There's a lot of talk about health insurance, the uninsured, single-payer, co-pays, and other topics related to health care, but everybody ignores the real question - how do we limit demand for health care?
If the government gave everybody free food, taxpayers would pay a lot of money, but there's a limit to how much anybody can eat. Unfortunately, there is no limit at all to how much health care a person can want.
I have a friend who lives in a town which lets people on welfare go to the emergency room for free. Last week, she had stomach pains, so she went to the ER. After a CAT scan and some tests, they concluded it was gas. A couple days later, a trailer truck blows sand in her eye, so it's back to the ER for ointment and an eye patch. When she goes back the next day, everything's fine. The next day, she thinks she's having an asthma attack. The ambulance takes her to the ER for lung scans, oxygen, and an inhaler. The next day she goes to the ER for back pain. As luck would have it, she sees the same doctor. He's fed up by now so he gives her pain pills without doing any tests.
What did all this cost? Scans are $3,000 to $5,000 and can be a lot more. Blood work, eye washes, ambulance rides, it all adds up.
So far, human wisdom has found two and only two ways to limit demand for health care. In England, Canada, and a lot of other places, they limit demand by fixing the annual budget for health care. If people want more services than the budget can handle, they wait in line. Enough people die in line to stay within the budget. People with money come to the US and pay for their own health care rather than wait.
The other way to limit demand is by price - if you can't pay for the operation, you can't have it.
My friend doesn't pay anything for medical care; she goes to the ER like it's her second home. If medical care is free, how do we limit demand?
That's the only real question about health care. Everything else is a detail.