Capitol Ideas

When the Luck Runs Out

A trip to the hospital has a way of clarifying the problems in our health care.

By From the September 2012 issue

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I DON'T BELIEVE I EVER WROTE an article about medical care. Now I will, mainly because my own health became an issue overnight. First I’ll say something about that, then I’ll take a quick look at the new health care law.

Early one morning, still in bed, I knew I had to go to the bathroom—quickly. But it turned out to be blood, and a lot of it. Then more of the same about an hour later. Then still more. I called 911 and was taken to the emergency room of a nearby hospital. More bleeding and I was admitted, although that took hours. Then more problems, including fainting when I went to the bathroom. At that point I was put into the intensive care unit, and I stayed there for two and a half days.

I don’t want to identify the hospital, but I was well taken care of. I have no complaints. But intensive care is not something that I can recommend. You are hooked up to gadgets that ring and ding more or less whenever you move. So sleep, indeed rest of any kind, is hard to come by. At least I was alone in the room and I didn’t have to listen to someone else’s television or snoring. My wife brought me a couple of C.S. Lewis books from home. A visiting doctor saw them and immediately said that The Great Divorce was his favorite Lewis book. I was impressed by that.

I began to see how much the trial lawyers have added to the cost of medicine. Everything is double and triple checked. But nothing in the tort law department is likely to change any time soon. Charles Kraut hammer has commented on this but liberal columnists and editorial writers generally ignore it. “The trial lawyers own the Democratic Party,” Krauthammer said.

It turned out that I had diverticulosis (not “-itis”), characterized by “pockets” in the colon wall. Sometimes you get one near a vein, which is why I had a good deal more bleeding than is normal. They gave me a colonoscopy—unpleasant because of the jugs of fluid you have to drink beforehand. But I was drugged and was hardly aware of the actual operation. I’m glad to say that nothing more serious was found.

I felt weak and tottery when my wife picked me up and drove me home. I slowly recovered—then I received the hospital bill. It was over $53,000. The bill said “for information only,” and I hasten to add that I do have Medicare. My wife, who knows much more about these things than I do, says she thinks that Medicare will cover most of it. Most? Not all?I’ll find out in due course.

NOW FOR THIS LITTLE DETAIL: As far as I know, except for a few brief intervals, I had no medical coverage for 35 years, between the ages of 30 and 65. As they say, I “got lucky.” I never had to go to the hospital in that time, except once, briefly, and on that occasion the doctor’s office that I had visited had to pay, for reasons too complicated to explain. I have also been fortunate enough to see doctors only rarely.

According to recent estimates, about 50 million U.S. residents lack medical insurance. Some put the figure higher. The number is often used without qualification to urge the nation to enact reform. But according to Carpe Diem, a blog by Mark J. Perry, an economist with the University of Michigan and a visiting scholar at AEI, surveys show that about 18 million of those uninsured had incomes over $50,000. Most of them could afford basic health insurance. In Michigan, Perry said, people aged 18 to 30 could get insurance through Blue Cross starting at about $50 per month—about the cost of a basic cell phone plan. Individuals under 65 could get coverage for $138 per month—comparable to a cable TV and Internet bill. Perry added this:

Since most households making $50,000 or more can afford multiple cell phones and cable TV, it would seem like they could also afford basic health insurance, and choose not to buy it. If they say they can’t afford health insurance, they should consider canceling their cell phones and/ or their cable TV service. If they choose cell phones and cable TV over health insurance, that’s a voluntary choice.

That was in 2009, so the numbers may have changed since then. But it’s certain that the uninsured include many who are voluntarily so. About 56 percent of the uninsured are under 35. The young often make a rational calculation that they don’t need health insurance because most young people in this country enjoy good health. That was my own reasoning.

As to the Affordable Care Act, otherwise called Obamacare, most of us know by now that the new law obliges us to have insurance. Those who refuse will be penalized. According to the Supreme Court’s recent controversial ruling, that penalty is a tax, which renders the law constitutional. Citizens will now be “taxed” if they don’t have health insurance by 2014.

The reason for this, of course, is to make premiums of younger people subsidize the growing ranks of the insured, particularly those with “pre-existing conditions,” who will now be covered.

Here’s Mark Perry again, this time in 2010:

The federal government wants to require young, healthy people to buy insurance because if they don’t, premiums for everyone else will go up. Insurance companies need low-maintenance, young customers on their rolls so they can raise money to cover benefits for lesshealthy people the health care bill will require them to insure.

Inevitably, this mandate will be shot through with exemptions. Native Americans and undocumented immigrants are already exempt, and more exclusions will no doubt follow. Congress is good at this kind of thing—passing laws with “afterthought” loopholes.

I wonder how many young people know they are being burdened with taxes to help the rest of us. They pay into Social Security, but will it be there for them 40 years from now? I doubt it. A young niece commented: “I can’t say that this has been a huge topic of discussion within my group…” Fact is, young people are too busy to think much about the distant future. And that makes them a good group to tax; they probably won’t notice, and many will happily go on voting for Obama.

THE BEST COMMENT on the new health care law was made by Nancy Pelosi: “We have to pass the bill so that you can find out what is in it,” she said. That was in March 2010, when she was still House Speaker. Not known for irony, Pelosi certainly never read the bill’s 2,700 pages herself. (It’s impossible to read because it keeps referring to sections elsewhere in the Federal Code.) The “you” in Pelosi’s quote should be “we.” She is right that we are going to find out what’s in it, but that won’t happen until long after the election.

The one thing we can say for sure is that the new law will turn out to be a lot more costly than the Democrats claimed. But they won’t care, because they see insuring people (with other people’s money) as a moral imperative that trumps all budgetary considerations.

In time, it’s likely that medical costs will be held down the same way they were with Britain’s nationalized health: by rationing, queuing, and postponing care.

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About the Author

Tom Bethell is a senior editor of The American Spectator and author of The Politically Incorrect Guide to Science, The Noblest Triumph: Property and Prosperity Through the Ages, and most recently Questioning Einstein: Is Relativity Necessary? (2009).