Great Analogy

At least from my perspective, this analogy for health care and government involvement makes the most sense. It comes from a commento on Megan McArdle's piece about first dollar coverage (and I know what that is now since I've been studying for my insurance exam!).

The comment was this...

It's more like groceries + flood insurance. For "normal" medical care, doctor's office type things, people pay out of pocket. You may need food to live but you buy the groceries yourself. The lower income people get food stamps. For big things, such as heart attacks, the government provides or subsidizes insurance like they do with flood insurance (plus probably making it mandatory), you may never need it, but it's there if you do.

 Exactly!

Do the majority of Americans really want the government to pay for their every day food choices? I certainly don't. But I do recognize that some people need government assistance even for the most basic need of food (the efficiency and effectiveness of the food stamp program is something to be debated though).

People should, for the most part, pay for their own food. Similarly, people should pay for their basic health care services.

Last year I went through a pregnancy and it wasn't an easy one. I'm a member of an HMO and so usually have a copayment, but not for maternity services. Except that I had to be referred to a specialist and I had to pay a portion of the cost. It wasn't exactly pretty, but we managed. It did give me a nice view into the actual costs of my treatment. A basic ultra sound was over $800!

It's sad that people with no kids, no plans for kids, single guys, et al help to subsidize my maternity care. It's even more sad that we aren't allowed to pick the exact types of insurance we want. Why should I pay a premium to cover hair plugs, chiropractor services, or psychotherapy if I don't need or want those things? (Granted, the psychotherapy is something I've needed in the not too distant past, but something I could have paid for out of pocket if needed.)

So let me pick my own coverage - which for us would include maternity care - and let our neighbor who isn't having anymore kids pick their coverage without maternity. Or let them choose to pay for basic coverage out of pocket and pay for a catastrophic plan only.

If the government needs to be involved, let it be at a catastrophic level (i.e. flood insurance) so that people don't have to declare bankrupcy in order to receive treatment. And if someone is so poor that they require food stamps, the government can offer basic coverage insurance options for them too.

Universal coverage will do NOT one DAMN thing to increase the actual health of Americans and will inevitably lead to more cost, less access, and way more waste & fraud.