Think Health Care Is Expensive Now? Wait Until It's Free

Recently I asked students how much it cost for a doctor visit. “My mother pays fifteen dollars,” said one.

“Fifteen dollars? I asked.

“Yeah,” he said. “That’s what she paid.”

“Okay,” I said, “But is that all it cost?” I pointed out that the average doctor visit costs between $95 and $265.

“She has insurance,” he said, “and they paid the rest. I didn’t know it cost that much.”

Many adult Americans don’t either and that’s our biggest problem with health care reform. I explained that people sometimes have a small “co-pay” and the rest comes from somewhere else. Those with insurance pay monthly premiums whether they get services or not. The poor, and people claiming to be poor, may have a small co-pay, and government uses our tax money to pay more, but it still doesn’t add up to the total cost of the visit - or the surgery, or the therapy, or whatever. To make up the deficit, providers charge patients with insurance more than the cost of their services, products or procedures - that’s why an aspirin can cost $13 at the hospital. Some doctors or dentists won’t take patients who won’t pay themselves or who don’t have insurance, because they can’t afford to make it on what government pays. Hospitals, though, have to take everyone. There’s no such thing as free health care, but more and more consider it their right.

It would be simpler if we all paid out of pocket, and that’s what 90% did before World War II when, according to economist Thomas Sowell, only about 10% of Americans had insurance. When government took over the economy during the war it imposed wage controls, so if a company wanted to woo an employee, it offered health insurance as a fringe benefit. That’s how employer-provided insurance caught on. However, many small businesses still can’t afford to offer it - especially lately. Huge, third-party government bureaucracies, and private ones too, add enormously to the cost of health care.

If we pay $95 or more out of our own pockets for doctor visits, it won’t be for frivolous reasons. We certainly wouldn’t pay $1000 for an emergency room visit unless it were a genuine emergency. However the poor, and those claiming to be poor, pay nothing for a such visits - or for an ambulance to drive them, so they’re much more likely to go for frivolous reasons like hangovers or gas pain, driving up costs enormously. Central Texas hospitals report that 82% of emergency room visits are people on “Medicaid or SCHIP.” According to the Austin American-Statesman:

In the past six years, eight people from Austin and one from Luling racked up 2,678 emergency room visits in Central Texas, costing hospitals, taxpayers and others $3 million, according to a report from a nonprofit made up of hospitals and other providers that care for the uninsured and low-income Central Texans.

If President Obama mentioned anything like this in his big speech to Congress, I didn’t hear it.

Notice I keep saying “or those claiming to be poor”? Many can hide how much they make, appear poor to government, and be eligible for “free” medical care. What percentage of the “poor” are really poor? A minority? A majority? Impossible to say. But we can safely conclude this: If we think health care is expensive now, wait until it’s “free.”

If more go under Obamacare, the deficit between what government pays and the actual cost of the services will also grow, forcing doctors and hospitals to pass along those costs to patients with private insurance - driving up premiums even faster. Then, unbelievably, Obamacare would actually tax those private plans. Don’t believe it? Check out studies by both government agencies like the Congressional Budget office, and private studies like one by PriceWaterhouse Coopers. This is what Democrats call “reform.”

Congress and the White House are determined to impose government-run medicine on Americans in the model of Canada and the UK. Economist Thomas Sowell sheds a little light on what Americans could expect:

In Canada, according to a provincial government website, 90% of Ontario patients needing hip replacements waited 336 days. In Britain, the wait is a year. As for technology, a 2007 study by the Organisation for Economic Co-operation and Development (OECD) showed that the number of CT scanners per million population was 7.5 in Britain, 11.2 in Canada and 32.2 in the United States. For Magnetic Resonance Imaging (MRI) units, there was an average of 5.4 MRIs per million population in Britain, 5.5 per million population in Canada and 26.6 per million population in the United States.

That’s why people in Canada wait about six months for an MRI. Dogs in Canada, however, can get one the next day because government doesn’t control veterinary care.