Why is there no discussion about insurance that covers only catastrophic risk?

Yes, the focus is flawed. I have worked for many older folks that needed wheelchair access in their homes after becoming disabled and they paid for it with a reverse mortgage while having health insurance.

Got sick and still lost their homes after paying premiums for decades, what a scam.

The only reason people need health insurance is if they are in a car wreck, get cancer or other similar catatrophic or long term care problems such as these. Use of insurance for routine care drives the cost of health care up astronomically. Face it insurance companies are in it for a profit right? So 9 out of 10 people lose with insurance. If they didn't the companies wouldn't make a profit would they?

I like the idea of catastrophic health coverage. That way if you really need to go to the ER for an X-ray no problem. You want to go for a rash or the flu pay out of pocket. If insurance was never used for routine care you could AFFORD to go see the doc. Hell a cash only clinic charges only slightly more than you pay just in co-pay. That should illustrate just how much insurance is inflating the cost of health care.

Those generous benefits you describe only apply to employer-based, large-group insurance. In the individual insurance market, catastrophic coverage is all most non-wealthy Americans can afford anymore.

Well actually this are discussion about individual health risk, they are done every day by responsible individuals and insurance agents. However, these discussions are not being done by politicians who write the expense/tax rules for their friends.

Everyone should buy his own policy for himself and his family members, the early you buy the policy and the longer you keep it -- the premiums should stay flat. Alas, thanks to wage and price controls in the 1940's --- the individual was taken out of the picture. Unions sold "free" insurance as what they got their dues members. But professions would walk to another job if they did not get an "illegal" raise so firms gave employees a "benefit" in health insurance. Alas, the policy was not geared to the individual --- so the healthy male with wife and family was paying to cover the boozing bachelor or the risk taking dare devil and 3 pack a day smoker.

Insurance is hedged risk. Insurance companies employ actuaries to compute the risk of individuals based on current health and "life style" (when that was allowed). Example; The odd of a 40 male getting HIV/Aids is lower if that male is a church going Mormon, Orthodox Jews, or Observant Catholic than if he is a Charlie Sheen dog. So who should pay a lower premium? Premium is a function of risk. The drunk driver should pay higher rates than the safe driver. Accident risk is akin to health risk.

However with employer paid health insurance, the employer could not out of medical ethics learn the health of each employee since any dismissal for being drunk would have been sued as discrimination. However all young exercise conscientious employees are paying for the older employees and for all the young 2 Wendy triple fries and shake types. So it would be to all employees benefits if the Tax code writing Congress would allow companies to increase the salaries of their workers by the current "Cobra monthly amount"

[Cobra is the shock layed off employee see when they are offered the companies medical insurance continuation. Say that Dave (40) was a DBA at company X, with the family package. The HR cutie (HRc) gets him to sign up for family coverage for his spouse(37) , 3 children (ages 6, 10, 16) for dental, Rx, Doctor visits and vision. the HRc tells Dave that $260 will be deducted from his check each of the 26 pay periods and he will have all those benefits. Let's say Dave is downsized 5 years later, when he is "paying" $339 per pay period. 4-5 weeks after Dave is escorted the door. Dave gets a letter saying that by law the employer has to offer a continuation of the coverage. And Dave now has 45 days to accept the offer of continuing his coverage only for the mere sum of 3260 per month which will only cover Dave for Doctor Visits --- Spouse and kids are not covered. Dental, Rx, Vision gone for all. This is sticker shock of the 1st degree. Dave did not know the true cost of his insurance.

If employers were allowed to give the Daves of their firms the full 4000 monthly cost tax free to each. The employee would have the incentive to shop around for the best medical/dental service available but only catastrophic insurance for each family member for perhaps 200 month for all. Set aside funds for dental and vision and put remainder of his cost into coins (Ag, Au) for the future. Again the crooks in DC would have to allow the Daves to buy the coins without any record and no income when they are cashed in for medical services when they get very old. Also the coins could be willed to his family again without tax, for after all he paid his income tax on his wages once. [<opinion> G-d only asked for 1/10 of this years harvest. If you saved your surplus wheat --- it was not taxed again in the following year. Government should only have one bite at the wage apple.</opinion>

The advantages of this plan are --- one.

1) It puts the obligation to pay for health care on the individual

2) The individual out of greed would see the wisdom to keep health by eating wisely, not taking risks and for covering via insurance for the catastrophic event that may happen.

3) Employers are out of the insurance buying market

4) Dave is not subsidizing the dangerous life style of the foolish.

5) Government has no business in examining the medical records of its citizens. Medical privacy was a sacred concept since Hippocrates (436 BCE), until Clinton's HIPAA ---

6) Doctors and treat patients for what they have not what their insurance payment will let them diagnose.

7) Government could downsize dramatically

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