Fareed Zakaria, noted editor of TIME magazine and known plagiarist recently tweeted this:

“A pure free market model simply cannot work in providing health care unless we’re willing to let people who can’t pay die.” 

My first inclination is to ask him who should be given credit for having said this first.  Let’s break his (maybe it’s his) statement down.   First, he assumes that without government, those who can’t pay wouldn’t receive care.  The fact is that it is the very intervention of the state, rigging the game for their crony pals (insurance and hospital buddies) that made healthcare costs explode, making access more difficult.  People within the Medicaid system have worse health and outcomes than those without insurance.  This is the compassion of the state.  We should ask how many people have died because we did not operate within a free market medical model, perhaps. 

Zakaria also confuses government with society.  Remember Bastiat’s lesson:

“Socialism, like the ancient ideas from which it springs, confuses the distinction between government and society.  As a result of this, every time we object to a thing being done by government, the socialists conclude that we object to its being done at all.”

There is nothing preventing Mr. Zakaria from donating some of his ill-gotten gains to a foundation or fund that helps the poorest among us obtain medical care.  I sometimes think that statists promote and embrace lots of government programs to hide their unwillingness to assist their fellow man.  They’d rather be in control of spending other folks money, rather than write a check themselves.

There is more to his little sound bite, but it is subtle.  Look closely at the last part.  “…unless we’re willing to let people…..”  He’s saying we are all in this together.  He’s saying that we bear the burden and the guilt of this path communally, isn’t he?  This is typical of the seasoned statist busybody.  He is saying that this is a “national” problem, not a local one.  He is also saying that we need a “system,” not a case-by-case sort of local approach.  He’s also saying that if you disagree with him, you’re a killer.

Let’s go further.  The last part of his soundbite is also revealing.  “…willing to let people who can’t pay die.”  Here he is saying that it is within our power to prevent death.  Wow.  This part discounts the extent to which people lead suicidal lives, doesn’t it?  The morbidly obese smoker with a family history of heart disease:  are we “letting this person die” or are they killing themselves, to some degree?  Why should money you are saving for your kid’s college be confiscated from you to help this individual whose behavior is a self-destructive black hole? 

Inherent in his statement is the hospital propaganda about the costs of care being so high.  As I have said, “healthcare doesn’t cost that much, but what the hospitals charge for it is another matter altogether!”  (It’s fun to quote myself while writing about a plagiarist.)  Hospitals like utility companies have what economists call high “fixed costs.”  After the initial expense of starting these companies, the cost of adding an additional customer approaches “zero.”  The additional cost of seeing another patient in the emergency room, once this institution is built and staffed, approaches “zero,” contrary to all we’ve been told.  Just because hospitals charge 70,000% mark ups on supplies and drugs doesn’t mean that their costs are high.  Very simply, it doesn’t cost much to provide the care that Zakaria says folks would die without. 

Finally and most offensively, Zakaria’s statement makes clear that he believes that if a physician is not going to be paid, that physician will provide no care.  Actually, the truth is that if a hospital is not going to be paid, they will likely provide no care.  I know this because we see patients all the time that hospitals have refused.  Unlike the hospitals, who as I have said wave the charity flag with one hand and fleece the taxpayers for their uncompensated care payments with the other, when we provide charity care, we do it for no charge, or for a minimal charge.  Does providing 10 gall bladder surgeries for what the hospitals charge for 1, mean that we provided 9 charity gall bladder surgeries?  I don’t think Zakaria would see things that way.

I hope this wasn’t a boring blog.  His statement was so loaded up with statist assumptions, I couldn’t resist. 

G. Keith Smith, M.D.