dmcanzi@watdcsu.UUCP (David Canzi) (07/05/86)
As with most debates over political matters, the extra billing debate has become a debate about the morality or immorality of some group of people. Specifically, in this case, the doctors. Most of the letters to the editor of the local newspaper supporting the ban on extra billing dwell on the size of doctors' incomes, with the implication that any doctor who wants more must be disgustingly greedy. The tone of these letters is generally one of stern moral disapproval. And the authors apparently consider this reason enough to ban extra billing, ie. to punish doctors who bill extra. Think about it: If we assume these people are arguing honestly, then they will use precisely the same arguments to convince others that they themselves find convincing. Since the argument they use the most to support the ban is one designed to convince other that doctors who bill extra are immoral, it follows that they believe that the immorality of an action is sufficient to justify punishing people who do it. I believe that, *even* *if* the doctors of Ontario are money-grubbing greedheads, the ban on extra billing is bad medicine. OHIP costs the Ontario government money, but as long as the doctors could bill extra, the government was limited in its ability to control the rates by the fact that doctors could bill extra. If too many doctors started to bill extra, enough people would understand why that the government would probably lose some of its popularity. Now that doctors don't have that recourse, the government probably will not raise the OHIP rates fast enough to keep up with inflation, or may even *lower* the rates. It has the motivation and now it has the opportunity. This is unlikely to have any serious untoward results in the short run, but if the billing ban remains in place and the government maintains tight control over the OHIP rates for a decade or two, there will be a shortage of doctors. Young doctors just graduating from med school or those in practice who don't have many patients can emigrate. Some will. Call it greed if you wish, but even those genuinely motivated by a desire to save lives may realize that they can save the same number of lives in the US and get paid better. People considering med school will think twice, knowing that the government would be directly controlling their income after they graduated. There are important similarities between the extra billing ban and rent controls: (1) a large group of voters benefit at the expense of a small group of voters. (2) The group that is hurt is perceived as greedy (a moral judgement). (3) The putative purpose of the extra billing ban and rent controls is to help the needy. (4) Both needy and non-needy people benefit, and the non-needy who benefit outnumber the needy. (5) The results of the government's actions are easily predictable, and in the long run they are worse than the problem that was supposedly being solved. And the most important similarity of all: In both cases, the mass of voters base their decision on the issue entirely on a snap moral judgement of the doctors/landlords/fill-in-next-victim and a belief that what they perceive as an immoral act must be punished. And their moral judgement blinds them to the harmful consequences of the actions they advocate. Their emotions are aroused, and rationality goes out the window. Many political issues come down to a choice between two alternatives: (1) Condoning (ie. not banning) an action that the majority of people consider to be immoral. (2) Banning that action, with the eventual result being that everybody ends up worse off. So, tell me: Is it so important to punish those we disapprove of that it's worth screwing ourselves? -- David Canzi manual page, n. the description of a command displayed by the "man" command. This usage originated at a time when it was possible to describe many Unix commands in a page or less.