Sunday, September 6, 2009

The Faces Of Rationed Medical Care

Alida Valli and Rossano Brazzi

In this essay the living (Barack Obama), the dead (Ayn Rand) and two fictional characters (Kira Argounova and Leo Kovalensky) come together to reveal the faces of government-controlled, necessarily rationed medical care.

There is no longer any doubt that the health care “reform” being promoted by Obama and his Democrat Party acolytes amounts to an eventual government monopolization of American medicine, with inevitable rationing of medications, procedures and operations which will fall most heavily on the elderly. Indeed, Pat Buchanan recently made the powerful case that simply on the basis of population statistics, even with a lighter hand of government on the medical care valve than is currently proposed, elder care will be heavily triaged in favor of the young.(

In her recent article “Ayn Rand and Socialized Medicine” (, Erika Holzer argues that fiction is a powerful, albeit underutilized weapon in ideological battles: “The Ayn Rand novel so powerfully written that it causes the reader to ‘personally experience’ the horrors of bureaucrat-controlled health care is her first novel, We the Living. Whether or not you’ve ever read We the Living — first published in 1936 — I urge you to read (or re-read) it now. Better yet, read the book and [then] view the restored English-subtitled Italian-made movie of the same name.”

So far, the battle over Obamacare has been limited to non-fiction and editorial cartoons.

Fiction, let alone film, has not been deployed on the battlefield. Now, with the release of Ayn Rand’s We the Living on DVD, it can, and should, be. (For information about how to order the new DVD and a documentary about the film, see

The jacket copy of Random House’s sixth printing of We the Living describes Rand’s novel as a portrayal of “the impact of the Russian Revolution on three human beings who tried to shape their own destinies: Kira, who wanted to be a builder, and the two men who loved her—Leo, an aristocrat, and Andrei, a Communist. But she was living in a totalitarian state.”

The doctor asked: “Are you his wife?”

Kira hesitated, then answered: “No.”

The doctor said: “I see.” Then, he added: “Well, I suppose you have a right to know it. Citizen Kovalensky is in a very bad condition. We call it incipient tuberculosis. It can be stopped—now. In a few weeks, it will be too late.”

“In a few weeks—he’ll have—tuberculosis?”

“Tuberculosis is a serious disease, citizen. In Soviet Russia—it is a fatal disease. It is strongly advisable to prevent it. If you let it start—you will not be likely to stop it.”

“What . . . does he need?”

“Rest. Plenty of it. Sunshine. Fresh Air. Food. Human food. He needs a sanatorium for this coming winter. One more winter in Petrograd would be as certain as a firing squad. You’ll have to send him south.”

She did not answer; but the doctor smiled ironically, for he heard the answer without words and he looked at the patches on her shoes.
“If that young man is dear to you,” he said, “send him south. If you have a human possibility—or an inhuman one—send him south.”

To save the life of the man she loved, Kira began her quest to obtain medical treatment for Leo.

In the first State hospital she visited, the official in charge told her: “A place in a sanatorium in the Crimea? He's not a member of the Party? And he's not a member of a Trade Union? And he's not a State employee? You're joking, citizen.”

In the second hospital, the official said: “We have hundreds on our waiting list, citizen. Trade Union members. Advanced cases.... No, we cannot even register him."

In the third hospital, the official refused to see her.

There were lines to wait in, ghastly lines of deformed creatures, of scars, and slings, and crutches, and open sores, and green, mucous patches of eyes, and grunts, and groans, and—over a line of the living—the smell of the morgue.

There were State Medical headquarters to visit, long hours of waiting in dim, damp corridors that smelt of carbolic acid and soiled linen. There were secretaries who forgot appointments, and assistants who said: “So sorry, citizen. Next, please”; there were young executives who were in a hurry, and attendants who groaned: “I tell you he’s gone, it's after office hours, we gotta close, you can't sit here all night.”

At the end of the first two weeks she learned, as firmly as if it were some mystic absolute, that if one had consumption one had to be a member of a Trade Union and get a Trade Union despatchment [referral] to a Trade Union Sanatorium.

There were officials to be seen, names mentioned, letters of recommendation offered, begging for an exception. There were Trade Union heads to visit, who listened to her plea with startled, ironic glances. Some laughed; some shrugged; some called their secretaries to escort the visitor out; one said he could and he would, but he named a sum she could not earn in a year.

She was firm, erect, and her voice did not tremble, and she was not afraid to beg. It was her mission, her quest, her crusade.

She wondered sometimes why the words: “But he's going to die,” meant so little to them, and the words: “But he's not a registered worker,” meant so little to her, and why it seemed so hard to explain.

She made Leo do his share of inquiries. He obeyed without arguing, without complaining, without hope.

She tried everything she could. She asked Victor for help. Victor said with dignity: “My dear cousin, I want you to realize that my Party membership is a sacred trust not to be used for purposes of personal advantage.”

She asked Marisha. Marisha laughed. “With all our sanatoriums stuffed like herring-barrels, and waiting lists till the next generation, and comrades workers rotting alive waiting—-and here he's not even sick yet! You don't realize reality, Citizen Argounova.”

This “reality”—of government monopolization of medical care, of its favored allies receiving preferential treatment, of the disfavored being shunted aside, of the unconnected left to perish—is what Obamacare will inevitably lead to in the United States of America.

But, ironically, a possibility for Leo to survive did exist under the Soviet system, at least in theory, which will probably not be available under Obamacare.

It took a month, but at the end of a month, she was convinced that the door of the State sanatoriums was locked to Leo and that she could not unlock it.

There were private sanatoriums in the Crimea. Private sanitoriums cost money.

I will not give away Rand’s resolution of this part of the plot line, but instead simply note that informed opinion in the United States today believes that Obama’s ultimate plan is to monopolize entirely all medicine and pharmaceuticals under government control. Which is to say, monopolize entirely under government control the power to decide who lives and, especially, who dies: criminals, the elderly, Down syndrome fetuses, “three generations of imbeciles” (see

In the scenes quoted above from her novel, Rand has written eloquently of what such monopolization did to Kira Argounova’s quest to save her lover’s life—words which can, and should, be used in the ideological/political battle that we’re now fighting.

But there is an even stronger tool available.

As Erika Holzer mentioned (, We the Living is also a motion picture. In that film the scenes quoted above, and a similar one which precedes it, are depicted with heart-wrenching dramatic effect. They can be viewed at We the Living-Depictions of state-run health care.

Those who would fight Obamacare and all that it necessitates and implies—and do so with maximum effectiveness through the use of powerful moving images—should assist all of us in promptly disseminating this video throughout the Internet.