By Selwyn Duke

Much bad policy is born of a lack of perspective.  This occurs to me when I think about our concerns over health care and the gravitation toward socialized medicine.

While we definitely have problems relating to health care that can be addressed (mostly caused by the government, in my opinion), often ignored is that much of our negativity arises from expectations about how much things should cost.

Expectation is an interesting thing.  I like cheap gasoline as much as anyone and remember the days when it was under a dollar; yet, I also find it interesting when people behave as if three-dollar gas is a violation of a Commandment.  The truth is that a gallon of soda can cost that much and premium bottled water even more.  Of course, some may say that we need gasoline; it is almost the lifeblood of our economy.  Although I wouldn’t call it a "need," it’s certainly true that it is more important than sugary carbonated water.  But isn’t the fact that it’s more valuable a good reason why it should cost more?   

Then, perhaps you remember that tempest in a teapot some years ago over automatic teller machine fees.  Many of these machines charge people a couple of dollars per transaction, and some folks were exercised about the fact that they had to pay such a price to obtain their own funds.  Why, it became such a cause celebre that some politicians got involved, pandering as they tried to curry favor with the masses. 

I look at it a bit differently than most.  I remember a time when there was no such thing as an ATM, when you couldn’t find cash machines anywhere and everywhere.  No one complained that they actually had to go to their bank during normal hours to withdraw cash; no one said, "This is outrageous!  There really ought to be machines in every store from which people can get money."  Yet, now we have this new service — one that we used to easily do without — and people complain because they have to pay a couple of bucks for it.

For my part, I avoid such machines for that very reason — it takes only a modicum of planning to get cash ahead of time at my bank.  Besides, there is something called a credit card.  But when I do occasionally have to use one, I appreciate the service and understand that the business offering it isn’t a charity and doesn’t put a gun to my head.  And many people must feel likewise, because if there was no market for the service at the going price, it either wouldn’t exist or the rates would be lower.

This is the power of expectation.  People become conditioned to expect certain goods and services at a certain price.  Then, when market conditions change and the price rises, it’s considered some sort of violation. 

Other than conditioning, there is little rhyme or reason to people’s expectations.  I would personally be more upset over the price of dry cereal, as paying $4 or more for sugary dry grain is a bit laughable.  But I don’t get upset; I simply wait for the products to be on sale or buy the no-frills brand.  The market is as the market does.

The same phenomenon is evident in the health care debate.  People expect medical procedures and drugs to be relatively inexpensive, but why?  Sure, 100 years ago medical treatment cost a mere pittance by our reckoning, but they didn’t have modern drugs and diagnostic procedures and the capacity to prolong life the way we do today.  We can’t expect the prices of a bygone era unless we return to its standards.

And the price of advancement can be staggering.  A new MRI machine costs one to two million dollars to buy and approximately eight hundred thousand dollars a year to run.  As for medication, to research, develop and bring a new drug to market costs over one billion dollars.  Moreover, I heard that malpractice insurance for an obstetrician/gynecologist in Long Island, NY, cost $120, 000 a year.  And this was about 15 years ago.

I know, like a neighbor of mine, some will say, "But health care is so important.  It shouldn’t be about profit."

That’s nice.  Very idealistic. 

The problem is that economic principles don’t suddenly suspend themselves and offer special dispensations for "important" services.  They are like laws of nature and don’t differentiate between desires and needs, what’s imperative and what’s frivolous.   They are unbending.  If we want quality in a field — any field — there must be a profit motive commensurate with the risk involved in the business endeavors in that field.  Economic principles won’t give us gas more cheaply than sugary water, low ATM fees, cheap dry grain, or reasonable health care out of a sense of compassion.  In fact, it’s often the opposite: If something is valued more highly and is in demand, the price tends to rise.

Again, there are problems relating to health care that we can and should address; tort reform that might ultimately lower the cost of malpractice insurance is one of them (talk to Little Boy Sue John Edwards about that).  But our lack of perspective is what really concerns me, as our unrealistic expectations make us easy prey for statist demagogues. 

And we’re already seeing the effects of embracing bad policy.  The medical field is becoming increasingly unpalatable for its practitioners, and doctors are leaving it in droves.  Tragically, the people replacing them are often very poorly qualified.  As one apolitical physician I’m close to said, "We’re getting the bottom of the barrel."  Alas, that’s what happens when you demonize profit.

The hard, cold truth is that we’re killing the goose that laid the golden egg.  We should truly hope that God blesses us with good health as we age, because we will not want to find ourselves at the mercy of what medical care is becoming. 

Think about this when you have a chance to vote for Hillary-care next year.