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Comment by cjfd | Hacker News Reader

This is nonsense. Most/all democracies have laws that only certified doctors can practice medicine. This makes doctors unequal from other people. Is this incompatible with democracy?

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Democracy is about equality of rights, not equality. People are not equal in every aspect, but they should be equal in front of the law, for example.

Freedom is not absolute because your freedom stops where somebodys freedom beginns.

Hence, if you practice medicine without qualifications there is a high chance you will hurt somebody. It is not undemocratic to protect against hurting others. Hurting others is not a right.

Interesting thought exercise though.

> Is this incompatible with democracy?

Yes. This is why every society of note limited the franchise prior to the 1900s. You can only have debates among equals among people who are equal. The sort of equality communists imagine requires that you either radically re-engineer the human pysche or implement Harrison-Bergeron-style handicaps on exceptional people.

Depends on what the doctor can do with that inequality. If it means the doctor gets paid 20 times more than others then yes that is incompatible with democracy, as over time that wealth difference will be used to increase the inequality. But if the power is limited to only decisions about health, which is necessary for healthcare to function, then it should be acceptable. You'd still have to make sure that even that level of power is not used to gain more power, though.

One can argue whether 20 times more is too much or too little but I would say that it is correct that a doctor gets paid quite a bit more than unskilled labor. Some people who become doctors might still go through with it if it were not but most (sane) people would not go through the lengthy and very demanding path that is medical school and residency if it was not a better paid than a job that very many people could do. I can tell you here and now that I don't think I personally would have had the stamina to become a medical doctor.

Sure, I can agree with that. There does need to be some kind of incentive to do jobs that enough people don't naturally want to do. But the differences in rewards should be kept as small as possible and created only as a last resort. As I said, power concentration should only be allowed if absolutely necessary. If no one wants to become a doctor, then I'd consider it absolutely necessary to increase the incentives of doing so bit by bit until we have enough doctors while keeping in mind the risk that comes with the power differentials created. At some point an extra doctor might not be worth the extra risk of power concentration.

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