Perhaps I should get better locks?

Dear Sen. Paul —

First of all, congratulations on becoming an ophthalmologist in the first place.  Eye trauma is one of the few medical problems that still gives me the howling fantods, so I sincerely salute anyone who can operate on the eye without his hands getting shaky.

Also, I actually kind of understand your point about specialty certification.  I certainly find the rules and obligations for certification by the American Board of Pediatrics to be tedious, onerous and arbitrary, and sometimes chafe at the absolute sway they have over my ability to practice.  (I’ve even thought about writing a post about it, then chucked the idea as boring inside baseball that would interest precisely nobody.)  Others may disagree, but I didn’t find your attempt to create a rival certifying body all that crazy.

This, on the other hand, I find confusing (via Andrew Sullivan):

PAUL: With regard to the idea of whether you have a right to health care, you have realize what that implies. It’s not an abstraction. I’m a physician. That means you have a right to come to my house and conscript me. It means you believe in slavery. It means that you’re going to enslave not only me, but the janitor at my hospital, the person who cleans my office, the assistants who work in my office, the nurses.

Basically, once you imply a belief in a right to someone’s services — do you have a right to plumbing? Do you have a right to water? Do you have right to food? — you’re basically saying you believe in slavery.

I’m a physician in your community and you say you have a right to health care. You have a right to beat down my door with the police, escort me away and force me to take care of you? That’s ultimately what the right to free health care would be.

I don’t follow your argument.

When the Supreme Court ruled that states have an obligation to provide all criminal defendants with counsel, lawyers weren’t frog-marched out of their beds in the dead of night to represent anyone.  I have no idea what scenario you’ve created in the fevered reaches of your imagination, but I don’t think the “physician enslavement” policy you outlined above is even remotely plausible.  Do you expect anyone to take this seriously?  Do you take this seriously?

Your perplexed colleague,


PS.  It seems Jonathan Chait is confused, too.

Russell Saunders

Russell Saunders is the ridiculously flimsy pseudonym of a pediatrician in New England. He has a husband, three sons, daughter, cat and dog, though not in that order. He enjoys reading, running and cooking. He can be contacted at blindeddoc using his Gmail account. Twitter types can follow him @russellsaunder1.


  1. Its amazing that what appear to be thoughtful people will make arguments like this. Judging from others i’ve seen make similar statements i think its safe to conclude he truly believes this and hard core ideology rots brains.

  2. Galen wasn’t a slave, was he? Slaves aren’t allowed to participate in government, right? Can we reduce Paul’s vote from now on to 3/5th of a vote?

    • No offense, Chris, but this continues to bug the hell out of me.

      Slaves didn’t have 3/5 of a vote. Slaves had no vote at all. Their masters had (loosely speaking) an extra 3/5 of a vote. The problem wasn’t that 3/5 is less than 1. The problem was that 3/5 is greater than negative infinity.

  3. With regard to the idea of whether you have a right to freedom of religion, you have to realize what that implies. It’s not an abstraction. I’m a homeowner . That means you have a right to come to my house and turn it into a church It means you believe in confiscation.

    • I’m not going to defend Paul’s rhetoric, but the underlying point is the difference between positive and negative rights. A negative right, such as freedom of religion, obliges other parties simply to leave you the hell alone. A positive right, such as a right to health care, obliges some other party to actually provide you the particular good or service. Obviously that other party in most cases is just the government, and typically the government just hires a willing provider rather than applying the manacles.

      • I take your (and Sen. Paul’s) point about a positive right to health care, and understand how this is a major area of dispute.

        But he is positing a patently absurd outcome. His argument glances so lightly off of reality that it renders his entire viewpoint ridiculous.

        • As a physician, Dr. Saunders, are you familiar with…Schweitzer’s work on Bach?

    • Mike!

      Sorry Mike, have gotten a bit behind on music recommendations.

      You’ll love this. Glenn Gould, Canada’s favorite son, at his finest. A gone cat to be sure. I think every finger of his must be the equivalent to ten for us mere mortals. His voicing is perfection, immaculate–every note he plays is transcendentally revelatory to Bach’s grand scheme, the Goldberg’s Gone Wild!

      • Sorry–“(here he goes again)”–obviously, did not mean for these comments to go to, “Perhaps I Should Get Better Locks.”

        Although, come to think of it, it’s not entirely off topic. Bach, locks, opening locks–Bach opening perceptual beauty locks that reveal the Master and Commander of the Cosmos.

        Okay, a bit of a stretch. Sorry.

  4. Aren’t lawyers expected to perform pro bono work?

    • I’d like to know the answer to this, too. If the answer is yes, then I’d like to know how much work is required. If it’s particularly onerous, then maybe the requirement should be reconsidered.

      I would at any rate point out that being a licensed professional comes with certain duties and that one can leave the profession to engage in other pursuits, not exactly an option open to slaves.

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