In my most recent video blog for the Free Market Medical Association, I describe what will happen if we expand Medicaid. Read the transcript here:


Hello. Dr. Keith Smith with you on behalf of the Free Market Medical Association. Thank you for joining me. We hope to see you all at our meeting next month, the details of which can be found at


What if I were to tell you that if I took a cup of water out of the shallow end of a swimming pool and poured it into the deep end, that the overall water level would rise? You would think I was crazy. That is simply not consistent with common sense.


What if I were to offer you my home for 40% off? Your reaction should be, “40% off of what?” At which point I would say, “Well make that 50% off.” You would still want to know, “50% off of what?”


This is exactly how economics works, predominately in the United States, in the healthcare industry. The free market does not work in this way. Prices are transparent and everyone can see them. We are surrounded, and the healthcare industry in particular, is surrounded by really bad economics. There are really bad economics everywhere. For instance, people who believe we can tax ourselves into prosperity. I actually heard someone say that we shouldn’t let very many prisoners out of prison because it would cost too many guards their jobs.


This is the kind of economic thinking that really is not consistent with common sense. It is not uncommon to pick up a newspaper and see where some town has been ravaged by a natural disaster, but there is always someone, some economist typically, who will comment how great this is going to be for the local economy.


These are really bad economic ideas. One of the worst I’ve ever heard is that if we expand Medicaid, it will actually help the economy. Well, it will help the economy of some, it will help the economy of people whose pockets have been lined, but it will not help the economy overall because any money that is used to expand Medicaid first has to be taken out of the economy; it has to first be taken from individuals. Because government, after all, has no money that it has not absconded with from individuals in the first place.

Expanding Medicaid as an economy booster is a truly bad economic idea. Not unlike the idea that we should not stamp out gangster crime because high-rolling gangsters frequent very nice restaurants and all the people at the restaurants would lose their jobs.

This is the type of economic thinking that is predominately present in healthcare. At the Free Market Medical Association, you can attend the conference and have conversations like this and many others with people who think clearly about the free market and about economic ideas in particular as they pertain to healthcare.

We hope to see you all there. Thank you for joining us.