Few of us relish paying for health care, but when we do, amazing things happen: Strangers listen to us and try to give us what we want. There’s a simple economic rule that what we pay for, we control. Insurers, hospitals, doctors, nurses, and drug companies listen to us when their livelihood depends on it. The more you take the individual customer/patient out of the equation, the more power we individuals lose.

The “health-care reform” currently touted by Beltway Democrats would take a system that insulates patients from the true cost of their health care — and insulate them more. It’s a scheme for spending even more of OPM (other people’s money). The Soviet Union ran the granddaddy of such schemes, even putting the cradle-to-grave “right to health” in its constitution. If we are smart, we will learn from the Soviets’ failed seventy-year experiment, which succeeded in putting people into early graves.

Take the individual out completely, as the defunct Soviet system did with all industries, and the individual becomes irrelevant. The Soviet government was the only purchaser that mattered and, consequently, the government, not consumers, told producers what to make. When the state tried setting quantity quotas for nails, factories produced lots of little, pin-like nails. When the state set quotas by weight, factories responded predictably and produced big, heavy nails.

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In the United States, the current debate over healthcare reform is really no debate at all. Both sides of the argument accept the fundamental principle of government intervention. Today few can recall a time when healthcare was not considered an entitlement. Americans caught up in this racket would do well to look south, to El Salvador. It has been a half-century since medical care in the United States could be described as a business. In El Salvador that is exactly what it is, a business. There, the customer (patient) meets the service providers (doctors, labs, hospitals, pharmacies) at that voluntary, mutually beneficial place known as the market price.1

The typical doctor’s offices I have encountered are two-room suites in buildings that are physically attached to small private hospitals. This is the arrangement for my pediatrician, endocrinologist, and otolaryngologist: a reception/waiting area and another space that serves as both office and examining room. This is low overhead at its finest. Only two people are involved, the doctor and his receptionist. No nurses, no staff, no large group practices, and no offices jammed with secretaries and insurance filers. There is only the receptionist out front that makes your appointments, takes your payment, and writes your receipt. A routine office visit costs about $35.00, cash or check. There is no mention of insurance for these routine services. Any dealing with this issue is strictly between you and your insurance company. The physician’s role is to provide service, receive your payment, and hand you the proper receipts. Furthermore, all the doctors I have dealt with in San Salvador have their personal cell phone numbers printed on their business cards.

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