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Reality Is Not Optional

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In my most-recent column for the Pittsburgh Tribune-Review I imagine a wholly unrealistic – as in, politically wholly unrealistic – response to one of Elizabeth Warren’s foolish statements [2]. A slice:

“Consider health care. For government to pay for everyone’s health care is for government to further increase each American’s incentive to overuse health care resources. Just as I’m more likely to order steak and lobster, rather than meatloaf, if the restaurant charges me nothing for my meal, I’m more likely to avail myself of highly costly medical care, rather than less costly care, if I’m shielded from the cost of doing so.

“For example, rather than go to an optician to be fitted for new eyeglasses, I’ll instead go to a more highly trained ophthalmologist. Why not? I’m not paying for it! And I won’t ever learn of the person with a serious eye disease who the ophthalmologist would have treated and cured had that highly specialized physician not instead spent time doing for me what an optician could have done perfectly well.

“Because what’s true for me is true for everyone, health care resources are over-used when government pays for our health care, thus driving costs to artificial heights.

“I know: You’ll respond that when people need medical care they should have unlimited access to the very best care. This line sounds good. And it would be fine if resources weren’t limited. But because resources are limited, providing unlimited amounts of the very best health care to everyone is simply impossible.

“Therefore, relieving us Americans of having to pay directly for our medical care will oblige government to ration care. That’s an inevitable result of causing the demand for many kinds of health care to exceed the supply. There’s no avoiding the need to prevent people from consuming all the medical care they seek to consume when they don’t pay for it directly.

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