As usual, Mr. Sowell hits the political nail right on its head.

As an health insurance broker, I have tried to educate my prospective clints on all the aspects of health insurance policies. Knowledge used during the selection process is good.

More than once a male prospect asked me why were maternity benefits in the policy. Being single, he did not want to pay a premium for that. It was a mandated benefit. Same with reconstructive repair due to a mastectomy. It goes on and on.

All worthwhile benefits - but, SOMEBODY has to pay for them.

Politicians looking good. Hope we change that to a thing of the past.

Tom,

As usual, brilliant. Your column sums the entire catastrophe we now call health care. I am experiencing the same problem with the health insurance premiums now. The premiums were increased by 22% in November 2009 and just this past month, the premiums increased $134 per month again (I think 18%, give or take). Of course my age and some health issues don't help matters; but, what's a person to do.

Duke

Dr. Sowell always has critical insight to the real issues. This can be summed in his comment that "there is no free lunch."

Politicians keep promising a free lunch and many voters choose to suspend disbelief and vote for the lying pols.

One needs to look not much further than procedures that are not "covered." Cosmetic breast implants, nose jobs, laser vision correction, etc. The historical cost curves of these procedures show the market at work. They are cheaper now in real dollars than they were The "covered" part of the health care cost curve shows the horrific mess that ensues when the market is regulated and distorted to the point it ceases to function.

Mr. Sowell, your analysis, as usual, is spot on. Government involvment in the healthcare industry now is largely what has driven up the current costs of healthcare. Imagine a large pie shaped water-balloon representing the cost of healthcare for 300 million Americans. Along comes the government (under Lyndon Johnson in 1965) with Medicare and Medicaid it lays a large brick on our metaphorical water-balloon to hold down costs for seniors and low-income adults and children. Given that the largest percentage of patients seeking treatment probably fall within these categories, that brick covers a large piece of our pie-shaped water-balloon. Would you say 65%, 75%, more or less? Well the point is - What happens to the remaining 35 to 25% of our water-balloon cost pie... IT SWELLS UP LIKE A GOITER ON THE NECK OF OUR HEALTHCARE SYSTEM. When a government directly takes a hand and interferes in ANY market system, supply, demand, costs, and pricing are ALL affected... adversely. Just my take on it. Great article, thanks.

Subsidize it and it gets bigger, tax it and it gets smaller. Our economy will never recovery from the assault by this group in DC. When you can call the insurance company for coverage while your house is burning, and govt subsidy/mandate says they can't turn you down, they go out of business. We all pay then. Reminds me that when my taxes get raised I increase the price of my products so even the people not making the 200K a year have to pay. America is being devoured by the disease called liberalism.

Bill, that's a good way of putting it and illustrates the Statist path our government is bent on taking us down. They will continue to subsidize costs of healthcare, which will cause those costs to continue to rise at alarming rates; and tax the wealthy, businesses and the middleclass, which will cause those parts of our economy that actually create wealth - to shrink.

What we are seeing is a premeditated path to "Change" America from the leading economy on the planet, to third world country status.

And let me go back and add another aspect to my earlier analogy - the pie shaped water balloon. As Mr. Sowell so aptly points out, the government mandates that hospitals HAVE to treat ANYONE who comes into their emergency rooms... including illegal immigrants. So the pie gets squished down even more and the part we have to pay gets even bigger. Here's a hospital administrator in Florida illustrating the point:

http://www.youtube.com/watch?v=Hgks5mbIijg&feature=related

I wonder what the total cost runs into for hospitals across the state of Florida, and Texas, and New Mexico, and Arizona, and California, and Oklahoma... and so on ad nauseum. Of course one of the primary mandates the Federal Government does have from us, the citizenry via the U.S. Constitution, is "to establish a uniform Rule of Naturalization... repel Invasions..." etc. A mandate they have uniformly failed to meet for decades.

Health care is a service whose price should depend on supply and demand. Granted that the supply of providers and hospitals is somewhat limited by the ability and resources to build more clinics and hospitals, of buying more equipment, or training more doctors and nurses, we still have a somewhat adequate supply that has met the demand so far, even when you take into account the huge influx of illegals who put a strain on medical care and have caused many hospitals in California to close their doors.

Since the government constantlly interferes with rules and regulations of the health care industry, and abuse and waste are ramptant, the cost of this service keeps going up. Add the cost of litigious patients and their greedy punitive lawyers and the cost goes up even higher. Add the cost of providing free health care, no questions asked to illegal aliens, and the cost goes up even more. And don't forget the cost of people who go to doctors all the time just because they can (it is free to them) and the cost of those who use emergency rooms for colds and other minor ailments.

Now comes Obama who wants to add more patients to the mix, several millions more, (nobody knows exactly how many because the numbers are revised up and down all the time by liberals to suit their topic of the day), cuts Medicare by $500 billion, and somehow he asserts that the service will be cheaper and more available for all. This sounds like a recipe for disaster except to liberals who are good at spending other people's money and are governed by feelings rather than rational thought.

Does anyone believe that, if you keep adding patients to the rolls of a local hospital and to the local doctors, and local pharmacies, somehow, magically, the wait will be shorter, the service will be better, and the cost will be lower? Perhaps in Alice's Wonderland.

We seem to miss the point. Mr. Sowell is correct. However when I look at his legislation I cannot see any health care reform. I only see an insurance scheme. Basics are not included. Why do uninsured pay more for service that those with insurance? Why do Doctors need to pay so much for malpractice insurance? Why are we unable to reform our tort system to end the absurd awards and the constant stream of lawyers chasing ambulances on television? Why? If we paid attention to the constitutional basis of our republic, and worked according to them, we might be able to untangle the central government's usurping of state's rights, AND responsibilities. Let us return to the Federal Republic we were designed to be and the problems we face will become much more easily addressed.

Again, if this health bill is about quality of care and how wonderful it is for everyone, why haven't the members of the Duma voted to have themselves included? Because they will still have the taxpayers paying for their good quality insurance; why would they want to be insured in the same way the trash citizens are? Hey, that sounds like elitism! Imagine that.

Could we require all groups such as La Rasa, the Catholic Church, liberals, Hollywood, lawyers, ACLU, CAIR, university professors, teachers unions, SEIU, NEA, etc. foot the health care insurance bill for all illegal aliens that they so promote and defend?

Mr Sowell, this series of columns should be must-read material for anyone purporting to have an opinion on American health care. The simple facts of life deftly laid out here are being carefully swept under the rug by the very people claiming to be on the side of The People. Obviously, President Obama does not care about The People. If he did, he would lobby for genuine reform instead of his Socialist disaster that he's locked himself into.

"Surely no one believes that there will be no repercussions from refusing to pay for what we want."

As a citizen born and raised in Massachusetts, I can assure you there are MILLIONS of Leftist voters out there who do in fact believe they legislate gravity out of existence if they can just get those evil Republicans out of the picture. The trouble is, after decades of Leftist media propaganda on the subject of health care, there are also millions more who have come to believe the Leftist lie that we can simply "pass a law" and get our health care literally for free. They are moderate people but for more than 30 years the Left has been the only ones allowed to talk, so their story is the only one that got heard.

"Some doctors are already refusing to accept Medicare or Medicaid patients because the government's reimbursement levels are so low."

A taste of how things will be under Obamacare. In his ridiculously optimistic proposal, Obama promises half a trillion dollars in Medicare cuts. Yet doctors are already balking at the low rates being paid NOW. What will they do if Obamacare is passed? Go out of the Medicare business entirely? Then the Liberals will call them "greedy" and they will "pass a law" to force doctors to treat Medicare patients. The rest of us will be forced to subsidize that care, just as we've been doing, so the Liberals will "pass a law" preventing doctors from passing on those costs to other consumers.

The result of that lunacy can only be far fewer doctors and a growing tendency (already shared by the radical Left) that elderly people are a burden that should be allowed to expire. Don't think so? How about Robert Reich's speech to some college kids in which he said "we can't keep spending tons of money on people who are only going to live a few more months anyway. So we're just going to let you die." That view is shared by many on the Left, including Obama, who said in another speech that those with terrible illnesses shouldn't hob the health care dollars, but instead "just take a pain pill."

"Similarly, if it costs a billion dollars to create one new pharmaceutical drug, then either we are going to pay the billion dollars or we are not going to keep on getting new pharmaceutical drugs produced. There is no free lunch."

TANSTAAFL is an immutable law of nature. No Liberal legislature or congress can repeal it no matter how well-intentioned they may be. If it costs a billion dollars to develop to a new drug, it's not "greed" on the part of drug companies to expect to earn that money back, especially when less than 20% of investigated drugs turn out to be worth anything, which means they also need to make up the money they sunk into the 80% of drugs that turn out to be worthless. That's how companies survive to turn out the next miracle drug next year.

Plus, these companies have a duty to their shareholders. If I own stock in Pfizer, don't tell me that company is not permitted to turn a profit, or my stock is suddenly worthless. If nobody bought stock (and nobody would buy stock if they were not permitted to make any profit from it -- why risk your money if the potential to earn a return on your investment is taken away??) then none of these companies would have money to gamble on the next possible wonder drug -- and we might as well go back to waving chicken bones and bleeding people to let the "bad spirits" out as a cure for disease.