"Healthcare" is supposed to be the big election issue, and politicians promise to give people universal and equal "healthcare," or prevent the bad guys from taking it away.
Everyone of course wants to be healthy, and a $3 trillion industry wants to keep the money flowing.
So, I have a confession to make as a doctor: I don't think I have ever kept anybody healthy. If someone comes to me asking for "health maintenance," I don't have a shot of "health" to give, or a prescription for "health" to be filled at your neighborhood Walgreens, CVS, or Rite-Aid.
And as a patient, I can't recall any ways in which doctors kept me healthy, although they did save my life by taking out my appendix, and they treated some illnesses and injuries. I am very grateful to them, and whatever I paid them seemed reasonable and well worth it.
To my mind, a healthy person is one who does not have to see a "healthcare provider" regularly or take medicine every day, and who can go to work, take care of family, and generally lead an active life.
We hear endless complaints about how we spend too much money treating sickness instead of preventing it. If only we had the government take all the money, plus trillions more, and "invest" it in health, we wouldn't have to spend so much, and everyone would be healthier--so they say.
This was the rationale for the National Health Service in Britain. Once the NHS took care of the backlog of untreated illnesses, much of the need for it would melt away. This did not happen. Expenditures kept rising and were never enough. The backlogs and waiting lists grew. Ambulances circle emergency departments, and patients are crammed into hallways and storage rooms.
Suppose you go for your government-funded, "value-based" health maintenance visit. Details of your once-private life will be entered into a very expensive electronic health record. (For most people, it will be their own data, but occasionally someone else's will be cut-and-pasted in, causing endless trouble.) You will be checked for diabetes or pre-diabetes, hypertension or pre-hypertension, tobacco use, cholesterol, in many cases gun ownership, body mass index, and other government-mandated items. You will get educated about the evils of tobacco (in case you have been on Mars and hadn't heard). You'll be lectured about obesity if your BMI is too high. You'll very likely get a prescription to lower your...