Why should there be "health insurance"?  There shouldn't.  Health is a matter of nature and nurture, of genetics and lifestyle.  Why would I start a company to insure health?  Insurance is the sharing of risk.  Where's the risk in health.  Either nurture doesn't matter because of nature, or nurture does matter and is manageable by the individual in question.

Americans' lifestyles are less-healthy than many others around the world in developed nations.  We exercise too little, are sedentary too much.  Too much meat, not enough fruits and vegetables.  Too much tobacco and alcohol and other drugs.  Too much murder, assault, rape, and gang violence.  All of these negatives, however, affect us based on personal choices and behaviors.  And behaviors have consequences.  Each of us is granted by our Creator, however, with the unalienable right to liberty, to choose for ourselves.  One consequence of that right is that each of us has an unalienable right to stupidity, and many exercise that right . . . regularly.  You can't fix stupid?

Among companies that provide -- as part of compensation -- some level of medical (not health) insurance, leaders have developed and encourage participation in "wellness" programs.  It has been demonstrated that healthy workers are more productive workers.  Also demonstrated has been that investment in wellness lowers company medical insurance costs more than cost of the wellness programs.

The contention, however, by proponents of a womb-to-tomb government-involved medical-care system that incentivising healthier diet and appropriate exercise will lower medical costs is bogus at best, disingenuous more likely.  What's smart for company executives is that their wellness programs postpone medical costs, say, until after retirement.  Then, those former employees become beneficiaries of Medicare and, in some cases, Medicaid or both.  It is irrefutable fact that sooner or later we all die.  The statistic that as much as 2/3 of our total lifetime outlay for medical care occurs in the last year of life still holds.  What those smart companies did was to reduce their costs while pushing them forward onto the government, and also likely increasing the drain on Social Security as those folks live retired longer.

Why is there no private-sector company offering flood insurance?  If you live near the shoreline of the Mississippi River, you'll definitely want flood insurance.  If I had a private insurance company, I'd see you as a bi-annual claim just waiting to happen and suck me dry.  If you live in downtown New Orleans, ditto.  If as a private-sector insurance guy I offered you flood insurance on your $100,000 riverfront homestead, I'd have to charge you about $60,000 per annum.   If you live atop a mountain, you won't want flood insurance, though as an insurance guy I'd need you to buy it to share the risk.  Why does FEMA offer "flood insurance"?  You have to ask?  It's the government, that's why.

Suppose you're a private-sector insurance gal, and you get a frantic phone call from someone wanting fire insurance on his house.  He wants it now and says he'll pay the first month's premium over the phone.  You say that someone will have to come out and inspect the place first, and you can schedule that for tomorrow.  He says he can't wait, because the house is in flames, and won't be there tomorrow.  He points out that he called you first, even before calling the fire department.  Would you make the deal?  You might, from a business perspective, see that as about as smart as offering ex post facto flood "insurance" to post-Katrina homeowners in the Big Easy, or life insurance to someone with terminal liver cancer.

In today's "healthcare debate" -- even as citizens with more than two gray cells to rub together know that what's being floated is either  the achievement of socialized medicine or another significant increment toward that end -- there is talk of  a role for private-sector insurance companies.  These entities are not now, nor have they been for decades, in a free and competitive marketplace.  Liberal-leftist fascism has emasculated them, regulating them such that they aren't really in the insurance business.  Analogous would be requiring the people living atop mountains to buy flood insurance, people in Iowa to buy hurricane insurance, the deaf to buy coverage for hearing aids, and the homeless to buy homeowners insurance.  A major focus in today's "debate" is whether "insurers" should be required to provide coverage for "pre-existing conditions" without surcharge.

This would be like requiring the fire-insurance gal to agree to insure the guy whose house is ablaze.  This would be like requiring the homeowners insurance rep to offer a flood insurance policy to someone whose house was already underwater.  So, when you get sick, you buy insurance . . . for awhile.  When you have stage-four lymphoma, you call Travelers or Blue Cross, and tell them that you'll pay for coverage at $100 per month for a couple of months, and send them the $300,000 tab for your care.

The auto insurance industry seems to be fairly sensible.  Risk is shared, but those deemed higher-risk pay higher premiums than those deemed lower-risk.  Urban higher versus rural lower.  High-crime area higher versus low-crime area lower.  Teenagers higher versus middle-age lower.  Couple of accidents and a couple of tickets higher versus no accidents or tickets lower.  Zoomzoom car higher versus 4-door sedan lower.  None of the insurance companies offers fuel or oil or lube or tire-rotation insurance.  None offers carwash or brake-job insurance.  Would be nonsensical.  Wouldn't be "insurance".  Indeed, both thinking rational auto owners and insurers see the wisdom in high-deductible -- say, $2,000 or more -- policies.  Why?  Everybody gets scratched and/or dinged.  Can't go to the mall without that.  It's the big crashes that are the budget busters, and with those there can be some financial risk sharing.

So, let's talk about insurance bennies.  How'd we get where so many Americans think that they shouldn't themselves have to pay for medical care; not procedures,  not prescriptions, not tests, not check-ups, not dental cleanings, not eye glasses, not condoms, not birth-control pills, not Viagra  (Wassup widdat?), and certainly not power chairs?  A century ago one of the top-five killers was diarrhia.  (Some will see that assertion as a blowback to my most-recent previous thread.)   Now, lots and lots of Americans think that no-cost-to-them MRIs, cat scans, joint replacements, micro-surgeries, "miracle" drugs and the like are rights.

In the current "debate", those on the left and, indeed, some of those not thought of as on the left eschew the idea of high-deductible plans, of people paying for everyday, routine, predicable basics themselves.  The first nickel is to be "covered".  Doctor visits for check-ups, annual eye exams and the resulting eyeglasses, dental cleanings, mammograms, STD screenings, abortions; everything.  For them from the get-go, risk and actual insurance are off-the-table.  Free markets and free choice are off-the-table.  Personal responsibility and unalienable rights -- all of them -- are off-the-table.

There is rationing in everything.  Only so many hours in the day.  So much to do; so little time.  So many wants; limited cash.  Shall I buy steak?  Can I afford it?  At issue here are (1) who will ration -- the individual (exercising liberty) or the government (exercising tyranny) -- and (2) supply and demand, with price the arbiter in a free market, or severely-limited supply from the government and infinite demand from consumers, with government bureaucrats the arbiter, based solely on government cost-containment.

Why did employers get involved?  Because of the government.  Did the government require it?  No.  The government -- early on in WW II -- tried to rewrite the laws of supply and demand.  The guv didn't want wages escalating and taking money away from the war effort (Remember, they were Keynesians), so they capped them.  Employers now couldn't compete for a scarce resource -- employees, given that so many men had become GIs -- by offering more pay, so they used their ingenuity and offered non-wage bennies, like medical insurance.  Why didn't the government crack down on those pesky-miscreant employers?  For FDR and his fellow liberal-leftist fascists having individuals dependent -- even if to employers rather than the government -- was an incremental step in the desired direction.  It was a small step toward where our latter-day liberal-leftist fascists are today as we speak.



Everything with which the federal government is involved is a mess.  Veterans Administration (VA) hospitals, clinics, and treatment are a tragedy for our wounded warriors and their families, and a blight on American culture.  Medicare is unconstitutional, bloated, corrupt, bureaucratic, and soon-to-be bankrupt.  Medicaid is unconstitutional, corrupt, and grossly-inefficient.  SCHIP is everything wrong with Medicaid, and on steroids.

Medicare, Medicaid, and SCHIP all serve to discourage and disincentivise personal responsibility among those who could and should take care of themselves.  They also discourage and disincentivise acts and organizations of charity for those incapable of taking care of themselves.

For Americans who would seek out and avail themselves of true medical insurance for the very same reason that they seek out and avail themselves of homeowners, auto, flood, hurricane and fire insurance  -- i.e., to mitigate the financial devastation of "the big one" -- state governments nationwide have unconstitutionally (14th amendment) regulated and manipulated insurers such that there isn't a marketplace where they and those wishing coverage can freely negotiate.

International intellectual-property law is inadequate and enforcement is selective.  The result is that patents and copyrights infringement is near-ubiquitous.  A pharmaceutical company can invest a $billion on a project that fails, then another $billion one one that succeeds.  On the second one, a company in, say, Asia steals the formula and produces the drug itself, already a $billion ahead of the game.  Then, the socialized medical system in Canada will negotiate for a bulk buy from the U.S. firm at a price a mere fraction of what Americans pay.  That is accomplished both because of the threat of ignoring a patent and by the pharma company violating U.S. laws against "predatory pricing in restraint of trade."