Health Care, Health Insurance Are Not the Same Thing

In response to the “Plenty of blame to share for high health care cost” editorial (Our Views, Sept. 12), I fully agree that we all are responsible for the high cost of health care and health insurance.

The first clarification is health care and health insurance are not the same thing.

Health care is not an exact science. When I go to see a doctor, I am asking the doctor to be my advocate. However, at no time should I relinquish my responsibility to decide what I want done. As a society, we are constantly looking for someone to blame when the outcome isn’t favorable.

Regardless, I am ultimately responsible to take, ignore or further look for medical advice. This requires that I have at least a rudimentary understanding of the suggested approach.

Conversely, health insurance is a contract of financial reimbursement. The key word is contract. In a contract, each party agrees to do something in exchange for whatever the other party agrees to do. This means I should not expect my insurer to pay for things that aren’t provided for in my contract. Again, as a society, we are looking for our own personal gain and complain, loudly, if we find out we can’t have it.

The final issue, and the one I don’t have an answer for, is whether health care is a right, a commodity or something in- between? The majority would likely agree when you go to the hospital for emergency care, that the hospital is obligated to stabilize you. Conversely, most would probably classify a “tummy-tuck” as a luxury that not everyone deserves. Between those two extremes is a continuum of possibilities that we as a society need to evaluate.

Unfortunately, there is an almost infinite demand for health care with a finite amount of resources available. In macroeconomic theory, if there is a much bigger demand than supply, the price goes up. Like it or not, we have to have some sort of rationing of health care. The question is: “Are we doing it optimally?”

I’m an actuary who grew up in Central Illinois.

Randall S. Edwards

Topeka, Kan.