Will free health care lead to unnecessary doctor visits?

Jim Huffman Dean Emeritus, Lewis & Clark Law School
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Last Sunday, The Peterborough Players, of Peterborough, New Hampshire, brought down the curtain on a two-week run of Jules Romains’s “Doctor Knock.” On opening night, artistic director Gus Kaikkonen introduced the Players’ rendition of the 1923 comedy as the French equivalent of Thornton Wilder’s “Our Town.” Perhaps he aimed to please the locals, who take great pride in their town being the inspiration for Wilder’s American classic. But however many French high school productions of “Doctor Knock” have been staged since 1923, it is a play with great resonance for 21st-century Americans. It is about health care.

Dr. Knock is a young physician who has purchased, sight unseen, the practice of a retiring doctor in a small French village. To his surprise and dismay, Dr. Knock discovers, upon arriving to take over the practice, that the retiring doctor has few regular patients. It seems that most everyone in the village is healthy, or so they think.

For a brief period, young Dr. Knock feels betrayed and accuses his predecessor of cheating him and setting him up for failure. But he soon realizes that the people in the village aren’t healthy — they’re just ill-informed about the state of their health.

Dr. Knock meets with the principal of the local school, urging him to help educate the populace about the multitude of health risks they face in their daily lives. He becomes acquainted with the town pharmacist, whose business has suffered in the midst of so many healthy people. He announces free consultations for every Monday morning and is quickly swamped by individuals who come to see him though they are feeling no pain. They leave knowing that they are on the brink of serious illness or death if they do not take immediate measures, including regular consultations with the doctor and prescriptions from the pharmacy.

Business booms for Dr. Knock, for the pharmacist and for the hotel that provides much-needed beds for patients from near and far. When Dr. Knock’s predecessor returns to collect on a payment due from the sale of his practice, the audience fully expects Dr. Knock to be exposed as a quack and a fraud. But it is not to be. The now-retired village doctor leaves knowing that, like everyone else in the village, his health is on the verge of collapse.

So what is one to make of this little tale, well acted by one of America’s best summer theater troupes? Will free services lead healthy people to consult with a doctor? And will they then be persuaded that they need regular consultations and prescriptions? It is, after all, only a play, and a dated one at that.

But somehow this all seems familiar. Is it possible that public education about ubiquitous health risks will lead people to discover maladies they didn’t know they had? Could it be that free or subsidized health care leads people to consult their doctor more often, even when what ails them is little more than an irritant?

Hmmm. It does make you wonder. Too bad the Peterborough Players didn’t take their show on the road to Washington, D.C.

Jim Huffman is a member of the Hoover Institution’s De Nault Task Force on Property Rights, Freedom and Prosperity and the Erskine Wood Sr. Professor of Law at Lewis & Clark Law School.