I anesthetized a man with laryngeal cancer the other day.  Nice guy, no insurance.  He will soon be bankrupt, but not because of any bill we sent him.  Not because of any bill that his surgeon will send him. 

He will be bankrupt because the system is corrupt.  He ultimately will require chemotherapy and radiation, neither one of which is available to him without going to a big hospital.  His radiologist (even though working at a hospital) will not send him huge bills.  His oncologist (unless they are a hospital employee) will not send him huge bills.   The hospital will bankrupt him.  The drugs he will receive are unnecessarily expensive for a number of reasons, all but one of which are due to government interference.  The FDA, whose purpose is to limit new competing manufacturers by enforcing rules and regs which only the big boys can comply with, drives the price of new drugs through the roof (you didn’t think the FDA was there for your safety did you?).  This occurs due to the rules and regs themselves and also due to the lack of real competition that results from enforcement of the rules and regs.  The hospital adds the final blow by adding a markup to these drugs of up to three thousand percent.   That’s right..no typo. 

If he needs to actually enter a hospital or requires a tracheostomy, his bills will easily overwhelm his finances.  Merciless hospitals will gladly keep adding to his tab as their take from the uncompensated care scam (where they get rebates from taxpayers for the amounts they bill for which they aren’t paid) depends on generating large and un-payable bills.  All the while these hospitals will “poor mouth” it talking as if they are going broke from patients like this man.  They will also make a point to educate all of us about their value to the community, as if bankrupting this man qualifies.

This man’s bankruptcy will be the work of the American Hospital Association.  It will be the work of the big insurance lobby and that of big pharma.  It will be the product of their greed and that of those in government all too willing to accept their bribes to make their bankrupting way of doing business the law. 

These corporate suits have now written a health care bill that will completely finish off their small competitors, paving the way for the abuses that only companies without competition can get away with.   This is corporatism.  This is fascism.  This is what Frederick Hayek warned us about in his “Road to Serfdom.”  The only thing worse than government, is government in bed with big business.  We don’t need to make sure everyone has insurance so these companies can make even more money.  We need to talk honestly about the costs, as very few of the costs in the health care marketplace can be justified, let alone even discovered. 

Unless we wake up to the government-enabled scams of the health cartel, we will find ourselves on “kill” lists to spare their stock prices.  I don’t think our soon-to-be bankrupt laryngeal cancer patient will survive to  see the kill lists, but you and I will, unless a bold and fresh market-driven approach is adopted.

G. Keith Smith, M.D.