“Why don’t you Americans want free health care?” That’s what a Portuguese friend asked me the other day, as he tried to understand Americans’ growing disgust with Obama Care. “It’s an excellent question,” I told him, “but for all the wrong reasons.”
First, who wouldn’t want free health care? Free? Bring it on. I have a well established position when it comes to free goods and services. I’m for them. The problem is they are extraordinarily rare. In fact, free is as elusive as the perpetual motion machine. Just as a machine needs an external source of energy to keep running, goods and services have associated costs, which are born almost without exception, by those who use them.
Just calling something free doesn’t make it so. When I rented my house here in Portugal, my landlady told me that the gardening service was included. Free! What that really meant was that she hoped I would retain her gardener, the price of whose services had already been incorporated into my rent. The gardener isn’t free; the way in which I pay him has just been concealed. My landlady is pretty good at that sort of thing (Free pool maintenance too!) but any government in the world makes her look like an amateur by comparison. Governments are the undisputed masters of concealing cost.
I tried to explain this to my friend. “What do you mean by free,” I asked. Of course he said that free meant no cost. “Do doctors in Portugal not get paid,” I asked, “Because I don’t want to be examined by a doctor who doesn’t get paid.”
“Of course they get paid,” said my friend, with a small note of irritation in his voice.
“Well who pays them then?”
“The government pays them,” he said, with that note in his voice rising, as if he were dealing with a moron.
“And where does government get the money with which it pays for all the free doctors?”
“From taxes,” he said. He’d lost the irritation now, and was speaking to me very slowly and clearly, as if I were a child.
“And who pays taxes,” I said, leaning into it now, drawing him out.
“Everybody pays taxes,” he answered.
I’m not sure that’s technically correct, because it seems that legislators grant themselves exemptions every time they come up with new taxes, but I didn’t want to interrupt our momentum, so I let it slide.
“So you pay for your health care with your taxes, right?” I said, waiting for the eureka moment.
“That’s right,” he said, nodding eagerly. He too, sensed we were on the verge of a breakthrough.
“So it’s not really free if you’re paying for it, is it?”
“But the government pays for it,” he said.
Now my friend is no idiot. He is reasonably well educated and has a good job. He’s in his mid thirties and has been working for a living for long enough to know which end is up. Still he, and most Europeans, cannot seem to think beyond the myth that has been ground into them since they were old enough to strap on backpacks and trudge to school. “Government knows better than you do how to spend your money, and only egomaniacs and Americans think any differently.” I could tell he was struggling with this as we talked, and although he eventually ceded the point that nothing paid for with taxes is free, I doubted that I could move him beyond that realization any time soon. If I could, I would explain that, not only are those things not free, but they are a worse deal than if you had paid for them yourself.
Maybe some day, after he’s digested our discussion a little more, I’ll get to explain how taxes go to pay not only for doctors, but also pay for a small army of administrators hired by the government to run the program to pay the doctors. So whatever amount of our money the government feels should be taken from us for medical care is diluted at the outset by operating expenses. Because of its overhead costs, and government’s tendency to grow, the government will never be able to purchase more efficiently than an individual. I’ve had this discussion here with other people, and I’m usually told that, because the government can buy in bulk, it can get better deals. I even remember hearing this once from a teacher when I was in middle school. It made no sense to me then, and it makes even less now. How many doctors will think it’s a good business plan to get less money per patient, but to make up for that by seeing more patients? How many patients will want to be under the care of a doctor who is forced to spend less and less time with them because he or she must see an ever-increasing number of patients in his or her fixed amount of working hours? Buying in bulk is great for paper towels, but it’s a lousy approach to health care.
Besides, just as the hand that feeds becomes the hand that controls, the agency that pays for things is the agency that gets to parcel those things out. Once citizens accept the (false) premise that “the government” is paying for a service, they have surrendered to the government all authority over decisions regarding that service. In my limited vocabulary, that’s called rationing. I may not agree that anyone has a right (or entitlement) to health care (no more than anyone has a right to food, if that means they can help themselves at any restaurant or grocery store) but I reject outright the notion that anyone in government should have the authority to decide for me what services I should be able to access, as long as I can pay for them.
It all seems like common sense to me, and you’d think it would make ring true to people like my friend, who must notice the unraveling of the vast Ponzi scheme of European socialism. The greatest problem with socialism though, isn’t the wet blanket it throws on economies. Socialism is most dangerous because it dampens the human spirit. It not only strips people of their incentive to work hard and make the most of themselves, but also implies that doing so is presumptuous, even rash. Socialism has taught Europe that refinement and maturity are measured not in a man’s ability to think for himself, but in his willingness to entrust his destiny to others deemed more worthy than he, simply because they work for the government.