Universal health care: You'll pay one way or another

With Terri Sciavo in the hospital for a decade and a half, and with a friend of mine in the hospital, without insurance, with a stroke, the subject of government insurance has come up in my circle of friends.

The thing a lot of people don't seem to get is that if we had a universal health care scheme, we'd all be paying for it, one way or another. We pay for "free" health care – or anything else – in some coin or another. Medical care is a scarce resource, which means there is less of it than there is possible uses to which it can be put.

The various coins we may be called upon to pay include:

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• Money, in the form of taxes or "user fees".
• Time, waiting in line, waiting for an appointment, or awaiting your turn. Hopefully, you'll get treatment before you die. Or your doctor does.
• Self-respect. Too many providers treat the system as a welfare system, where health care is a gift of the State, and the subjects (no longer citizens) must show proper appreciation. You'll hear the occasional recipient of public funds talk about the amount of work they go through just to obtain the pittance they do get. That, too, is coin.
• Stuff that never gets developed – Just as it takes money to provide medical care, it takes money to develop new drugs and treatments. Someone has to pay researchers, someone has to pay volunteers for tests, someone has to buy raw materials for drugs and equipment, and someone has to pay for the overhead for the research facilities. If you impose a cap on how much a hospital can charge for a treatment, then you impose a cap on how much it's worth to spend developing a treatment. Sure, you can subsidize the research, but that's what you're doing. That money has to come from somewhere.

The free market has one advantage over systems that pay in other kinds of coin. Money can be traded on to the next person as far as you like. The doctor who collects a dollar from me can trade it to a plumber to fix a clogged toilet, who can trade it to a grocer for a candy bar, who can ...

Just try doing that with time, or with self-respect, or with inventions that no one thought it worth the cost to develop.

And by the way, my friend, with the stroke and no insurance, is in the hospital right now getting treatment. Even the uninsured don't get thrown into the street. At least not right away.

(And as it happens, the vast majority of "street people" are people who have problems upstairs, and need to be in a hospital for other reasons. And would be, except various rights groups decreed they have the right to live where they choose.)