If You Build It, They Will Come; K.Billingsly

In California, no government agency ex ists to provide health care for middle-class working people and their families. There is, however, a system for the poor called Medi Cal, which the taxes of middle-class work ing people pay for, but which remains off limits to them. A number of press accounts have pointed out massive fraud in the MediCal system, which is limited by law to California resi dents. But people from countries as far away as India have flown in, received operations costing hundreds of thousands of dollars in one case $2.7 millionand quickly de parted the country leaving the bill to Cali fornia taxpayers who can't use the system themselves. In some cases, MediCal' s own personnel helped people to commit this fraud and tried to cover up investigations. Here a bureau cratic principle was at work. More" clients" means bigger budgets, which means a bigger K.L. Billingsley is a media fellow of the Pacific Research Institute in San Francisco.

allocation from the state and increased job security. So the bureaucratic incentive, un like the private sector, is to ignore fraud and bloat the budget. Democracy is not simply the counting of heads but involves the rule of law. In 1986,the United States government granted blanket amnesty to millions of people who had flouted American immigration laws. Federal and California officials rewarded not only them but those whose status re mained illegal. In 1988 MediCal began providing pre natal care to illegalimmigrants residing in or even intending to reside in the state. Cali fornia even launched an advertising cam paign called "Baby-Cal," spending $78,000 for spots on Spanish-language radio and television stations transmitting from Mex ico. The state quickly got what it paid for, and more. "If you build it, they will come, " was the phrase from the movie Field of Dreams. California not only built it but advertised it on television. And they came, in droves.

According to the most recent figures cited in a San Diego Union-Tribune study, un documented aliens gave birth to nearly 96,000 babies in the state during 1992. This constituted a full 85 percent increase over the last three years and does not include those covered under amnesty who also used MediCal. The costs for 1992 came to $230 million. That same year 40 percent of Cali408 fornia's 237,000publicly funded births were to undocumented immigrants. And 41 per cent of those who used MediCal for mater nity care also used the welfare system after delivery. There are several lessons here. First and foremost, as fiscal conservatives have often pointed out, you get what you subsidize. For example, if you subsidize single-parent fam ilies, you will get single-parent families. If you subsidize indigence, you will get indi gence. If you subsidize the births of foreign nationals in the country illegally, you will get what you pay for. But state officials are just now learning that lesson.

MediCal's John Rodriquez told the Union-Tribune that in his "wildest imagina tion" he never imagined the program grow ing so fast. "I think," he added, "we are seeing a magnet effect." Precisely. America has been and always will be a .country of immigrants. Historically, how ever, immigrants have traditionally come through legal channels in search of oppor tunities, not through illegal channels in search of handouts. The "Baby-Cal" fiasco NOW ON TAPE I 409 shows how welfare state fraud has cor rupted immigration. And as Cuban-Ameri can author George Borjas points out, most people now coming are unskilled and may wind up on welfare even if such programs were not their original attraction. As the MediCal episode also proves, good intentions can have disastrous conse quences. And contrary to what one often hears, there is no "free" health care, some thing California's four-billion-dollar debt confirms. Federal politicians might see a warning here, but they seem to be missing the point.

On the contrary, they are now promising universal health care for every American and claim that a tax on cigarettes and changes in Medicare will pay for it all. The failed statist medical experiments of other countries provide some prospects as to its possibilities of success. And California's MediCal program gives some clues as to what we can expect in the way of waste and fraud. American nationals will hold no mo nopoly in pillaging the system. If you build it, they will come. D Politicized Medicine The right to health care services and benefits, which so many are proclaiming today, is merely the right to seize income and wealth from other individuals through the body politic. Further government intervention into health care will only make matters worse. For the busy physician or commuter, PoliticizedMedicine is now avail able on six audio cassettes professionally prepared for FEE by one of America's leading producers of audio books.

Includes: "The Economics of Medical Care," "Free Medicine Can Make You Sick," "Why I Left England," "SocializedMedicine: The Canadian Experience," and "National Health Care: Medicine in Germany, 1918-1945." Six 60-minute cassette tapes, $29.95 (Please add $3.00 for shipping and handling.) THEFREEMAN IDEASON UBERTY EnvironmentalRegulation: Just as Bad as Any Other by Gregory B. Christainsen T wo sweeping studies of government regulation and deregulation, respec tively, have been published in recent years. The findings of these studies deserve to be better known. The studies also merit atten tion for what they did not say about envi ronmental regulation. The first study, by Robert Hahn and John Hird, was published in the Yale Journal on Regulation in the winter of 1991.It surveyed all of the major benefit-cost studies on regulation that had appeared before the authors wrote their article. The authors concluded that in only two 'areas, the envi ronment and highway safety, could one plausibly argue that the benefits of regula tion had outweighed its costs. It should be emphasized that, with respect to the areas outside of the environment and highway safety, the authors were not claiming that regulation had had no benefits. They were claiming, however, that in light of its costs, people generally would have been better off if regulation had not occurred.