Health Care Freebies Create Needies

By Dr. Brian Russell

Among the many apparent flaws in the philosophical and practical underpinnings of the President’s vision of health care in America, I believe that he and his supporters have failed to take psychology (behaviorism specifically) into account in projecting future demand on the system that they envision – a system in which non-emergency access would be afforded to everyone in the country (citizens and non-citizens alike) by the federal government.  Here’s my point in a nutshell:  freebies create “needies.”  What do I mean?  I mean that as soon as you start guaranteeing something to anyone who “needs” and “can’t afford” it, lots of people who didn’t seem to need it previously and/or were affording it themselves previously suddenly start “needing” it and suddenly “can’t afford” it.  I’ll illustrate.  If you take a stack of pizzas to a street corner in the heart of Beverly Hills, and you put up a big sign saying, “Free pizza for anyone who needs a meal and can’t afford one,” those pizzas will be gone very quickly, and while we all need food, not a single person who took one of your pizzas will have been unable to afford it on his/her own.  How does this translate to health care reform?  If the Obama plan is implemented, not only will the currently uninsured (many if not most of whom are uninsured by choice) be afforded access to non-emergency health care, but many people who currently afford their own health care (and therefore think carefully about whether/when to access it) will start accessing it more often.  As far as I can tell, however, the Obama plan only takes the former into account – i.e. projects increased demand on the system when currently-uninsured people gain full access to it but fails to project a further increase in demand on the system due to the increase in accesses by currently-insured people.  Thus, if the Obama plan is implemented, the increased demand for health care in this country, I believe, will be much larger, unmanageably larger, than the Administration seems to contemplate.  Ergo, it seems to me that the only way to keep demand for health care manageable under the Obama plan would be to ration care.  That’s right, health care rationing in America – I see no way around it under the Obama plan.  Fortunately, hopefully, I think that the American people intuitively understand that.  A predominantly-private health care system, one that does not guarantee everyone in the country non-emergency access to health care, incentivizes every American who can possibly afford to secure his/her own access to care to do so – as the vast majority of Americans currently do, even by the Obama Administration’s estimates – and to then access that care judiciously.  That’s exactly as it should be – both philosophically and practically.  It’s fine, noble even, to want people (kids especially) who are unable to secure their own access to health care to be afforded access somehow, but it’s philosophically, practically, and psychologically unsound public policy to attempt to effectuate that goal by distributing freebies and creating “needies” among the vast majority of Americans who remain capable of securing and moderating their own health care access.

Dr. Brian Russell is a licensed psychologist, attorney at law and familiar national television pundit on psychological, legal and cultural issues.

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