Is Medicare Voluntary‪?‬

A radically egalitarian medical system would require "everybody in, nobody out," an expression frequently used by proponents of a "single payer" system. A search of the Physicians for a National Health Program website (www.pnhp.org) finds 86 citations of this phrase. Anyone receiving or providing a medical service outside the system, it is argued, would be siphoning off, for selfish personal gain, resources that rightfully belong to the collective. In this paradigm, "health care" is, axiomatically, called a "right." Like all other rights including life, liberty, and property, it is viewed as being bestowed by the system, which immediately places limits on it. One has the "right" to receive "necessary" and "appropriate" medical services without charge at the point of service, but no right to obtain or provide services not supervised and permitted by the system. There are corresponding duties. All must pay taxes, and those granted the privilege (license) to work as a medical professional must provide services under conditions prescribed by the system. Operationally, the system turns all "rights" into privileges. Compulsion is an essential feature of the system.