As Hippocrates Said, 'First, Do No Harm'


WASHINGTON — Washington. -- Because Bill Clinton was a Southerner, a leader of the Democratic Party's moderate Democratic Leadership Council, because he ran as moderate and has pursued numerous programs and policies begun under previous administrations -- many people concluded he was in fact a moderate, who would govern within familiar boundaries.

Then came the largest tax increase in American history, and in foreign policy a ''peacekeeping'' policy based on dramatically new conceptions of U.S. interests.

Now comes the Clinton plan for health-care reform -- a plan radical in its assumptions and its goals -- which would ''nationalize'' one-seventh of the U.S. economy and set in motion the most far-reaching, most revolutionary experiment in social and economic engineering tried in this country in this century.

Though sometimes described as one more extension of the welfare state and its ''security net,'' the Clinton plan is not about weaving medical security nets.

It is not about providing health care to those who cannot afford it or funding health care for the needy.

It is not about training more or better physicians and nurses or persuading them to move into areas where doctors are scarce.

It is not about providing more or better health care or encouraging competition or preventing monopolies and their associated abuses.

It is about a massive transfer of power to the federal government, and vesting in government the power to control access to medical care, to allocate medical resources, to control prices and salaries, and to make decisions affecting the life and death of virtually all Americans -- except those few lucky enough to be born or die so quickly there is no time to clear their intentions with designated primary-care givers.

The Clinton reforms do not reflect the familiar American approach to reform. They do not provide incremental change. They do not tinker with the market. This proposal would eliminate the operation of the market entirely in medicine -- and establish socialism in a single sphere.

Under the Clinton plan, what is now determined by supply and demand, by hope of profit and consumer choice would be determined by national health boards. The incentives of the market system would be replaced by the coercions of state's regulation.

Under the Clinton plan, price controls, salary controls, budget caps and designated health providers would cut the nexus between work and reward. The bureaucratization of health-care delivery would cut the link between patient satisfaction and physicians' incomes, between excellence and reward.

The Clinton proposal makes all the mistakes typical of socialism.

It ignores the expectations of doctors about the reward for long years of education and training. It disregards ties and confidences between patients and physicians. It treats the tens of millions of people affected by the proposed health reform as if they were ciphers who can be moved about, assigned and reassigned, rewarded and deprived at will, organized and reorganized on the decisions of wise, disinterested bureaucrats operating from an all-powerful federal government.

I find it incredible that the President and Mrs. Clinton believe Americans are so passive and that American society is so malleable.

The Clinton health-care reform package would be a larger step toward collectivism than the New Deal and Fair Deal combined. As Franklin Roosevelt and Harry Truman knew, those were reformist programs that preserved the essen- tial elements of the capitalist system. This plan does not.

Only in wartime have we given government the power to allocate, ration resources and impose price controls -- as the Clintons plan to give government now. Because this kind of statist economics does not work, former Communist countries of Eastern Europe and socialist democracies of Western Europe are privatizing, deregulating and diminishing the role of the state in economics -- hoping, thereby, to infuse in their economies some of the energy and success of the American economy.

I do not believe the Congress will pass this plan, which effectively deprives us of the doctors whom we have chosen, limits our access to specialists, to second opinions and advanced technology, and would deliver us -- ill -- into the hands of a great new bureaucracy.

I believe Congress will remember its ''immediate dependence on the people'' and respect the desire of the overwhelming majority of Americans to maintain control over the decisions most vital to themselves and their families.

American health care is already the best in the world. Some tinkering can make it even more widely available and responsive to our needs.

So let Congress tinker. But especially in dealing with medical care, let it remember Hippocrates' injunction: ''First, do no harm.''

Jeane Kirkpatrick is a fellow of the American Enterprise Institute.

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