One of the problems we have with our health care system in the United States is that it's based on an outdated insurance model. Insurance is something you buy in case something goes wrong. You are required by every state I know of to purchase something called liability insurance for your car. Liability insurance actually covers those people in the other car of a theoretical accident in which you are deemed to be at fault. Since a split second mistake behind the wheel can cost someone an entire lifetime of income in addition to medical expenses, you are advised to carry enough liability insurance to cover all of your assets. This means that your insurance would pay all of a claim (minus deductible) if you are sued for all that you own.
You are not required to carry collision insurance which covers damage done to your own car or comprehensive insurance which covers damage done to your car while it is parked. The main reason is that you're not going to sue yourself for those damages. There are also some technical reasons why various degrees of collision and/or comprehensive insurance are recommended for some people. Melissa has to park her car in a busy lot at work where it is vulnerable to hit and run drivers or vandalism. Then there was the day that someone smashed one of the car windows while it was sitting in our driveway. It is considered statistically impossible to live your life without being involved in auto accidents.
Car insurance does not cover things like preventative maintenance because it is a hedge against bad things happen. That sort of maintenance is another hedge against disaster since most insurance doesn't actually cover mechanical breakdowns even if you've had your car maintained. Therefore, it is likely that the average person will file less than a dozen claims over their lifetime and I'm trying to guess high. Deductibles and large uncovered areas of your car make it certain that you will never consider filing an insurance claim to be a good thing.
Health insurance is a completely different matter. The vast majority of health insurance claims filed are for basic preventative maintenance. You get immunized as a child, get your teeth cleaned and checked and get screened for various diseases as you get older. A true insurance system would not cover these costs because there is no way to hedge against the risk. On the other hand, our car insurance system requires periodic inspections of your car so that you are less likely to have a malfunction that ends up hurting someone else. Our health insurance system does not require you to get those awkward symptoms checked out and the result is one of those "bugs" that runs its way through the workplace as employees expose their peers to risks through a system that requires them to do so.
Here's another difference between a health insurance system and a car insurance system: a badly damaged vehicle will most likely be "totalled" by your insurance company. This means that the cost of repairing the car exceeds the total current value of that car. In such a case, the insurance company pays you the listed value of your car to put toward buying a new one.
What happens when our bodies sustain catastrophic damage due to injury or illness? Thankfully, there is no legal way to set a price on your body. They can't "total" you and pay less than the total cost to repair you, right? Actually, they can. All of us who are disabled go through a process where our doctors prescribe a treatment and the insurance company refuses to pay for it. They have committees set up to decide what treatments are covered and what is not covered. They also have the ability to decide that a treatment should only cost a small portion of the actual cost. There are entire departments devoted to avoiding payment on claims. Sometimes, the doctor is under contract to absorb the rest of the real cost but some patient will be covering the rest of the true cost. Otherwise, the doctor would lose money doing the job society needs them to do. Do we really need to pay for the denial department of the insurance company as well?
When you start to look at the system based on some sort of social justice, you will see that it is hopelessly broken. Patients deserve the medical care that will get them the best standard of life possible which I'm defining as having as much freedom from pain and other unpleasant conditions as possible. Doctors spend decades racking up debts while working absurdly hard in schools, internships and residencies. They deserve a relatively high standard of living which I'm defining as the ability to afford the nice things in life in addition to paying off all those debts. Insurance companies are in the business of making money and have stockholders who deserve to be represented by people who will try to maximize the value of their investments. One of these things does not belong here if you'll permit me to paraphrase "Sesame Street."
The very idea of health insurance makes no sense because holding down costs and raising profits does not maximize health results. We need to take on health care as a societal responsibility. Even big business would benefit from a better approach because every one of those workplace "plagues" cuts productivity. I don't have the numbers to back this up but I'm venturing a guess. If you add in the possibility of a serious epidemic, it would be obviously in the best interest of each business to avoid punishing employees for taking sick days. In this growing world of 24 hour/7 day a week over 365 days a year business, there has to be room for some increased schedule flexibility.
Disability insurance needs to play a greater role in all of this. Despite the massive zipper scar on the back of my head from brain surgery, I had trouble qualifying for the private long term disability that I bought. Then, like most people, I was rejected by Social Security Disability but I was lucky. My private disability insurance hired me a lawyer to represent me in my third try. In my case, the judge who handled my hearing in the third stage was fair and the doctor working for Social Security knew what he was seeing. I never had to testify through my case of the twitches because that doctor read up on my case, saw my symptoms for himself and made my points for me.
Lucky as I was, that delay cost me late fees on my rent and kept my money out of the economy for months. Multiply that by a couple of million people with varying degrees of the same problem and the system meant to keep out freeloaders costs the economy many times what letting a few bad apples get through would cost. From the social justice point of view, subjecting those who already suffer to all that difficulty is a crime.
I don't pretend to have all the answers but I will suggest a few here and there. The main point would be taking health care out of the insurance system and putting into something new. This new something would examine health care from a social justice point of view. Where there is social justice, society benefits.
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