So Much for Health "Insurance"

Implications: It's intresting that nowhere in this article was the topic of true insurance for catastrophic illness brought up.  The problem with our current health insurance market is that for most it is pre-paid care, not insurance against a rare, but catastrophic, event. 

Analysis:  Put another way, if consumers were willing to pay the full cost of routine care, up to a deductible of $2-3000 per year, a policy that covered 100% of costs above that amount would be relatively cheap.   There would also be plenty of money available for the rare disaster, making rationing and micromanagement of medical decision making unneccessary. The Health Savings Account model most closely matches this fundamental concept.  A tax-free and tax-deferred savings account is established, out of which routine care is paid.  Above a pre-defined deductible, 100% coverage kicks in.  Most individuals consume relatively small amounts of healthcare and would accumulate savings.  This approach also limits employer exposure and should be seen as a way for large companies to control their healthcare costs.  The HSA could be accessed by a debit card which would eliminate tons of paperwork.  I'm continuously amazed by the amount of paperwork involved in a $150 claim for a routine office visit! 
This is, of course, a political issue.   The Democrats see HSAs as a stake in the heart of nationalized, single payer care, which is their longtime goal.  They constantly work to regulate them to death.  Republicans are more likely to support HSAs, but have not been eloquent or aggressive in their defense.  Even if there is a Republican president, the Democrats will most likely retain control of Congress.  It is unlikely there will be any significant movement on this issue, at least for the next four years.

Richard Amerling, MD