Vin Suprynowicz

What was it like to go to a doctor in America 60 years ago?

The family doctor couldn’t offer high-tech diagnostic tests or treatments, mind you. But neither would you find the office full of employees negotiating on telephones with Medicare, Medicaid, or private insurers, trying to determine what treatments would be “covered,” and what percentage of the doctor’s real costs the “coverage” would pay.

Charges would seem quite low, by today’s standards. Many doctors treated “charity cases” for free, though that was their own decision. Most Americans paid their modest bills on the spot, or arranged their own, ad hoc, “time payment” plans.

What was it like trying to buy a telephone in America, 60 years ago?

You couldn’t. Most telephones — largely identical, heavy black desk sets — were owned by a monopoly enterprise which only rented them to consumers. You couldn’t even unplug a phone and move it to another room — you had to call one of the company’s “installers” to do such work. A “mobile” or “cellular” phone? What’s that?

Today, no one complains about a lack of choice or technical innovation in telephones. Because the old monopoly was broken, hundreds of suppliers now compete for consumer dollars by offering smaller and lighter portable phones with ever greater capabilities, at prices so low even children carry personal telephones — in a choice of colors.

There’s no ponderous phone-subsidizing bureaucracy threatening to bankrupt the nation, called “Phonicare” or “Phonicaid.” The free market works great, providing a service it’s now hard to imagine doing without. Furthermore, we’re free to go “phoneless” any time we choose.

On the other hand, American medical care over the past 60 years has come under increasing government regulation, control, and economic dominance, thanks to the welfare-state schemes called “Medicare” and “Medicaid,” which were supposed to make medical care “more affordable” for the poor and elderly.

Each of these schemes has overrun its intiial cost estimates, not by a mere 10 percent or 20 percent, but by a factor of 10 to 20. In company with “Social Security,” their costs will soon dominate the entire federal budget.

Now, “Optimists say” the $848 billion “health care reform” package drafted by Senate Majority Leader Harry Reid, D-Nev., “would eventually reduce both private premiums and the swelling cost of government health care for the elderly and poor,” reports Lori Montgomery of the Washington Post.

“Pessimists,” on the other hand, “fear the initiative would leave Washington struggling to pay for a new $200-billion-a-year health program even as existing programs require vast infusions of cash to care for the aging baby-boom generation,” the Post reports.

By imposing new taxes now, but phasing in “benefits” only over a period of years, the Reid bill is rigged to fool federal 10-year cost analysts into believing it will shave “less than 2 percent from deficits projected to top $9 trillion over the next decade.” After that, the Congressional Budget Office figures its impact on federal deficits projected to balloon to roughly 14 percent of the economy by 2035 would be minimal.

“The hope that health-care reform would take care of our budget problem has evaporated,” admits Isabel Sawhill, a fiscal expert at the Brookings Institution.

Furthermore, the budget-balancing act assumes Congress won’t later renege on imposing new taxes and spending cuts. “Many budget experts also worry that lawmakers may not have the stomach to keep the new taxes and spending cuts intended to pay for the package,” The Post reports. “Republicans are already planning to offer an amendment to strike more than $400 billion in proposed Medicare cuts from the package, a move that would blow a huge hole in financing for the bill.”

In merging bills drafted in committee, meanwhile, Sen. Reid “significantly watered down” two of the most important “cost-containment” provisions: an independent commission to automatically restrain Medicare spending, and a tax on high-cost health insurance policies that was opposed by the labor unions. (For the record, taxing the rich is not “cost containment,” any more than it “reduces your food budget” to rob a convenience store so you can afford to keep eating steak.)

This is like watching a skilled carny operator shift the three walnut shells, in hopes we can find the one that contains the pea. Problem is, the fellow palmed the pea way back at the start.

White House Budget Director Peter Orszag insists the legislation “creates a feedback and continuous improvement loop that will allow us to learn as we go,” while insisting that “Doing nothing is guaranteed to fail,” since — without change — health care costs are poised to swamp the federal budget.

Leaving aside how much confidence is instilled by the admission that the administration plans to “learn as they go” after being handed trillions more dollars — kind of like buying a new Cadillac, handing the keys to your 13-year-old, and saying “Go out and learn the drive, son!” — the final statement is simply not true.

The costs of each American’s “health care” can’t do a thing to the federal budget. If the costs exceed what each American can afford to pay, they will — they must — simply boycott the more expensive treatments till prices come down, as always happens when supply exceeds demand.

(For the record, the same thing would happen if the government stopped subsidizing low-interest student loans. College attendance would drop; the colleges would then trim costs and reduce their tuition and fees to recapture some of that business.)

No, what threatens to “swamp the federal budget” is the arrogant assumption that the federal government can and should “cover” all the medical costs anyone chooses to run up.
What Washington should be doing is reining in or planning to privatize Medicare and Medicaid. Instead, they plan to make all medical care “free” for everyone, and promise us it won’t cost a thing.

If you believe that, let’s go to the nearest ATM and draw out your life savings. Then, I’ll bet you can’t figure out which walnut shell holds this little pea …