Maggie's Farm

One of the conservative arguments about health care is the prediction of explosive growth in the use of health care when it appears to be free. I have serious doubts about that.
There's probably some truth to the idea that I'll at least go along with an additional diagnostic test or a minor medical procedure if I'm going to pay little or nothing for it. Cost is only one reason to decide whether or not to have a health care procedure, though. My sweetheart's big objection to having a mammogram isn't the cost, it's the squeeeeze. I used to work for a urologist (really) and I can't imagine accepting any procedure we did just because it was cheap for the patient. Very few people will undertake major medical care because it's cheap, nor can we forego it because it's expensive.
Most people will spend most of their life-long health care dollars during the last twelve months of life. For most, that's in the last stages of terminal illness like COPD, heart disease or cancer. For a few, that's the horrendous expense of treatment for a sudden accident or illness that overwhelms them in a matter of days. I can't vouch for the case, but remember that Jim Henson (Kermit the Frog) died within a couple of days of entering ICU. He probably had more health care expense in his last 48 hours than in the previous 48 years.
Those expenses will only go down if some people -- a lot of people -- decide to accept palliative care rather than attempting a cure. That was my mother's decision at 78; my church friend, 75, is going for a cure. What parent of a teenager is going to say, "For that kind of money, make my son comfortable and let him die"?
It's a real dilemma and I don't have the answer. I don't believe Demcare is going to increase the usage of healthcare very much. I expect it to make healthcare harder to use -- ration by waiting list.