Recently I have been having a discussion in comments with a reader positively disposed toward some sort of government provided health care. As some of the points raised may be interesting to my readers, I thought I would mention them here for the benefit of those who don't read comments.

One of the complaints raised by my commenter is that without insurance he would have been forced to wait for early diagnosis and preventative medicine. And granted, under the current system, those who lack funds or insurance do often have to wait, make do with less than ideal medicine and so on. However, that is true of every commodity on earth. Anything in limited supply, which includes medicine, will be distributed in such a way that everyone cannot get as much as they want. That is the very definition of an economic commodity. If everyone could have as much as they wanted whenever they wanted, it would no longer be an economic commodity, it would be a free good such as air.

As medicine is an economic commodity, whether provided by the free market or the government, there will be limitations on how much is available and when. Currently the limits are largely set by a combination of insurance policy and your own willingness and ability to pay. There is also some charity, and the government controls a sizable chunk, so there is already some government decision making for the elderly and poor, but by and large you decide through your choice of insurance*, and your decisions to pay, what care you will get**.

When the state takes over, they will control what care you get and when. And, judging from both their "effectiveness study" plans, and from health care provided in other nations,t he primary solutions will be long waits and outright denial of care. Services which are deemed "not cost effective" simply will not be available. Other services will be kept affordable through rationing. Where now those who are able and willing to pay can get an MRI when they need it, while others may need to wait, in the future all will simply have to wait.

But at least it will be free, right? Well, that is the second lie. If the government is equally efficient (and there is reason to doubt that), then they will still need to pay every bit as much as you do now. There is no such thing as a free lunch. And as Obama's attempts to break his tax promise show("Translating Political Statements"), those costs will not fall only on "the rich". In the end, you will likely end up paying slightly more to get a lot a less.

And that does not even take into account the other negatives we have seen in nations fofering "universal health care". the tendency for the best and brightest to avoid medicine as a profession due to the bureaucratization, low pay and second guessing by government regulators***. Not to mention the inefficiencies, waste, and graft involved in any government enterprise ("Government Efficiency"). As well as political decisions("Confirmation of My Argument"), which tend to make sensible cost control measures impossible. In the end government always provides things at a greater cost than the private sector.

Let me close this on one thought. Those same people who now tell us the government should be entrusted with providing us with wonderful health care at no cost to us are the same people who were recently telling us what a hell on earth Walter Reed was. If they believe the government could not even provide adequate health care for a smaller group when supplied with more than adequate funds, how do they think the government will provide us with superior care when they are providing it to everyone with very minimal funds?

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* As tax policy has tied insurance so tightly to employment, we no longer think of insurance as a choice, but it is. you can still obtain private insurance, even if your employer also provides it. (Ideally we would separate insurance and employemnt but even under the current system, it is still a choice to keep your present employer provided insurance. See "Almost Right")

** There are many who will argue "the poor have no choice", but by and large they do. Being poor is, for most, a choice. They chose not to study, not to get a job, not to stay sober, not to show up at work. There are cases where disability or true misfortune kept people from earning money, but by and large poverty is a choice. Maybe not everyone can make it to great wealth, but people can choose to earn more in most cases. And, if you truly worry about your health care, then you can take a larger part of your income and put it toward health insurance or care. See, still a choice. There are a few exceptions, but they cannot be allowed to set the agenda, any mroe than we should create cars with the blind in mind or design concert halls around the ends of the deaf. (Also, see "Subsidizing Irresponsibility and Poor Planning" and "Perverse Incentives" for a discussion of the consequence of subsidizing those who choose poorly.)

*** I know a number of people in the medical field (including my wife), and even now, with much less government involvement, the bureaucracy tends to frustrate them enough that some consider changing either professions or specialties, to something less constrained by rules.

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POSTSCRIPT

One other thought. When all medical care is "free", won't the trial lawyers be able to argue that the "standard of care" should be near perfection, as everyone should get anything they need? That being the case, won't malpractice cases become even more prevalent and even more damaging to the profession? As the Democrats owe so much to the trial lawyers, I doubt they would shut off this lucrative field, but as they can't afford to allow the lawyers to sue the state, I foresee something akin to the "super site cleanup fund", a massive lawyer slush fund run by the government to pay off dubious malpractice claims. And guess who gets to fill that lawyer feeding trough with their tax dollars?

POSTSCRIPT II

Some think that eliminating "inefficiencies" in private health care will make government provided care cheaper. However, that argument is based on two incorrect premises. First, that the government is more efficient than the private sector, which experience proves incorrect. ("Government Efficiency") And, second, that profits, advertising, and other free market costs as waste". As I argue in "Misunderstanding Profits" they are essential features and bring savings many times greater than their costs. Eliminating them will not only eliminate those "costs", but also the matching savings, leaving us with higher costs despite the nominal "savings". The truth is, the state simply cannot manage an profit making enterprise as efficiently as the private sector ("Bureaucratic Management","The Limits of "Scientific" Management"), and health care is a profit making enterprise. Yes it is essential to life, but so is food and we do not socialize that. Just because something is vital does not mean it should be run by the government. Almost always vital goods are better provided by our fellow citizens and not the government.

POSTSCRIPT III

I would normally provide a list of previous posts here, but, as I feel this topic will become more prominent as the topic come sup more and more, I am planning a sort of "socialized medicine round-up" article very soon, so I will leave my links until I post that article.

As I did not provide my usual welter of links, let me suggest readers check out the following: "A Thought on Healthcare","Why Obamacare Will Fail", and "The Secret Behind the Rhetoric". Along with the posts linked above, they provide a fair picture of my thoughts on ObamaCare and why it will fail to provide what it promises. I would also recommend "Appealing to Arrogance", it provides a little insight into those who argue "Yes, I was wise enough to provide for myself but those other people..." I have written a lot on the topic of our view of "other people" and the way it colors our political beliefs, and this is probably the best place to start examining that topic.