Recently, one of my sons facetiously suggested that we turn the air conditioner down to the lowest temperature and open the windows to cool it off outside.  I made the comment that this would help with global warming.  We all had a good laugh but then I started thinking.  This is Keynesian economics.  Just as my son’s suggestion discounted the heat contribution of the compressor and fan, Keynes’ economics discounts the damage done by the accumulation of debt and the depreciation of currency.  This is also a clear demonstration of Bastiat’s “What is seen and what is not seen,” no?

But isn’t this also Obamacare?  What is seen will be many more people with insurance cards/coverage.  What will be discounted (not seen) will be the fine print on the card:  “this gives you a right to hope for care,” or “this gives you a right to die in line.”  The physicians fees associated with this plan will be low.  Really low.  So low that no one will see these patients.  This is intentional.  Medicare for everyone. This fee fixing below cost is the purpose of the IPAB (independent payment advisory board).   Rationing will be the result and the doctors will be made out to be the bad guys, nevermind (discounting) the price offered for an office call or heart surgery will be well below the market-clearing price.  How many cars would a car dealer sell if forced to sell them below his cost?  How well-stocked would the grocery store be if the owner were forced to sell the items below cost? 

Ask a Medicare beneficiary sometime how hard it was to find a doctor to see them after relocating.  Most physicians don’t want to see Medicare and Medicaid patients because the payment is poor and hassles are intense(make a mistake on a claim form and you can go to prison for fraud).   Obamacare just made it worse for the Medicare patients and others on government plans.  Access to care is a problem for the uninsured but will be much more so for those on government plans like Medicare and Medicaid.  Ask a physician who he’d rather see, a Medicare patient or someone paying them what they can out of their pocket.  That uninsured individual who was paying for their care will now have that money taxed out of their pocket and will be in a line, rather than in the doctor’s office.  The money taxed away from him will go to the cronies who wrote this bill, not for his care. 

Will this new UCA (Unaffordable Care Act) health care guarantee care?  No.  Many will be denied access to care because they have this new “insurance” card in their billfold.  If you are “covered” by an insurance that pays a physician less than he is willing to see you for, he is …..ready?….not going to see you.  If you have nothing, he’ll probably see you out of charity.  It is another thing altogether to put a gun to his head and tell him he is going to see UCA patients and be paid significantly below the market clearing price.  Many insurance cards will be seen.  The denial of access and rationing will tend to be discounted or not seen.

Are there people who fall through the cracks and have poor access now?  Yes.  This is the fault of the government and their prior interventions in to the business of health care (tax code discriminating against individual purchases of true insurance, for instance).  The court’s ruling on the UCA represents the institutionalization of “falling through the cracks,” rather than the exception.  I believe that this bill was meant to create sufficient chaos in the medical marketplace that many will beg the government to ride in on their white horse and rescue us from the crisis they have caused with their ultimate goal:  a single payor system.  

As Walter Williams has said, “if you want to boil a frog, put him in cool water first so he won’t know what’s going on and won’t jump out.  Next thing he knows, it’s too late to get out.”  We all need to work to identify all that is not easily seen and protect ourselves with a healthy amount of skepticism from those who, as representatives of “the government,” are “here to help us.”

G. Keith Smith, M.D.