Milton Friedman on Medicine and health care
I have examined the story in this area in the United States, in particular with the American Medical Association during the course of the 1920’s and 1930’s. It’s an extreme example of a very powerful trade union which succeeded in keeping down the number of physicians and in the process raising costs, which succeeded in retarding the development of efficient group medical practice and in the process reduced the quality. I mention this not to attack the American Medical Association or the members of it. They are noble, able people who wanted good things, but were misled. But only to suggest again a sense in which the developments in medicine are not special to medicine.
Context. From a talk to physicians, published in Private Practice in July 1981, on the trend toward government control of medicine and the prospects for reversing it. On the American Medical Association in the 1920s and 1930s, a history he says he had examined.
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Milton Friedman, “The Market and Human Freedom” (Private Practice (July 1981); reprinted in the Congressional Record, Extensions of Remarks, September 9, 1981, pp. 19996 to 19997, introduced by Representative Larry McDonald of Georgia as “Professor Friedman’s recent article on this subject” in “Private Practice magazine for July 1981”, 1981), Congressional Record, September 9, 1981, p. 19996. https://miltonfriedman.org/quotes/ama-powerful-trade-union-noble-misled-1981
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He also said
Almost everywhere medical practitioners have formed themselves into organizations that have generally, with the assistance of the state, restricted entry into medicine—all, of course, for good purposes. Nobody ever does undesirable things for bad reasons; all for the good purpose of raising standards of medical practice.
Context. From a talk to physicians, published in Private Practice in July 1981, on the trend toward government control of medicine and the prospects for reversing it. Following the Hippocratic oath forward through the centuries of medical practice.
The Market and Human FreedomSpeech, 1981, Private Practice (July 1981); reprinted in the Congressional Record, Extensions of Remarks, September 9, 1981, pp. 19996 to 19997, introduced by Representative Larry McDonald of Georgia as “Professor Friedman’s recent article on this subject” in “Private Practice magazine for July 1981”, Congressional Record, September 9, 1981, p. 19996Checked against the sourceRead the originalThe strongest political influence on a legislative body is exercised by special-interest groups of citizens who favor a government program that confers substantial benefits on them, while imposing small costs on a large number of their fellow citizens. … A corollary is that we cannot correct this situation by electing the “right” people to Congress. Once elected, the “right” people will do the wrong things. And they will be pressured to do so by us, in our capacity as members of special-interest groups, even though we elect them in our capacity as members of a majority outraged by the growth in government’s spending and scope.
Context. From the book’s closing chapter, where the Friedmans set out a numbered list of lessons on how the public will can be translated more effectively into government policy; these are the first two. The ellipsis leaves out one sentence, which calls each such group a corner of an “iron triangle” of beneficiaries, politicians and bureaucrats. The next point says that only the presidency or a constitutional amendment can let the general interest prevail.
Tyranny of the Status QuoBook, 1984, Harcourt Brace Jovanovich, Ch. 9 “The Iron Triangle: How to Defeat It”, pp. 165–166 (with Rose D. Friedman)Checked against the sourceFind the bookFor example, the supporters of tariffs treat it as self-evident that the creation of jobs is a desirable end, in and of itself, regardless of what the persons employed do. That is clearly wrong. If all we want are jobs, we can create any number—for example, have people dig holes and then fill them up again, or perform other useless tasks. Work is sometimes its own reward. Mostly, however, it is the price we pay to get the things we want. Our real objective is not just jobs but productive jobs—jobs that will mean more goods and services to consume.
Free to ChooseBook, 1980, Ch. 2 “The Tyranny of Controls”, pp. 40-41Checked against the sourceFind the book
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