What's next? How about automobile coverage for seniors so they can get to their doctors, hospitals, pharmacists and other
places necessary to their physical and mental well-being? As far as we know, such a bill hasn't actually been proposed in
Congress. So let's do a thought experiment with a "MediTrans" program and model it after Medicare.
For starters, MediTrans would cover privately-owned automobiles. There are already government-subsidized taxi and bus
services, but many say that it is degrading to force seniors to depend on such services. Seniors would have a 20% co-payment
(copay) for automobile purchases or leases. The government would pay the other 80%, just as Medicare pays 80% of the
Medicare fee schedule to doctors.
What would happen? Based on the Medicare experience, many seniors would suddenly be able to buy new cars, especially
the more expensive, and presumably safer, luxury models. Do the numbers. A senior who had saved $16,000 towards a new
car could now buy an $80,000 Dodge Viper SRT-10; the government would pay the other $64,000. A $130,000 Hummer
H1 Alpha would now be affordable for many. At the low end, the senior could spend $10,000 and get a $50,000 Cadillac or
Lincoln. Seniors would promptly buy out auto dealers' new car lots.
Automakers would ramp up production ASAP. They would justifiably conclude, "Our customers really like our cars, especially
our high-quality models. Let's invest in more research into more advanced features such as built-in cardiac monitors and
defibrillators, plus GPS guided automatic driving to the nearest hospital, in case the driver's (or passenger's) heart goes into
ventricular fibrillation. The defibrillator might get the heart going again but some hearts don't respond adequately and need
prompt hospital treatment. Every minute counts!"
Meanwhile, dealers would build new and fancier showrooms.
Substitute hospitals and doctors for car dealer and medical school training programs for manufacturers and you've got a pretty
good idea of the market signals given to those institutions when Medicare started pouring money into the medical system in
1966. Doctors saw more patients because of the 80 percent discount.
Medical schools and specialized training programs expanded to meet the new demand. At the same time, Congress poured
more and more billions into medical research. Some of this research resulted in new or improved medical treatments, creating a
new supply of available services naturally resulting in new demand for these wonderful, modern services.
However, as with Medicare, the official government cost projections would underestimate the costs of the system, perhaps by
900 percent, as happened with Medicare. Government would have to start controlling the MediTrans system to keep costs
down and to control fraud and abuse.
To try to control the demand, the government would probably limit how many cars a senior could buy, say no more than one
every two years. Even so, the government would soon find that some senior customers were scamming the system by buying a
new car as often as possible and reselling their surplus vehicles at really good prices. So the government would have to start
tracking vehicle ownership and transfers and perhaps even limit showroom visits.
Citizens not eligible for MediTrans would soon notice that their maintenance as well as vehicle purchase costs were shooting
up. Auto magazines would investigate and find that the severe demand-crunch from seniors translated into gussied-up service
facilities and higher prices for everyone.
If MediTrans had started when Medicare did, the cheapest car available today would likely now cost $50,000 with the
average horseless buggy running $150,000. Quality galore, especially since the government would naturally start regulating the
safety and other additional features required for seniors' safety, even in cars not purchased by seniors.
Who's to blame? Ultimately, the politicians who created the system and we citizens who failed to call them on their folly. Once
in place, everyone responded rationally to the distorted market signals created.
Then the crackdown.
It would not take long for the government to discover it could no longer afford to keep seniors in all the cars they wanted. They
would also find that some seniors now spent their own money to keep up their habit. But after prosecutors threw several
dealers in jail for selling vehicles to these customers, dealers quickly learned that government rules prohibited sales to seniors
without official MediTrans approval.
We've seen many doctors and hospitals go out of business or be prosecuted because of these and other government-induced
problems.
In other cases, seniors would claim to do their own oil changes and would get a MediTrans certification/prescription slip from
their overworked service shop for free oil from their auto parts store. But, instead of leaving well enough alone with their
allotted five quarts of oil and filter, some would tell the shop their car burned a lot of oil and would get multiple oily
prescriptions sell their surplus gunk on the street.
Of course, the MediTrans cops would eventually find out about this scam and have Congress pass an Oil Dealer Enforcement
Act (ODEA). As part of their plea bargain, some MediTrans recipients would make up and tell lies about their deals resulting
in a 20 years to life prison sentence for the auto supply owner.
Unjust and far-fetched, you wonder? Pain doctor William Hurwitz MD suffered this injustice after he treated lying pain
patients, despite heavy government supervision of the doctor and his patients. Dr. Hurwitz was sentenced last year to 20 years
to life in prison.
Oops. Maybe we shouldn't have written this. Some politician is likely to get ideas ... Sorry.
Unwinding these backfiring programs and policies will take many decades. We pray that our political leaders learn to learn to
respect the constitutional and common-sense limits inherent in recreating and maintaining liberty under law. And then, work
towards restoring liberty and appropriate law.
Editor's Note:: Robert J. Cihak wrote this week's column
