No "Health Care"?

By Thomas Sowell

Tuesday, September 4, 2007

During the first 30 years of my life, I had no health insurance. Neither did a lot of other people, back in those days.

During those 30 years, I had a broken arm, a broken jaw, a badly injured shoulder, and miscellaneous other medical problems. To say that my income was below average during those years would be a euphemism.

How did I manage? The same way everybody else managed: I went to doctors and I paid them directly, instead of paying indirectly through taxes.

This was all before politicians gave us the idea that the things we could not afford individually we could somehow afford collectively through the magic of government.

When my jaw was broken, I was treated in an emergency room and was given a bill for $50 -- which was like a king's ransom to me at the time, 1949. But I paid it off in installments over a period of months.

Like most young people, I was lucky enough not to have any heavy-duty medical expenses that would have required major operations or a long hospital stay.

That is still true for most young people today, which is why many people in their twenties do not choose to pay for medical insurance, even when they can afford it.

They know that, in an emergency, they can always go to an emergency room. And today the idea that you ought to pay for that out of your own pocket is considered almost quaint in some quarters.

It is not uncommon -- especially in California, with its large illegal immigrant population -- for hospitals to have to shut down because so few people pay for the emergency room care they receive.

There are, of course, people with huge medical bills that they cannot possibly pay. Believe it or not, that also happened back before the modern welfare state.

Some hospitals -- whether public or private -- could absorb such costs, with the help of donors. There were people with polio living in iron lungs, which is why rich and poor alike gave money to the March of Dimes.

But that is very different from hospitals being stiffed every day by emergency room users whose only emergency is that they want to keep their money to spend on fun, instead of on doctors.

The biggest of the big lies in the "health care" hype is that a lack of insurance means a lack of medical care. The second biggest lie is that health care and medical care are the same thing.

Doctors cannot stop you from ruining your health in a hundred different ways, so statistics on everything from infant mortality to AIDS are not proof of a need for government to take over medical treatment.

Few people show the slightest interest in what has actually happened in countries with government-controlled medical care.

We are apparently supposed to follow those countries' example without asking about the months that people in those countries spend on waiting lists for medical treatments that Americans get just by picking up a phone and making an appointment.

It is amazing how many people seem uninterested in such things as why so many doctors in Britain are from Third World countries with lower medical standards -- or why people from Canada come to the United States for medical treatment that they could get cheaper at home.

Government price controls on pharmaceutical drugs are more of the same illusion of something for nothing.

People who are urging us to follow other countries that control the prices of medications seem uninterested in the fact that those countries depend on the United States to create new drugs, after they destroyed incentives to do so in their own countries.

Since it takes more than a decade to create a new drug, a politician can be elected president by hyping price controls on drugs, spend eight years in the White House, and be living in retirement before people start to notice that we no longer get the kinds of new medications that successively conquered deadly diseases in the past.

Thomas Sowell is a senior fellow at the Hoover Institute and author of Basic Economics: A Citizen's Guide to the Economy.

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