By: Guest Authors
By: Brooks A. Mick, M.D.
Insurance is the pooling of risk against unexpected catastrophic occurrence. One buys automobile insurance to cover the costs incurred in accidents. Automobile insurance does not cover the cost of changing the oil, replacing air filters, checking the antifreeze, refilling the windshield washing fluid, replacing wiper blades, inflating tires, polishing the paint, vacuuming the interior, or cleaning off the windshield. Can you imagine how much automobile insurance would be if it covered all the minor maintenance?
But that is precisely what people purchase when they buy “health insurance.” They are NOT actually purchasing only insurance, which used to be available as Blue Cross, which covered serious illness and surgery that required hospitalization. Indeed, it used to be called hospitalization insurance, and it was true insurance. Now we have what should be called prepaid health care, for it covers backaches, head colds, athlete’s foot, and hangnails. It covers obesity, high blood pressure, and acne. It covers depression and anxiety.
And you know how much that pre-paid health care costs. It costs so much precisely because IT IS NOT INSURANCE! Calling this insurance is not only logically wrong, but leads to illogical thinking regarding health care.
If we returned to the concept of actual hospitalization insurance, the kind of coverage that would protect one against catastrophic occurrences and disastrous medical costs, then health insurance would be relatively inexpensive. To cut health care costs, I propose that we should return to that old model of true insurance.
If other people wish to pay for pre-paid health care, then let them, but other people who do not wish this type of coverage should not be forced to pay for it. Perhaps some people have sufficient funds that they can cover ordinary doctor visits and would not need any other type of coverage. Perhaps some people might wish to institute or subscribe to medical IRA or medical savings accounts wherein money could grow tax-free and could be used for everyday medical care if they wish. Some might wish to purchase pre-paid health plans covering routine doctor visits. This would correspond to the old Blue Shield plan before everything became rolled into HMO plans and employers received tax breaks to buy pre-paid health care for employees.
In many ways, the old systems were better and offered more options–more diversity, you might say. If you wanted only hospitalization insurance, you could purchase it relatively cheaply. If you wanted to pay more for coverage for office visits, you purchased it. You were not forced to subsidize a neighbor who wished full coverage when you did not.
Who could be against choice and diversity?