According to Dr. David Gratzer of the Manhattan Institute, in 1960 about half of health-care expenditures were directly controlled by consumers. Today, it is about 15 percent. Over the same period in which consumers have relinquished control, per-capita health-care spending has quintupled and costs have skyrocketed.
When someone else is paying, individuals behave differently. In a recent book by Shannon Brownlee of the New America Foundation, "Overtreated: Why Too Much Medicine is Making Us Sicker and Poorer," she argues that up to a third of our health-care expenditures are frivolous and ineffectual.
Beyond the pure economic calculus lies the moral question of individual responsibility and freedom.
Last year, the pharmaceutical firm Merck unleashed a state-by-state lobbying campaign to get state governments to mandate that teen-age girls receive an expensive vaccine they developed to combat the virus that causes cervical cancer.
Deemed irrelevant was the fact that this virus is transmitted overwhelmingly through promiscuous sexual behavior. Those most at risk are poor black girls, so the costs would flip over to government (taxpayers).
The core behavioral problem, immorality and promiscuity, driving the poverty and risk of the disease is not only ignored but effectively subsidized.
Our health-care ills are symptomatic of our social ills. And our social ills reflect a society where the link between personal responsibilities and costs and personal rights and benefits has been largely severed.
Soviet-style mandates like what Clinton wants will simply dig the hole into which we are sinking deeper. The approach is morally repugnant, the antithesis of everything that a free society is about, and, like the former Soviet Union, does not work.
More individual freedom, choice and responsibility in both the delivery and purchase of health care is our only hope.