In everyday talk about financing health care, such words as"
insurance," "coverage," "choice,""
competition," and "plans" are solidly entrenched as
synonyms for "health care." Such word usage is highly
The words have a powerful "All-American" appeal, generating
visions of individualism; privacy; market magic; freedom from governmental
interference, control, and inefficiency; and individual deal cutting with"
Big Insurance." None of these visions is realistic.
Big Insurance can specify in a policy any of these illusions for a
price—but only as their risk statisticians (actuaries) will let them.
These "insurers" love their nonsystem. Even so, Big Insurance
knows it can't outwit sickness and disability, so it minimizes its risk. Thus,
a private-market policy will cover only what it says it will. To insurers,
sickness and medical disability is a business loss, reducing profit. Profit is
the lifeblood of Big Insurance, so health insurance can never be
universal—there is too much risk out there
Sickness and medical disability, however, take place without regard to
insurance "coverage." That's why we get so frustrated and angry
when our policies don't provide what we need, and many individuals are
Health care is a service—highly personal—and can never be
completely covered by our current system. It is not a collection of"
widgets." And it is very expensive. Families can be ruined
financially. All of this we know, and we see it all every day. Yet, we
continue the private market idolatry.
We need a new and true choice, not chosen by Big Insurance and not paid by
it. We need a system in which we essentially insure ourselves—that is,
an American system, like Medicare for all. It should be a single-payer (U.S.
government), universal-care system paid for by a special tax, administered by
the secretary of Health and Human Services, and negotiated with providers each
The new system would not change anyone's choices. It, like Medicare, would
be a choice, a true choice, and Big Insurance could compete but no longer be
artificially protected from the market.
This new voluntary system would soon gather the most patrons because it
would be an infinitely better buy. The savings could go to reduce the special