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I may be one of the few individuals alive who has been thrown out of a curio shop in Nogales, Mexico.

I was negotiating the price of an ironwood statue of a leaping sailfish with the shop attendant when he wearied of my lowball offers. “Get out of my store.” My embarrassed family had disappeared.

In the thirty years since I have mellowed, especially since I try to buy everything I can locally. As a business owner, I am acutely aware of the myriad of overhead expenses.

I am not so mellow when it comes to medical equipment. The prices of “medical grade” equipment continue to astonish. I got a burly DeWalt air compressor for my wood shop recently for $299. A similar, and I mean really similar compressor in our office operating room just went out. Fifteen thousand smackers.

So, imagine my delight when the subject of a new laser came up. We have an erbium-based laser called a “Halo” that does a nifty job of getting rid of brown spots and smoothing out wrinkles without a lot of down time. Our lovely aesthetic staff informed Steve and I that patients really liked the Halo and that it was busy all the time and…..

They wanted another one.

I had gagged and convulsed when we got the first one. The laser is about the size of a small refrigerator and looks a lot like a welding machine. Explain to me how that thing could be over two hundred thousand dollars! What could be in there?

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The initial quote on the new one was over three hundred. So, I went full Nogales on the laser company, demanding they throw in their $40K handpieces and $20K “filters”. This newer version will tighten up loose skin as well, but for that much money I want eternal youth. This time I embarrassed poor Michelle our aesthetic coordinator, who probably hadn’t signed up to work at a livestock auction.

Much has been made in the current political cycle about greedy corporations and rapacious medical companies. “Medicare for all” will get rid of insurance companies, regulate pharmaceutical prices, and in general quell the rabid rush for the medical dollar.

A friend of mine recently had a big bleed in her brain. She received state of the art scans, fabulously expensive drugs, cutting edge high-dollar procedures and devices—all in an institution renowned for its take-no-prisoners business plan. She has no deficits.

Another acquaintance, who is a highly productive professional and world-class taxpayer, works only because of a $5000 a month drug without which he would be crippled.

This whole medicine-as-a-business is a roiling hot mess. But when we stifle the greed and cut the profits and regulate the system do we wipe out innovation and discourage risk? Will the entrepreneurs and gamblers go elsewhere? Is the mess we have now preferable to the mess we might create nationalizing the wild, wooly industry we have?

Anyone involved in the delivery of medical care should be motivated by a compassionate altruism. That’s what Santa told me when he stopped by for a couple of shots of Grand Patron last Christmas Eve. In the real world, money and self interest spin the globe. Aligning those forces with our objectives might yield the best results.

By the way, if you are thinking about that $55,000 dishwasher, give me a call. I’ll help you out.

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