But seriously — we need to bring back the concept of responsibility for oneself and one’s actions, and paying one’s own way.
As you (and Gingrich) point out, part of that is being responsible for your own health care costs, by whatever method works for you.
For most of us it’s health insurance.
But if you want to “self insure” AND BEAR THE BRUNT OF THE CONSEQUENCES IF YOU CAN’T AFFORD TO PAY, then that’s OK too. But no liver transplants, hip replacements, brain surgery, etc. for a “self-insurer” on the public dime! If you “self-insure” to avoid insurance payments and draw a losing hand healthwise, you just suffer and/or die. Cold? maybe. Tough. We’re broke.
I can't imagine another way out that will not draw us into the disastrous slippery slope that will be co-ops or "expanded Medicaid" or other euphemisms...we need to privatize, make portable and drive down costs by opening a free market that means that the 3 companies selling insurance in MD would have to compete with the 46 in PA.
Performance based outcomes will propel the better providers to the top and the market will sort out the lesser programs. 25% of the "uninsured" are "the invincibles" (the 18-25 year olds) that feel no need to buy insurance...if they do not buy insurance they can contract with private fee for service firms that will compete and possibly make loans or give them credit for procedures.
The higher risk 50-65 uninsured (uneligible for medicare, but struggle with no coverage, low income, job loss or pre-existing conditions) get assigned to a "risk pool" that better performing insurers will ultimately compete for, because they are able compete for them at reduced rates, giving them good coverage and reasonable rates.
The elderly will be covered by medicare and the indigent will be treated pro-bono by participating hospitals. I would like to see THAT pool covered by University Hospitals, many of whom have billion dollar grants behind the universties and should make use of the interns and younger doctors to keep the indigent covered, much as many law firms do.