Okay, I can’t claim to have seen Sicko.  So I’m not writing to condemn it, or to slam Mr. Moore.  Whatever I may think of his political bent, he does have a way of rattling cages.  I can’t fault the guy for that.

I have, however, been reading some reviews of the movie.  And one of the things that comes through is the way that reviewers believe what Mr. Moore is saying:  everyone would be happier if health-care were free.  And who could deny that reality?  Free!  Everything that’s free is better!

‘Take money out of the equation.’  ‘Make health-care a thing that doesn’t depend on money,’ etc., etc.

I agree.  My ten-year-old son, Seth, has insulin dependent diabetes.  I appreciate the fact that my job allows me to give him access to excellent care.  He wears an insulin pump, which is an enormous advance over multiple injections each day.  His diabetes is going well, and he has the promise of a long life.  Money makes that possible, and for those without money, the possibilities are fewer.  Free care would be a wonderful thing.  I care for patients every day who can’t afford to pay their bills.  They could use some free care for their illnesses, too. 

It does seem an inequity that people struggle to get health care for purely financial reasons.  America has tried to patch that problem in various (usually ineffective) ways, from Medicaid to Medicare, from EMTALA to Social Security/Disability.

I suspect that we’re on our way to a national health insurance system, if not an entirely socialized system. 

I see advantages and disadvantages if this happens.  I suspect that for me, as an emergency physician, it will not change my income.  I’ll make less per patient, but be paid for everyone I see.  I’ll do OK, at least until someone figures out that I’m doing OK, and the government decreases my payments. 

That’s how I see the future of health-care.  Because it is so important, many people believe that it simply has to be free to be equitable for everyone.  See, necessary things are always free, right?  Like housing and food.  All you do is go to the store and ask for it, and you get food!  It’s a wonderful system we have!  Wait, that’s not right, those things aren’t free at all!

Well that’s all I want to point out. Even health-care in the purest idealized socialist system, in the most European, Marxist based, Castro-modeled, academic leftist dream-scape, won’t be free.  Get this:  health care can’t be free. 

It can be free to the people who receive it, provided they are low enough on the economic scale.  But to anyone with money, health care will cost something.  It will feel good to have those surgeries and prescriptions handed out without a bill. No question.  But it will come at the cost of very high taxes.  The money will come from the government, but governments don’t produce…they consume.  And what they consume is productivity in the form of taxes. 

If care in the US is socialized, look for very high income taxes, in the 50% range for most everyone with a decent income.  Maybe that’s where we have to go.  Maybe that’s the wave of the future.  I know many folks who will benefit enormously from that system.  I know some who won’t, and who will feel no desire to be financially productive when so much of their income is going to a federal program. 

I don’t know the answer.  Some days I’m ready to socialize it all, to make it easier across the board.  So everyone gets their antibiotics and procedures.  Some days I want to return to the days of McCartyism and sound a red scare at anyone who wants to offer free anything to some of the societal drags that abuse the system year after year, and in the process steal from me and from my partners.

But whatever way I swing, one thing remains true.  Free health care will never be free.  It will always cost something, and that thing it costs will be money.  And make no mistake about it. 

So however Michael Moore may present it, and however we all want to remove money from the equation, it will always be there, green and silver, staring back at us and demanding to be included in all our plans.



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