Because of the recent decline in our health care system, today's physicians practice in a "medical gulag" and suffer from a "siege mentality." The reasons for this, as learned from examples in both ancient and recent history, are the topics for this unique collection of essays which are divided into five sections: "lessons from history"; "medical ecology"; "towards collectivism in medicine"; "the role of public health"; and "managed care, corporate socialized medicine and medical ethics." The author, Miguel A. Faria, Jr., M.D., is the Editor-in-Chief of the Medical Sentinel, the official journal of the Association of American Physicians and Surgeons (AAPS). He is a former editor of the Journal of the Medical Association of Georgia, and a former Clinical Professor of Neurosurgery and Adjunct Professor of Medical History at Mercer University School of Medicine.
Dr. Faria shows that recorded history holds parallels to our current situation which can provide us with valuable insight for our future. This is not because history is cyclical, but instead because human nature never changes.1 He compares early American medicine to that which existed in the Roman Republic during the first and second centuries B.C., when it was at the pinnacle of its glory. Then, medical practice was based on the earlier Greek tradition of Hippocrates, as refined by the great Roman physicians Scribonius Largus, Aulus Celsus, and Pedacious Dioscorides. It was guided by a virtue-based medical ethics, incorporated a strong patient-physician relationship, and was free of government regulation.2
In a second historic parallel, the recent decline in American medicine is compared to the decline in ancient Egypt which followed the introduction of the Law of Hammurabi. This resulted in the government using oppression, coercion, and intimidation. As the medical environment deteriorated, Egyptian physicians were forced to practice defensive medicine, just as we see happening today.
The author attributes the tragic downfall of American medicine to a deterioration in our medical ethics - specifically, to a change from Hippocratic (where the patient is paramount) to veterinary ethics (where a third party's interest is paramount). He predicts this change eventually will lead to the "impending dark age of corporate socialized medicine."3 The decline also is related to our society's lack of an objective philosophy. As Dr. Thomas A. Dorman, a physician from California, is quoted: "It is the loss of philosophical concepts, the loss of the spirit of free will and individual responsibility represented in these schemes, together with conceptual muddle-headedness which are sounding the death knell to the philosophy of our civilization."4
Dr. Faria also astutely relates our problems to a failed legal system which is based on subjective law. This major tragedy has developed from a 19th Century legal doctrine known as positivism, which is based not on the natural rights of man, but instead on man-made or government-granted rights. It follows the philosophy of "might makes right"5 and is the direct cause of many of the problems we now face. Among these are the Federal Reserve System (a government-approved cartel with a monopoly over the money supply) and a series of subjective laws, including the Civil Rights Act, the Medicare Act, the Americans with Disabilities Act, the Family Leave Act, and the laws imposing the welfare state. State intrusion into medicine has resulted from the use of administrative law to enforce CLIA and OSHA, and from the imposition of Diagnosis-Related Groups, the Resource-Based Relative Value Scale, Volume Performance Standards, and the peer-review process. All this has resulted in what the author describes as a "medical gulag."6
An especially ominous failure of our political system has been our government's attempts, aided and abetted by the public health entities and organized medicine, to use results-oriented research based on junk science to disarm its citizens, which Dr. Faria shows has been perpetrated in spite of the following facts:
1. 20,000 gun laws already on the books that are seldom used to disarm criminals.
2. The state has no legal responsibility to protect its citizens from crime. The duty of the police is to apprehend criminals and bring them to justice after a crime has been committed.
3. 73% of women will be victimized and more than a third of them will be raped, robbed, or assaulted at some point in their lives. Yet, female victims using handguns in self-defense are successful 66% of the time, while those fleeing the scene only 35% of the time or using physical force only 23% of the time.
4. The defensive uses of all firearms by citizens (up to two and one half million uses per year) dwarf the offensive gun uses by criminals. So that "firearms are used more frequently by law-abiding citizens to repel crime than by criminals to perpetrate crime."
5. The medical costs saved by guns used by law-abiding citizens are 15 times greater than the costs incurred by the criminal uses of firearms.7
In spite of these facts, the war against gun ownership is progressing at an alarming pace, assisted by the junk science of gun control research conducted by public health and published in the mainstream medical journals.
Our fight against the imposition of America's own brand of National Socialism has not been joined effectively by the American Medical Association, who should be our most powerful ally. The author attributes the AMA's pragmatism to...,"a lack of vision, a lack of leadership, a lack of moral compass..."8 This pragmatism results from a lack of philosophy, which makes it impossible for the AMA to fight the proponents of pseudo-altruism and self-enslavement. As Dr. Faria so aptly notes, "appeasement does not stop tyranny. It nurtures despotism."9 Not only must we face the AMA's lack of support for private medicine, but powerful foundations such as Henry Kaiser Permanente and Robert Wood Johnson (as well as the federal government itself) are working to support corporate socialized medicine via the collectivist concept of managed care and HMOs. Opposing all these powerful groups and alone in its defense of private medicine, has been the AAPS, its effectiveness bolstered by its uncompromised ethical and moral principles.
The author suggests that we might solve our problems through education. However, in order for logical ideas to triumph, we need an educated citizenry, which the state-controlled school system has denied us. Very few Americans today have an adequate understanding of the Constitution, of the concept of individual rights, or of the difference between a constitutional republic and a democracy.
Altruism is listed as another solution, along with individual-based philanthropy and humanitarianism.10-13 A better term might have been benevolence, since the ethical meaning of altruism is just the opposite of kindness, good will, or respect for the rights of others. It is "the doctrine that the general welfare of society is a proper goal of an individual's actions."14 This moral code requires service to others as the only justification for an individual's existence, with self-sacrifice being one's highest moral duty.15 Dr. Faria recognizes that the idea that someone else has a right to the product of one's labor leads logically to the taking of property from physicians by the state. He correctly describes this as "legalized plunder, institutionalized service, oppression, and injustice."16 The failure to recognize the evil of altruism is all too common in our society, and poses one of the more important obstacles we face in the fight for private medicine, individual rights, and freedom.
In the last section of the book, the author describes Thomas Sowell's "The New Orthodoxy" and Supreme Court Justice Clarence Thomas' "The New Intolerance," which are used to silence academicians and professionals who are not politically correct. He then lists the tragic events which led to his resignation as editor of the Journal of the Medical Association of Georgia. He attributes this infamous act of censorship to two problems: 1) that physicians want to "ply their trade making a good living and don't want to make waves," and 2) that the leaders of organized medicine don't want to deal with issues that make them uncomfortable. Instead, they, including the AMA leadership, have abandoned absolute medical ethics for situational ethics, pragmatism, and political expediency in order to preserve their financial security and filigrees of power.17
Medical Warrior brilliantly documents the disastrous deterioration of our legal, educational, and health care systems. It is the ethical and philosophical underpinnings of our society which must be corrected. Unless these are changed, no matter how many "medical warriors" we can recruit (and as Dr. Faria has discovered, there are precious few), we will be unable to reverse the powerful collectivist tide sweeping us towards socialism and the loss of our freedom.
Dr. Faria provides a unique historical perspective on our deteriorating health care system and offers workable solutions to restore it. With his masterful grasp of history and his ingenious insight into economics, philosophy, politics, and human nature, he has provided us with an enormous contribution to the recent literature on health care reform, and an important weapon in our life-or-death struggle to preserve private medicine. The book should be read by every physician (and by every patient).
Reviewed by Jerome C. Arnett, Jr., MD, FCCP, Elkins, West Virginia.
1. Faria MA Jr. Medical Warrior - Fighting Corporate Socialized Medicine,
Macon, Georgia, Hacienda Publishing, Inc., 1997.
2. Ibid., p.17.
3. Ibid., p.25.
4. Ibid., p. 155.
5. McMenamin B. Un-natural justice. Forbes Magazine, May 1997, pp.122-128.
6. Faria, op. cit., p.13.
7. Ibid., p. 118.
8. Ibid., p. 162.
9. Ibid., p. 144.
10. Ibid., p.11.
11. Ibid., p.92.
12. Ibid., p.25.
13. Ibid., p.158.
14. Websters New World Dictionary of American English, third college edition, New York, New York, Simon and Schuster, 1988.
15. Binswager H (ed.). The Ayn Rand Lexicon, Objectivism from A to Z, p.4.
16. Faria, op.cit., p.100.
17. Ibid., p.191.
Reprinted with permission from the Medical Sentinel, Fall 1997 - Vol. 2, No. 4 , pp. 149-150. Copyright © 1997, Association of American Physicians and Surgeons.