Statist Medicine

by R.J. Rushdoony

(Although written in the middle of “The Cold War”, this article on government-sponsored medicine is relevant to the health-care debate going on today. –Ed.)

An important book published recently is Alexander Podrabinek’s Punitive Medicine.1 The author is now serving a sentence of exile in Siberia. This is a careful and documented account of the use of psychiatry for political purposes in the U.S.S.R.

Notable opponents of the communist regime are discredited by being sentenced to mental institutions, there to be drugged and tortured into submission. The psychiatrists act on orders from above. They justify this prostitution of their profession by saying that no man in his right mind would speak out, take a stand against, or contradict and challenge the state system and the official ideology. “Normalcy” and mental health to them means living with the system. To question or fight the system is for them not a normal act nor a sensible one; hence, it is a sign of mental problems.

Thus, mental health is defined by conformity to the Marxist order, not by a sound mind in relationship to God, and to men in and under God. Normalcy and mental health become whatever the state decrees and does. Such a definition is very close to that of the Western democracies and their schools; men are group directed, subject to group dynamics, and are trained to regard the behavior of those resisting the group as “deviant.” (One mother of an intelligent boy, whose father was a noted scientist, was called to the public school to discuss her “deviant” son. His “problem,” which brought him under suspicion, was a preference for reading over playground horseplay.) The group is the norm; society determines standards and mental health. The Marxists have simply put this humanistic standard under more disciplined direction: not the group, but the state, determines normalcy and mental health.

As a result, we have what Podrabinek calls “legalized lawlessness.”2 The new psychiatric “hospitals” are less evil,3 but all grow in perversity with time, and sadism becomes the order of the day among doctors and guards.4 No doubt, the courage of the resisters is a reproach to them, and intensifies their sadism and evil. Added to this is the fact that orderlies use patients for sexual perversions.5

The Soviet definition of mental health as conformity leads to strange diagnoses such as these: “She is suffering from nervous exhaustion caused by justice-seeking;” “You have schizo-dissent,” and so on.6 “Soviet psychiatry does not allow any opportunity for conscientious refusal to adapt.”7

Very aptly, Juliana Geran Pilan calls all this “The Shame of Soviet Medicine.”8 The problem is not restricted to psychiatry but is common to all medicine in Marxist countries. For example, venereal diseases are dogmatically called “bourgeois.” How can a bourgeois infection exist in a socialist paradise? It not only exists but is very widespread, although not acknowledged. No statistics are given on V.D.; it has supposedly been abolished. Because it has been abolished, there are no clinics to treat it. The unhappy patient must go to the “dermatology” clinics for treatment! Dermatologists visiting the Soviet Union are assumed to be specialists in venereal diseases.

The same is true of narcotics. The newspapers like to write about “The Absence of Addicts in the Soviet Union: One More Proof of the Superiority of Communism Over Capitalism.” All the while, the use of drugs flourishes, and a drug culture is very real.9

The point is clear. Diseases and problems do not “exist” unless the Marxist state allows them an official existence or recognition. Medical training is controlled; doctors and psychiatrists are controlled; hospitals are controlled; drugs, like all medical practice, are a state monopoly. The medical profession serves the state, not the patient. Doctors are a part of a bureaucracy which has a state-controlled life and conscience.

Punitive medicine? Of course. It cannot be otherwise. As Podrabinek notes: “Punitive medicine is a tool in the struggle against dissidents who cannot be punished by legal means.”10

The most serious mistake we can make is to treat punitive medicine as a Soviet aberration. We should instead see it as the logical conclusion of all socialized medicine.

The advocates of socialized medicine believe that such a step would bring more medical care to the poor and needy. The fact is that, at least in the United States, the poor have usually had more medical services rendered to them than any other class. The fact of their poverty has made them the recipients of free services, or subject to very nominal fees, and hence they have more readily used doctors.

But the problem goes deeper. Ostensibly, socialized medicine will serve the people. Senator Edward M. Kennedy, in his book, In Critical Condition, The Crisis in America’s Health Care (1972), sees socialized medicine as “the choice of conscience.” “The government” will supposedly have a conscience and a concern for the poor which doctors ostensibly lack. Private practitioners, whom he sees as grasping businessmen, will somehow all become Good Samaritans when the federal government controls them. His picture is a passionate, selected, and extremely partial one. It is also very unrealistic.

There is no reason to believe that socialized medicine anywhere will serve the people any better or as good as private practice. On the contrary it will serve the federal government. Let us remember, after all, that the Sixteenth Amendment (the income tax) was voted into the U.S. Constitution in the name of helping the poor! The income tax was to be limited to “soaking the rich” and distributing the wealth. It would make a freer and happier America possible. The worker would come into his own, and there would be a better America after all.

There is no reason to suppose that a socialized and federalized medicine will be any more benevolent that the Internal Revenue Service. The I.R.S., after all, was created with at least equal idealistic motives. Anyone who can think of the I.R.S. as the people’s friend today does indeed have mental problems! Socialized medicine will be no better than the I.R.S., and potentially far worse. Any and everything which puts us into contact with a powerful state and its bureaucracy is dangerous, and socialized medicine will place us in a very close relationship to that power-state: at pregnancy and childbirth, in ill health and accidents, for a variety of required medical examinations, and much more. Also, as euthanasia becomes an accepted practice like abortion, the more the state knows about you, the less safe you are.

Already, of course, the hand of the state is very heavy upon all doctors. Medical schools are extensively subsidized and thereby federalized. Because of funding, the medical school looks as much to Washington, D.C., as it does to the general practitioner, or the surgeon, and their problems. Hospitals are also serving the state and are more ready to displease doctors and patients than federal authorities. What the state controls serves state purposes.

Thus, Alexander Podrabinek’s Punitive Medicine gives us merely the avant garde aspect of the new medical practice, socialized medicine.

It is a very logical development. The state is a punitive agency or institution. Its purpose is to punish or to vindicate. Its basic and truest instruments are the courts, the police, and the military. Their purpose is to punish or to vindicate. The life of the state is geared to punitive action. St. Paul, in Romans 13:1-4, makes clear that the true function of the ministry of justice (the state) is to be a terror to evil-doers. The state is the agency of coercion. The church’s function is to educate; industry’s function is to produce, and the medical professions’ function is to heal. To place the healing arm of society under the coercive or punitive arm is the height of folly and unreason.

No realm taken over by the state has escaped its coercive and punitive nature, to the detriment of its original function. Thus, before the states in America took over education, the United States had the world’s lowest illiteracy rate and a remarkably capable populace. Today, after a century and a half of Horace Mann’s evil “reform,” state control of education, we have our highest illiteracy rate in history. Jonathan Kozol, in Prisoners of Silence, gives us some very alarming estimates, from federal and other sources. The Office of Education estimates that fifty seven million Americans are unequipped to carry out the most basic tasks. This means over 35% of the entire adult population. Some place the figure as high as sixty four million. Perhaps twenty three to thirty four million of these are illiterate; the rest can barely function. Illegal aliens, who may number as high as eight million, are not in these statistics at all. Kozol is a liberal, a concerned liberal. How does the teachers’ bureaucracy deal with all criticisms of its incompetence? With evidences of illiteracy among teachers themselves? Typical of its reaction is an article on “New Right’s Attack on Teachers” in the Tennessee Teacher, April 1980. Well, it is all an ugly conspiracy! “Since we as teachers believe in public education and in professional dignity, then surely we see the New Right as very wrong—a dangerous threat to the freedoms we inherited and continue to espouse.” A bureaucracy calls itself the vessel of freedom! This is 1984 and newspeak indeed! It is also the voice of monopoly and unreason. Coercion remains in the public schools, because they are agencies of the state: compulsory attendance laws, the persecution of Christian Schools, and the like. But education is disappearing.

There is no reason to believe that socialized medicine will be any better. It will rather become punitive medicine.

Thus, the problem is not merely a Soviet problem: it is our problem as well.

The sphere of the state is the ministry of justice according to the Bible. Its activities are properly punitive, and its jurisdiction must be limited to those areas which are legitimately punitive. Healing is not one of these. When the state takes over all areas, coercion prevails in all areas. As a result, because no independent, uncoerced, and free voice exists, corruption is the bribe. Without it, the economy would collapse.11 As Brokhin further observed: “There will be a Watergate-style scandal in the Soviet Union. No party boss ever has been or ever will be brought to trial and jailed for bribery, corruption, or theft. If one corrupt high official were ever sent to jail, all the rest would have to go too, almost without exception.”12 Where charges of corruption are made in the U.S.S.R., they are a façade for a personal vendetta, or for coercing dissent.

American life—and medicine—needs to be preserved from statist controls. Punitive medicine is not an agency of healing but an aspect of total terror. Those who seek it should be viewed with distrust. At the very least, they suffer from moral and intellectual myopia.

  1. An important book published in 1980 is Alexander Podrabinek’s Punitive Medicine. The author served a sentence of exile in Siberia. This is a careful and documented account of the use of psychiatry for political purposes (at the time in the USSR);
  2.  Ibid., 99.
  3. Ibid., 34.
  4. Ibid., 30ff.
  5. Ibid., 31.
  6. Ibid., 78.
  7. Ibid., 77.
  8. Reason Magazine, January 1980.
  9. See Yuri Brokhin: Hustling on Gorky Street, pp. 74, 121.
  10. Punitive Medicine, 63.
  11. Ibid., 97.
  12. Ibid., 102. 

(From the Chalcedon Medical Report #8, an early Chalcedon Foundation newsletter, as republished in Dr. R.J. Rushdoony’s Roots of Reconstruction book (first published in 1970 and updated in new editions through 2003), pp. 499-503. )

© Used with permission of Chalcedon Foundation (

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