Posted on 08/05/2025 10:31:22 AM PDT by E. Pluribus Unum
The hidden cost of “free” services.
Walk into a government clinic in Lagos on a Monday morning, and you’ll see the real price of “free” healthcare. Even early in the day, the benches are already full. Mothers clutch sick children, elderly men sit on the floor, and everyone waits, sometimes for hours, just to be seen. When a nurse finally calls a name, there’s often a quiet expectation for a “token,” a polite word for a bribe, to move the process along. And if you do make it to the doctor? The medicine is often out of stock. You leave with a prescription in hand and another bill to pay at a private pharmacy.
This isn’t a glitch in the system. It is the system. For millions around the world, “free” state services come with a hidden surcharge that doesn’t appear on a receipt. The poor end up paying not just in cash, but in time, in dignity, and in opportunities lost.
For people living on the margins, time is money in the most literal sense. A woman who sells oranges on the roadside might earn $5 on a good day, but if she spends that day waiting at a public hospital, she loses not just her income but her customers. A teenager who queues for hours at a broken municipal tap before school sacrifices more than her morning; she loses the chance to study, to learn, to dream beyond that line. These are invisible costs, what economists call “opportunity costs”—but for the poor, they are crushingly real.
There’s also a humiliation tax. In many public clinics and schools, the poor are treated not as clients but as inconveniences. Patients are scolded for “bothering” nurses...
(Excerpt) Read more at fee.org ...
“Patients are scolded for “bothering” nurses”?!?
AI could (and probably now can) decide on the ‘best test’.
AI could (and probably now can) interpret test results.
AI could (and probably now can) lay out a treatment plan.
AI could guide a surgery with image generation.
“The medicine is often out of stock. You leave with a prescription in hand and another bill to pay at a private pharmacy.”
I assume the author would like a 100% market system wherein paying at the private pharmacy would happen 100% of the time and not just “often”.
There are private basic medical care coverage plans sold in Britain.
The English NHS might be changed so it would pay for a resident of England to join one.
This is not just picture from abroad.
Since Obamacare kicked in, the US clinics started to resemble this too!
In England, your primary care doctor at one time would get capitated amounts for his patients. He would then buy the best private plans for the care he could not himself provide.
The traditional British NHS was a network of regional trusts with some trusts roughly equivalent to the Cleveland Clinic and Mayo Clinic.
The current US system with entities like iNova (Northern Virgina) and Partners (metro Boston) is very similar to the traditional NHS system except that the US ‘trusts’ have to fight entities like insurance companies to get paid.
People in President Teddy Roosevelt’s time would think of entities like Johns Hopkins and Partners as trusts.
“Even early in the day, the benches are already full.”
One hundred and fifty years ago the rich shunned hospitals.
Eleanor Roosevelt had her surgery at home.
Starting around 1910, US hospitals ‘cleaned up’ their act.
I have a “Tarascon Pediatric Outpatient Pocketbook”.
It has a 1936 image called “Children’s Clinic” on it.
In the foreground is a doctor about to examine a baby in the crowded waiting room.
Behind the crowd is a nurse.
In the background a second doctor is looking apprehensively partially behind the door of a room.
My neighbor has a physician assistant daughter married to a doctor in a mid-size city.
Despite the doctor’s connections, my neighbor still had a few weeks wait for her cancer surgery.
The surgeon was able to remove the cancer.
If we want faster cancer treatment times, it is my understanding that Medicare funding for residencies would have to be increased.
There’s a reason why there’s a Turkish phrasebook sitting on top of two Turkish dictionaries near my PC.
Nine reasons - the six teeth already extracted and three that will have to be.
When I was diagnosed with a colo/rectal tumor in 1996, my local hospital in Sunnyvale, CA admitted me for surgery three days later. Looking back from 30 years later, the 1990s were not only a different time, but a different era.
Of course, it didn’t hurt that the medical group ran the hospital, my Dr was the Chief of Oncology, the surgeon was chief of thoracic surgery and my radiation therapist was chief of radiation therapy.
Yes, AI can or will eventually do all those things, but the cost is the destruction of the human knowledge and human capital base.
Making the entire human race dumber is probably not the best use of technology.
The incentives Obama and Biden put into the system turns our best hospitals into 'Veterans' style hospitals where everyone feels their doing a favor helping citizens. It's time to dump toxic incentives ...
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