Let’s say that the government decides to set the price of widgets at $100. As long as someone can make a profit at $100, there will be plenty of widgets. This is Adam Smith’s invisible hand of the market at work. As soon as the cost of making and selling a widget nears $100, two things will happen. Quality will go down, and widgets, especially good widgets, will become scarce. Unless, of course, the government demands high-quality widgets. Then there will be no widgets, except in Mexico and China.

Now let’s say that the government decides that a sector of widget makers (of variable quality) will be required to provide widgets to all comers. There will be long lines for people to get their cheap widgets. I can hardly wait for mine.

As soon as it becomes unprofitable for the rest of the medical profession to take care of people under the “fixed” system (think Medicaid), these patients will land at our doorstep. We seem to be scraping by for now, but we’re not a limitless container into which the government can pour the masses that have new insurance that no physicians (except us) will take. The long lines and intense dissatisfaction will cause those with money to find an alternative solution.

There will be a tipping point when hospitals can no longer remain public if they are to survive, and those patients with money will help them in their predicament. It will not be a cataclysmic bang. Instead, the two-tier system will be born gradually as some public hospitals quietly go private, and those people insured under the federal system are shoehorned into a shrinking supply of public hospitals.

What Congress often fails to consider is the ability of Americans to find a way around its schemes. The growth of organized crime after Prohibition is a good example. Now, I don’t expect there to be speakeasies for hip replacement, but ingenious people will find a way.

Private hospitals and private physicians will care for patients with private insurance in plush facilities that have the latest technology. The public hospitals left behind will barely survive on the meager funds in the federal system.

Too Orwellian to believe? Talk to anyone who has lived in Great Britain. This will happen, and people with money will be better for it. Those physicians who go “private” will also be better for it. The people Congress intends to help and those not rich enough to escape it will suffer terribly in an underfunded, two-tiered, health care quagmire fit for a Third World country.