An article I missed, back in the N&O in Raleigh. By my friend and ex-student Don Taylor, at the Sanford Institute.
Excerpt: DURHAM -- In my health policy class at Duke, I teach students two "laws" that govern all health systems: (1) Everyone dies; the only questions are when and from what? and (2) before that, the healthy subsidize the sick.
The first law is inescapable. Making the second function is the essence of health policy. These two laws hold true in Canada. The U.K. Germany. Japan. The U.S. Medicare program. Duke University's private employee plans, and every Blue Cross and Blue Shield group plan sold in North Carolina. In fact, the reason you have heard discussion of the State Employees Health Plan this spring is because Law 2 above was no longer functioning because there were too few healthy state employees and dependents subsidizing the sick ones.
The whole article is interesting. My own view is that the problem is NOT that there are too few healthy subsidizing too many sick. The problem is that there are too many demands that health care "should be" free, and so it is expensive. Our system is focused on providing expensive cure, not cheap prevention.
Look, I have auto insurance, but it doesn't pay for oil changes. People need to pay more of their own costs, not in money terms but in basic maintenance and lifestyle choices. Get off your fat ass, put down the potato chips, and go for a walk.