The observation that the entity that pays is the entity that receives the attention is quite poignant.

Comparing health insurance to car insurance doesn’t quite work out. Making a claim against car insurance can be as much a nightmare as dealing with claims for medical insurance.

I’ve been pushing the idea of adding a loan component to Medical Savings Accounts, making it a Medical Savings and Loan. In addition to the medical savings account, people would pay a premium to access a guaranteed interest free medical loan. (For medical loans, people pay the premium on the front end of the loan, rather than on the back end of the loan. People would default on loans if they do not recover from the medical condition.)

Since most people would be paying back their loans, the MSL would revive the negotiation between doctor and patient.

In case anyone is not paying attention, the poor aren’t faring very well in the current system. I’m sure it would help them to have the prices go down in a system where health care providers and insurance providers found it necessary to more openly compete with other health care and insurance entities than they do now – where everyone competes but only within a very narrow, and artificially constrained space making for not much competition.

It really does come down to freedom and control. For those who do not want the responsibility of making their own choices I am sure that there will be insurance companies and HMO’s who are still more than happy to sell those services as part of insurance plans – with appropriate premiums. The trick is that those who do want to take responsibility for their own care should not be constrained by government theorists regarding what they are able to decide for themselves.

But detractors argue that some health issues are so complex and/or emergent that individuals simply can’t make informed decisions about them. They ask How useful pricing information is when a loved one collapses and needs immediate medical care or when your daughter breaks her arm. How do you deal with the diagnosis of a rare cancer? The average person, they say, is unqualified to decide which services to buy in such instances.

They also claim that market based systems incentivize people to avoid useful preventative care and result in higher priced interventions later on. They are oblivious to the fact that it is our middleman system that does this currently.

The detractors always raise the specter of the poor and suggest that the poor would fare, well, poorly under a market based system. However, I have never gotten a single statist to give me any answer at all as to why helping “the poor” requires forcing everyone into a massive government health care bureaucracy.

Detractors will also say that health insurance is not directly analogous to car insurance. If your insurance company doesn’t adequately cover automobile issues, you can replace your car. But you can’t replace your body if your insurance company inadequately covers health issues.

It really comes down to the issues of freedom and control. There are those that want more power and control over others. Many individuals don’t want the responsibility that accompanies individual liberty on this matter.