from the author. Perspectives in Biology and Medicine, 32, 4 ¦ Summer 1989 \ 617 Dear Sir: Dr. McQuitty's fulminations about a future of a "politically and bureaucratically rationed, welfare state lunch" constitute data, not argument. They reveal the emotional mindlessness that the least thoughtful in American medicine express when pondering the advantages and disadvantages of governmental health insurance on the Canadian model. Mention of the "quivering corpse of socialism" is modern bushwackery, not analysis. And even where McQuitty raises interesting issues—like the problems of delay in getting useful medical care— the development of thought is arrested to the point of pointlessness. On the other hand, ajournai on perspectives in biology and medicine must, I suppose, have room for muttering, however confused in fact, argument, and implication. Theodore R. Marmor Institutionfor Social and Policy Studies, Yale University, 111 Prospect Street, New Haven, Connecticut 06520 618 Letters to the Editor ...