There are a lot of Americans who like to spend twice as much on medical care than they have to. They believe that having a choice of medical insurance companies somehow lowers the cost of medical care. They claim “competition” and “free enterprise” works the same way in medicine as it does in the supermarket, in a department store or online shopping.

I have no idea what they are talking about.

When I go to the supermarket or shop online, I get a description of the item I’m looking to buy. I also get a price that I can compare with similar items, so I know in advance how much I’m paying. I know that in general, if other people don’t buy the same item, the cost of the item I want to buy won’t increase. I can even decide where I want to do my shopping.

None of that applies to health care.

When I walk into a doctor’s office (even my office), I don’t see the price of my care posted anywhere. Even if I knew the price (or the co-pay), that is just the beginning. There are all sorts of hidden costs that are tacked onto that service. Labs, x-rays, immunizations, EKG’s and fees to those blood draws, injections and interpretations are all added on at an additional cost that I have no foreknowledge of. No “free enterprise” there.

If I’m sick and need emergency care, the ambulance has to take me to the nearest emergency room – by law. Where’s the competition in that? Once I get to the emergency room, do I get to choose what services to buy for my symptoms? Do I get a choice of tests to run to figure out what ailment I have? Where are those “free enterprise” and “competition” things again?

Here’s the real kicker: when someone who doesn’t have health insurance enters the hospital or emergency room and they can’t afford the medical bill, who pays for their service? I do (actually, we all do). The hospital passes those costs along to me either directly, or through my insurance company. Of course, my insurance company isn’t going to “eat” that extra charge either. They’re going to pass that along to me as well. So I’m not only paying for my health care, I’m paying for the uninsured as well. So much for that “free enterprise” system!

Quite frankly, I’d like to cut my medical bills in half (or more) with a nationalized system that includes everyone. As long as I have to pay for the uninsured anyway, I want to do it as cheaply as possible. That’s what every other industrialized country has done. Oh, their systems aren’t perfect either, but they pay half of what we pay, they live longer than we do and their health systems are ranked much higher than our according to independent, international surveys (despite the fact that we have the best doctors and the best hospitals).

Some people call this socialism. Well, I don’t care if they call it “Stalinism” or “McCarthyism” or “Late-for-supperism,” if I can get better care at a lower cost, then count me in.

Maybe you are afraid of labels and would rather pay more and get less for your dollar.

All I know is that the people who are making huge profits off of the health care industry, (profits from money I pay them for overpriced medical care) are spending money on advertising and contributions to politicians to keep things the way they are. I understand why they do it, I just don’t understand why we go along with it.

James Fieseher MD, FAAFP, Dover, New Hampshire.