‘Free medical care’ isn’t really free

The scene was the ER of an Air Force base hospital.

I was the MOD (Medical Officer of the Day). Not much going on. Some of the crew were listening to the radio. The atmosphere was a bit like that before a thunderstorm. We knew that soon we would be very busy. And then they came. The waiting room became full to overflowing. An airplane crash? A multiple motor vehicle accident? Nope, the movie just got out, and virtually all the complaints were trivial (the serious non-emergent cases waited for referral to a distant, larger hospital). You see, medical care was “free”.

I can’t get over my friend Erik Steele’s column of July 9, in which he wrapped in the flag, with reference to the U.S. Constitution, a call for “universal access to health care” (read total government control of doctors and hospitals). Wrong prescription.

Rationing medical care, in one form or another, will always be a fact of life. No nation can afford to give everyone everything they want anytime they want it. Presently in this country personal economics and employers have a role in limiting supply. In a government-run system, supported by taxes, there is also a limit to what the taxpayers will bear, thus long waiting lines and outright inaccessibility to certain technologies.

Yes, the USA is alone among the industrialized countries in not having state-run “universal access.” This is not to say, however, that our incremental approach has been wrong. Who would willingly trade what we have for what exists in Canada or England? Ah, they say, ours will be better funded! What they don’t add, is through higher taxes! You think Maine is taxed enough? You ain’t seen nothin’ yet if the push for Maine’s going it alone in a single payer system comes to pass! And what would that do for the image of our state as not a good place to set up a new business?

Single payer advocates stress fairness. Is it fair for you and me to pay for the millionaire’s colonoscopy? His medicines? Our efforts should be directed to helping those who truly need assistance.

As one who has spent many years recruiting new physicians to Bangor, the thought of Maine’s adopting a totally government-run system is a very depressing thought. As it is now, if Maine’s doctors and hospitals had to rely totally on what Medicare and Medicaid paid, many would go out of business. Not only would such a system kill our recruitment (which is challenging enough as it is), but we would inevitably see the exodus of many physicians from the state.

Dr. Steele’s reference to the Constitution is ironic. Its glory is in its unique limitation of the powers of government. The Founding Fathers were rightly suspicious of allowing the government large and unchecked powers.

“Free medical care” isn’t free. Maine may soon be a test case. Will our public fall for the siren song of the Utopians who promise everything without reference to the cost? If that should happen, and all medical policy decisions are made in Augusta and Washington, there will be no turning back. We have many government-run systems to observe and evaluate. Surely this country has the good sense not to join them!

Alan W. Boone, M.D. recently retired from 32 years of practice and medical administration in Bangor.