The economic demand for car insurance has a rational basis, the nature of the demand for health insurance is not.
That's why single payer for health insurance is not the same as single payer for car insurance.
What does single payer have to do with it?
Insurance fundamentally provides two services:
1) Risk averaging across the population for statistically unlikely, but expensive events (Not everyone will get cancer or need a heart transplant, but if you do, you likely cannot pay for it).
2) Converting randomly occurring expenses into predictable monthly expenses, including statistically likely expenses over the course of even an individuals life. (This is true even without the individual risk sharing of 1 above, i.e. even if you could handle your entire life's health care cost yourself, insurance shifts the timing of savings/payment. There is value in that function)
In order for 1 & 2 to work, you have to be insured, you can't opt out when you want, then bitch to get back in when you are sick. A shockingly large fraction of the American public seems clueless on this fact.
The fact that, as you mention, we clamor for expensive health care in the terminal stages of life is indeed one of the things which drives up the cost of the system. But again, what does single payer have to do with that?
The only thing that I can see is that single payer would place the ability to decide such things in one entities power. But if that is what you want as a means of controlling cost, why not keep a multiple payer systems (for competitive reasons) and instead let the government (your single payer option) dictate the same cost containment rule to all the players? |
