But it is whatever we make it. It's a human construct; we can make it whatever we want.
You can do with the companies what you want, force them to preform whatever action you want them to (if your the government), but then what they are doing isn't insurance.
You can redefine the word, but then you just need a new word for the old concept. The old concept is a useful one. Redefining it in order to distort things to support an argument, not so much.
At the same time a whole bunch of healthier people are entering the paying system. Bottom line should be cheaper, 'cause your spreading risk.
No covering everyone increases costs. Esp. because what is often called "medical insurance" is really largely a medical payment plan, covering risks that are not insurable risks. Current "insurance" covers every day predictable and relatively moderate costs (helping to drive them up by covering them. The PPACA moves us further in this direction by requiring more such cost insulation, but outlawing plans that only cover such risks, and requiring more and more coverage for more and more things (and in a number of cases with limited or no co-pays or deductibles). And also by forcing payment for preexisting conditions.
Even insurance that really did function as insurance, that didn't cover ordinary, predictable, moderate medical expenses, and that included at least some small co-pays or deductibles for insurable risks, to reduce cost insulation, would still not decrease the cost of medical care by spreading risks, it increases the cost of the medical care industry through overhead, and through the remaining cost insulation that isn't wrung out by such a structure, and by increasing demand because more people can get treatment. But while increasing the total cost, it makes it more predictable for individuals, which is important. So for all the negatives that any form of health insurance (and probably to a degree other forms of insurance) comes with, its still a net positive.
But piling on more and more cost insulation (requiring it, not letting people get plans with less insulation even if that is what fits their needs best), PPACA drives costs up. It has some measures that theoretically could contain costs, but it goes about it ass backwards. It sets up a basic structure that increases cost (both for the government/taxpayers and in total), and then has provisions which could limit payment for care after increasing demand for it. |
