AHC: Make an Iatracratic State

I recently saw this word in a dictionary once 'iatracracy,' it means rule by physicians but to the best of my understanding there is no example of and actual iatracracy anywhere in history. Your challenge is to explain how medical doctors could establish themselves as a ruling class and manage to rule their country for at least 15 years.
 
My POD would be after 1900, but have the spanish flu hit even harder, and have the medical professionals in one of the countries accuse the government of being retarded. A war weary population would believe these accusations, having just survived a devastating world war, which they blame the government for.. Then a doctor would run for public office, on a program of pacifism and some weird form of health-socialism. Getting the vote, he'll start to fill the government with medical professionals, would do a good job and this continues for some years.
 
I love the idea - there are some defacto situations that might arise i.e. Theocracies and Meritocracies. But the idea is fascinating.

I don't think it is that hard either - it is fundamentally the usurpation of power by a scholar class. I think the reality is that an Iatracratic state is more of a flavour of a Bureaucratic state - with the Doctors having the power because, hello - the not only have the respect of the people they care for, but they also have the army on their side because they stitch them up!

I think you'd want to look at how a highly trained minority group can integrate itself into a society and be respected rather than feared. I did a weird old piece about how Phoenician settlers could eventually become the Pharaohs of Egypt (see here) - and I think having a large number of charitable doctors might be the ticket. The charity works get them respect, whilst they're slowly working themselves into powerful positions. Canny doctors start using the respect they earn to dominate their families (which could include scribes, merchants, etc) and eventually become the advisory class to the Pharaoh.

--

If you want a pure Iatracracy - I don't know how feasible it is, but having a ruler that relies on the health of their people for power doesn't seem that removed from the rule of the village elder, or clan leader. I think if you have some sort of horrible disease in a moderately advanced area, you've got the chance of the doctors effectively getting the reward for saving many people. It is a bit handwavy, but perhaps you have something like cholera - with a priesthood that revers water, and a medical class that has cottoned on to the vector of cholera early. Priesthood is wrecked. It isn't hard to see how the idea that the Gods should be revered for saving them seems bonkers, when the Priests all die.

Cue rebuilding, respected doctors essentially lead the community, and the King/Army relies on their support for the support of the people. If the King is gone, I could see level-headed doctors try and co-ordinate with each other, effectively building a flat system, and appointing one of their number to co-ordinate everything, leading to a hierarchy.
 
I remember reading a science fiction setting once where a society got so caught up in public health laws that eventually the Public Health Service was de facto running the country. They took it to farcical extremes, including all imports being sterilize before entry into the country and there were even public health SWAT teams that would arrest and forcibly quarantine sick people "for the greater good". A huge bureaucracy evolved around public health, and a lot of the laws and regulations were not subject to things we would take for granted in the criminal system (such as in the U.S. things like habeas corpus, Miranda, right to a lawyer, etc.) because these were all administrative actions. See civil asset forfeiture for an example of how such travesties work.

You'd probably need a pretty scary health environment for this to work, though, so that the public would be willing to tolerate it. Something like the 1918 epidemic might do it, but it would be better if it were ongoing. One option I could see- since there historically were some pretty draconian public health laws about it OTL- would be a mutation of TB that makes it survive desiccation better and thus be even more easily spread. (TB is the reason for the "no spitting on the sidewalk" laws that you hear about.) An easily-spread consumption epidemic in the 1800s or first couple of decades of the 1900s would be moderately terrifying. I could see roving "no spitting" enforcers in the cities and government-run consumptive concentration camps sanitariums. Etc. This would be before effective treatment of TB was developed, but then the public health bureaucracy continued to run things even after there was effective treatment available out of bureaucratic inertia, though they assumed new concerns. Prohibition! (The PHS vs Al Capone?) Mandatory annual checkups! (With, probably, a single-payer national healthcare system pretty early.) Genetic hygiene laws with forced sterilization! (After all, OTL.) And, eventually, trans fats and tobacco banned!
 
Last edited:
Top