When patients request tests and procedures that are not medically indicated, the common response we always hear. “Hey, it doesn’t cost me anything. It’s covered by my insurance.”

But the facts are actually reversed. It does cost and the cost is about twice as high as it could be if he paid directly for this. Why does this gluttony occur?

When the payment of a service is controlled by a third party, the insurance carrier, the cost of care increases. Sometimes in astronomical proportion. But who really pays? It is still you. It may come out of your wages as healthcare benefits. It may come out of taxes, which we all pay. You may think it comes out of other taxpayers pockets. But guess what, the other taxpayer thinks the same and his excesses will come out of your pocket.

We can shift health care costs, but the shifting will be in both directions. Maybe the other person will be more skillful in shunting more to you than you can shunt to him. Then this shifting has had a greater effect on your income than his.

Then the competition comes in. We see it most prominently in government programs, whether Medicare, Medicaid, or Veterans care. It is most apparent in VA care. Claimants come in all the time demanding disability benefits because they think they’re worse off than a friend of theirs who obtained benefits.

On one occasion, I mentioned that life may not be fair. Since he was a believer, I mention that Jesus never committed any crime but he still was crucified. The veteran got up out of his chair next to my desk, and extended his hand. “Doctor, you are absolutely right. I have no basis for complaining,” as he excused himself and left. He even dropped his request for benefits.

Scottish dialect: “O wad some Power the giftie gie us To see oursels as ithers see us!“^[1]
–Robert Burns (January 25, 1759 – July 21, 1796) was a poet from Scotland.

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Medical Gluttony thrives in Government and Health Insurance Programs.

It Disappears with Appropriate Deductibles and Co-payments on Every Service.

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