Many Swedes reason that they are safer when the county government [in Sweden the county governments run most of the hospitals and finance them with the county income tax, which is around 15%] pays for their health care than they would be if they paid for their health care themselves, via their own wallets. For, they reason, if they themselves paid there would always be a risk that they would not be able to afford their health care - if they developed a grave illness which required an expensive treatment and which they had not insured themselves against. But the government has so enormously much more money than the citizens as individuals, they reason. So - there will never be any problem for the government to pay, will there?
 
The Swedes who reason this way are forgetting one thing. Namely this: at the same time that they are reasoning in this way, all the other citizens of the Swedish welfare state are doing it too. So, the government´s enormous economic resources are matched by equally enormous expectations on the part of millions of citizens. Therefore, the government will not always be able to pay for all the health care which the citizens might need. The fact that the government finances the citizens´ health care with taxes just means that it becomes the government which gets to perform the job of adjusting the consumption of health care to the available resources – instead of the individual citizens doing that job themselves. Tax financing of the health care means that the government must ration it. The government will get to decide who will get health care - and who will go without.
 
Some bureaucrat in the health care apparatus will then reason like this for example – “Shall we give this man an expensive bypass operation? He needs it – but he is 75 years old, so he does not have so many years left to live anyway. Maybe we should instead give this five-year old girl an expensive treatment for her damaged brain? She needs it – but the chance that the treatment will succeed is quite small. Maybe we should instead give this 45-year old woman an expensive treatment for her lung cancer? She needs it – but she has been smoking for thirty years, so it is really her own fault. Maybe we should instead . . . etc, etc.
 
There are no objective principles which the bureaucrats can follow when they decide who gets health care and who doesn´t. So it will be deuces wild.
 
The welfare state´s politicians but of course never tell the people that they ration the citizen´s health care. It is a very sensitive issue, to say the least. To be open and honest in this question could cost any politician who chose to be honest loads of votes. Therefore the health care bureaucrats will ration the health care in silence – even in secrecy. Stealth is the means the government usually uses when it needs to do things which are unpopular but necessary – such as, for example, registering the Communists during the Cold War and dumbing down the children of the politicians´ own voters´ children in the public schools.
 
But when the health care is “free” (i.e. tax-financed) there is no incentive for each citizen as an individual to limit his consumption of health care. So he goes to the acute clinic as soon as the children catch a cold, he will expect that every single one of the hospitals in the country will have the very most modern, most expensive medical technologies, he will expect that the hospital will do tests even when it is extremely unlikely that the test will turn out to be necessary etc. Initially the government will meet the exploding demand for health care, which the initiation of tax-financing lets loose, by granting more and more money to the health care sector.
 
But the amount of money which the tax-payers possess is, of course, limited.
 
And not only does the tax money eventually begin to run out. In addition, the politicized health care becomes less, and less efficient as time goes by. A sort of cost pressure gradually builds up. And when the politicians no longer can procrastinate - but begin to act - things get still worse. Politicians and bureaucrats are not better at saving money efficiently than they are at managing expanding operations efficiently. The politicians will hire more bureaucrats to manage the economization projects, and will instead cut down on the number of doctors and other crucial health care staff.
 
The staff which remains will be more and more overworked when the staff is down-sized. And in addition, their wages will be held down in a desperate attempt to save money. The worst thing for the individual doctor, however, will be the crossfire which he winds up in. On the one side he will have the spoiled-rotten patients who imagine that they have a right to the world´s very best health care, without having to pay a cent for it themselves via their own wallets. And on the other side the doctor will have the conceited bureaucrats who demand that he keeps the costs down, so that the hospital does not exceed the budget. The stress which this conflict will give rise to will gradually destroy the doctor´s ability to think straight and to thereby do his job well.
 
And it is a mistake to imagine that the problems in the socialist health care system will be dealt with if only they become known. Bad conditions which are open secrets in socialistic operations can exist or grow for indefinitely long periods of time without anybody doing anything about them.
 
The maltreatment of Sweden´s diabetics is just one example of this among many. In 1984 the chairman of the Swedish Diabetes Association, Bertil Dahlén, sounded the alarm about the unnecessary amputations of feet and toes on elderly diabetics. Dahlén claimed that about 1,400 of the 1,500 yearly amputations of the feet or toes of diabetics were unnecessary. They could have been avoided with better prophylactic foot care. Sweden´s newspapers wrote about Dahlén´s warning. But in 1997, thirteen years later, nothing had been done about this problem. Roughly 1,500 amputations of the feet or toes of diabetics were still being performed each year. Docent Jan Apelquist, at the hospital of the University of Lund, said in Svenska Dagbladet (a daily newspaper) on February 2nd, 1997 that “A number of Swedish and foreign studies show that one can with relatively elementary means do much to avoid amputations, and thereby reduce patients´ suffering, and forestall physical handicaps.” But the socialistic health care system had still not got around to it.
 
So - the morally corrupt majority of the Swedish people miscalculated when they imagined that they could obtain an increased level of welfare by letting their health care get financed by taxes. When they did not themselves pay for their health care out of their own pockets, they did not themselves have any control over their own health care.
 
Only a total privatization of *both* the production and the financing of the health care can save it. If the hospitals were private and were run for profit, and if the health care was paid for directly by the hospitals´ customers and the customers´ private insurance companies – then the health care would become successively better and less expensive, instead of just steadily deteriorating. For the customer is king – whenever he is the one who pays.
 
And health care is not so expensive that “ordinary” people cannot afford to pay for it via their own wallets. If an “ordinary” Swede can afford to pay many thousands of crowns per year in tax to the county government (in Sweden it is the county governments who run most of the hospitals) in order to finance his health care – then he would be much better able to pay for his own health care via his own wallet, if the health care system were privatized and the taxes to the county governments were abolished. He would be able to pay for routine health care expenditures with private savings, and he would pay for really large expenses (for serious illnesses for example) by purchasing private insurance before he became ill.
 
Of course, no one would be able to afford infinitely much health care, if he paid for it via his own wallet. But he would get to make the necessary priorities and choices himself, instead of being at the mercy of the anonymous bureaucrats who ration the health care whenever it becomes socialistic. And you are safer, are you not, when you keep the power over your own life in your own hands, instead of handing it over to strangers?