solve that problem by rationing care. You don't get the big bill. But often you don't get the treatment either.

I remember when I was a freshman in college I went to a friend's apartment. One of his roommates turned the thermostat lower in the winter. He had done it just before I got there. Another of his roommates questioned him about it. He said, "The apartment complex said if we keep our utilities usage in check they won't have to increase rent next year." The other roommates basically looked at him and said, "Everybody else has their apartment warmer. I don't want our heat turned down for nothing." The psychology surrounding that kind of thing is way too screwed up in this country.

Another anecdote I remember is at one of my son's soccer games a teammate broke his arm. It wasn't a terrible break. Painful, but the kid was handling it. The parents called for an ambulance. I was stunned. To me ambulance rides are what you get when it's a life or death thing. The dad explained, with no sheepishness at all, that his insurance covered the ambulance ride and his son would be seen quicker. It never crossed his mind that insurance costs for everyone go higher when you use your benefits like that.

In the U.S., either our taxes would go up or, more likely, the government would remove benefits, increase wait time and deny care even more than insurance companies do.