The Reason Interview With Nick Gillespie

Jeffrey Singer: Get Government Out of Health Care

Apr 23, 2025

In a compelling discussion, surgeon and Cato Institute fellow Jeffrey Singer advocates for patient autonomy in health care, criticizing government overreach. He highlights how regulations like licensing laws and the FDA's drug approval monopoly hinder competition and innovation. Singer draws parallels between personal freedom and public health, exploring sensitive topics such as end-of-life choices and trans youth health care. With rich historical insights, he argues for a reimagined health care system that prioritizes individual choice.

52:04

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Jeffrey Singer

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Quick takeaways

Jeffrey Singer emphasizes the importance of patient autonomy in healthcare, highlighting its historical evolution and the need for informed consent in medical decisions.

Singer critiques government overreach in healthcare, arguing that regulations like CON laws and the FDA's drug monopoly limit competition, innovation, and ultimately patient access.

Deep dives

Patient Autonomy and Informed Consent

The discussion emphasizes the critical evolution of patient autonomy and informed consent within the healthcare system. Jeffrey Singer highlights the historic context by referencing Mary Schloendorf's landmark case in 1908, which asserted that patients must have autonomy over their bodies and informed consent before any medical procedure can occur. This case marked a significant shift from paternalistic medical practices, where physicians often withheld information from patients, to a more collaborative approach. Singer underscores that while doctors are now trained to respect and promote patient choice, the concept of autonomy is relatively new in medical ethics.

Intro

3min

From Paternalism to Patient Autonomy

5min

Navigating Healthcare Autonomy

21min

Rethinking FDA's Role in Drug Approval

11min

The AMA's Role in Establishing Medical Licensing

2min

Navigating Health Care Reform: Authority vs. Autonomy

3min

Redefining Gender Care for Intersex Infants

4min

The Ethics of Assisted Suicide and Government's Role in Healthcare

2min

Jeffrey Singer, a Cato Institute fellow and longtime surgeon, argues that government overreach in health care undermines patient autonomy, which should be the guiding principle in medical decision making. Drawing from historical examples and personal experience, he critiques licensing laws, the Food and Drug Administration's (FDA) drug approval monopoly, and Certificate of Need (CON) regulations as protectionist measures that limit competition and innovation. Singer contends that private institutions—like insurers, hospitals, and certification boards—already create strong incentives for safety and quality, making many government controls unnecessary.

Reason's Nick Gillespie and Singer also explore complex topics like end-of-life choice, trans youth health care, and antibiotic regulation, emphasizing the balance between personal freedom and legitimate public health concerns.

This interview was recorded at The Reason Speakeasy, a monthly event in New York City that doubles as a live taping of The Reason Interview. Go here for more information on upcoming Reason events.

Subscribe to the new YouTube channel for The Reason Interview With Nick Gillespie here.

0:00 — Introduction
0:50 — Singer's medical career
3:55 — Your Body, Your Health Care
8:40 — Government interference in your health care
14:23 — CON laws
20:00 — Licensing and credentialing rackets
29:48 — The FDA's drug approval monopoly
31:30 — The thalidomide scandal
34:11 — Off-label drug prescriptions
37:00 — FDA approval for naloxone and Plan B
40:20 — The American Medical Association's push for licensing
43:00 — RFK Jr.: reformer or madman?
45:05 — The food pyramid and other government follies
45:57 — Intersex infants and trans health care
50:09 — Right to die and patient autonomy