As Milton Friedman warned, "There's no such thing as a free lunch."
There's no such thing as a free heart transplant either.
So there's no reason to brand Tony Keck a health-policy heretic for stating the obvious. As reported on our front page Saturday, Keck, director of the S.C. Health and Human Services Department, told an audience of insurance executives Friday at The Sanctuary Hotel on Kiawah Island:
"If somebody else is paying the bill, I don't think there should be any expectation that people can go wherever they want, whenever they want, for whatever they want."
That is, "if somebody else is paying" the medical bill.
And increasingly, the "somebody else" is the government, i.e., the taxpayers.
Keck has stood tall for the hard call Gov. Nikki Haley made in rejecting the unaffordable Patient Protection and Affordable Care Act's offer to vastly expand Medicaid eligibility in our state.
Then again, from another story in this newspaper last week: "A new federal report published Tuesday shows that the number of Medicaid applications submitted to the S.C. Department of Health and Human Services in October was 20.2 percent higher than recent monthly averages."
And: "More than 1 million South Carolinians already carry Medicaid cards."
Gee, how poor is our poor old state anyway?
And how much more contagious Obamacare chaos will spread within and beyond our borders when (or is that if?) the law starts requiring employers with at least 50 employees to provide insurance coverage for their workers?
The individual-mandate debacle has already forced the president to apologize for repeatedly making a promise ("If you like your plan, you can keep your plan") he couldn't keep.
The business mandate was postponed for a year by a White House edict that conveniently delays the brunt of its consequences past next year's congressional elections.
However, that can't keep our state's federal lawmakers from being on the Obamacare spot.
For what it's worth
Sixth District Rep. Jim Clyburn, the No. 3 Democrat in the U.S. House, defended the law on CNN's "State of the Union" on Nov. 17. He said of HealthCare.gov's bumpy entrance: "The fact of the matter is, this is a rollout problem, this is not a values problem. And I think that if we were to look at what we're attempting to do with the Affordable Health Care Act, you will know that what we're trying to do is change a value system in our country."
Yet no legislation or executive fiat can change this value system: As government benefits rise, it must collect and/or print more money.
Our senior Sen. Lindsey Graham, who faces a thunder-from-the-right Republican primary challenge next year, will soon be paying a personal Obamacare price of his own. He announced Monday that he will enroll in the law's South Carolina insurance exchange instead of taking the special exemption (and federal subsidy) available to members of Congress and their staffs.
As Graham put it in a written statement: "Obamacare is being pushed on the American people, and we should live under it just like everyone else."
And: "As a 58-year old male living in Oconee County my insurance costs are going up about $400 a month, more than 200 percent, under Obamacare. In addition, my health care coverage will be a fraction of what it used to be."
And: "The worst is yet to come, but I will continue my fight to repeal, replace, defund and allow Americans to opt-out of this horrible government program."
"The worst is yet to come" is an epic line from narrator/producer William Dozier at the end of each Part One in the subtly subversive 1966-68 ABC "Batman" series.
Holy soaring deductibles!
All decisions are final
With another alarm about what's coming, Michael Tanner, a senior fellow at the libertarian Cato Institute, wrote in Saturday's New York Post:
"The good news, if you want to call it that, is that roughly 1.6 million Americans have enrolled in Obamacare so far. The not-so-good news is that 1.46 million of them actually signed up for Medicaid. If that trend continues, it could bankrupt both federal and state governments."
Clearly, medical costs must be sharply cut - at least when "somebody else" is paying them for the swelling ranks of Nanny State dependents.
Therefore, I hereby volunteer to serve as the Obamacare Death Panel of One for our community. Sure, deciding who gets - and doesn't get - which medical treatments will be a tough job.
But somebody's gotta do it.
And after all, there's no such thing as free dental either.
Frank Wooten is assistant editor of The Post and Courier. His email is email@example.com.