Et tu, WSJ ?!

The airwaves are full of ads from doctors, dentists and other health care providers encouraging you to spend "unused" dollars before the end of the year. Even my own dentist, in advance of a routine appointment last month, sent me a personalized letter informing me I had used only a fraction of my Dental Plan's annual limit, so wouldn't I like more dental care before year end? (Oh please, let's go for a crown!)

I don't blame providers for trying to drum up business and perhaps there is some logic to spending unused flex dollars that can not be rolled over from year to year. Just because you've satisfied your health plan deductible or other out of pocket limits, let's not kid ourselves - as the ads would have us believe - that there is no cost to additional spending.

The WSJ Editorial Board has been a great champion of restoring "consumerism" to health care markets. They have long advocated that individuals should have some "skin in the game" so as to make more prudent spending decisions. Thus it was particularly galling to read an advice column authored by Anna Wilde Mathews in a recent Wall Street Journal 'Sunday' feature, in which she suggested to readers that at this time of year they need to "check that you aren't missing out on free stuff"!!!

Let me make this crystal clear: whether paid for by your insurance plan or the government, health expenses are NOT "free"! Premiums (or taxes) paid - whether all or in part by an employer - proportionately reduce employee spendable income. And claims paid - even those at year end after our deductibles have been satisfied - add to overall utilization which causes even higher premiums (or taxes).

This lesson reminds me of the P. J. O'Rourke quip: "If you think health care is expensive now, wait until you see what it costs when it's free."