In the realm of consequences, there are those we intend and those we do not intend. No matter the greatness of the cause or extensive forethought involved, there will always be unintended consequences. Some will be desirable and others not.

If a toddler hits his head and concerned parents present him for evaluation, the intended consequence of a CT scan of the brain would be identification or elimination of a brain injury as the cause of symptoms. Satisfied parents would be a positive unintended consequence of the study (let’s hope that’s not the reason for the CT scan). A negative unintended consequence might be brain cancer 30 years later when the kid’s wife is pregnant with their first child.

History and economic theory are full of examples of unintended consequences. Sunken ships create a hospitable undersea habitat. Aspirin, initially sold as a pain reliever, prevents strokes and heart attacks. The adhesive used in Post-it note pads was originally thought to be a failure because it didn’t stick tight.

How great life would be if all unintended consequences resulted in happier fish and cool office stuff. But no.

Price controls (as in the 1970s) might, in the short run, help a few that can’t afford something; but ultimately, they lead to scarcity. Asbestos is a great fire retardant, but it causes lung cancer. Raising taxes may, in the short run, raise extra funds; but in the long run, it leads to lower revenues and an unhappy populace.

Andrew Gelman makes the point that when a simple system tries to regulate a complex system, things often go poorly. The “Great Society” is an excellent example of good intentions gone haywire. There is ample evidence that the creation of Medicare was the start of our current economic problems in health care and health insurance. Despite the outlay of a zillion dollars, we still have proportionately as many poor people, and we have subsidized out-of-wedlock births and destabilized families in the process. And who’s for that?

And here we are on the verge (well, maybe not, thanks to Massachusetts) of Congress voting to “fix” health care. Given that large-scale government meddling in the private sector routinely makes things worse, I have full expectations (bet-the-house-and-the-car expectations) that history will repeat itself abundantly.

Sure, it would be great if every one of our patients “paid.” Not so great, however, when the pay is 25 cents on the dollar. In order for this system to work, the government will ultimately control its costs by controlling prices (and access). And controlling prices leads to what? Scarcity. You’re learning fast.

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.

Yes, it would be nice to wave a wand to eliminate the problems that plague the economics of health care in our country. The proposed plan, however, will cause infinitely more hardship than it relieves. Just wanting to make something better doesn’t justify a flawed plan. It’s time to start over with ideas not destined to have consequences that will plague our country for generations.

Write your congressional representative today.

Dr. Baehren lives in Ottawa Hills, Ohio. He practices emergency medicine and is an assistant professor at the University of Toledo (Ohio) Medical Center. Your feedback is welcome at David.Baehren@utoledo.edu.