A healthy debate about health care - Or: Just say no to free stuff you can't afford

The last time I looked, insurance was a business, not a social service.

But maybe I had better look more closely because after listening to Hillary Clinton, Arnold Schwarzenegger and numerous other politicians who are eager for votes, I am starting to think maybe health insurance is not a business at all, and not even just a social service, but actually an entitlement.

Here's how health insurance works, or at least how it had always worked until the government got involved:

It's really not that complicated. You pay money today as a gamble that you are going to get sick in the future. Insurance companies take your bet because they have statistics which show the likelihood you are going to get sick. The higher the likelihood, the higher your premiums (the money you put at risk).

If you don't get sick, then the insurance company has won the bet. You are out the cost of the premiums, and they don't have to pay you anything. Of course, you still have your good health and you didn't have to suffer any anxiety over how you would pay your medical bills if you did get sick.

If you actually got sick, on the other hand, then you would still be out the cost of the premiums, but the insurance company would have to pick up a large percentage of the cost of your actual medical care. In that case, the insurance company loses the bet.

That's good for you, but of course if the insurers lose too many bets they go out of business. That's why they base rates on actuarial tables to clearly delineate how much everyone should pay for their insurance to make it a profitable business. That's also why some people are uninsurable. If someone already has cancer, his or her premiums would basically have to equal or surpass the expected cost of the medical care or it would make no sense for the insurer to take the risk.

I don't know why I have to explain this. It should be pretty obvious to everyone. Insurance is not a new concept. But since Congress discovered they have way too much money on hand, politicians have been trying to think of new ways to spend all the extra dough. And because everyone gets sick some time, apparently some folks in government decided a good way to spend the billions of dollars of extra money would be to help the insurance companies pay for health care for people who don't have enough money to gamble on their own.

Notice: There are two fallacies in this proposal.

The first fallacy should be obvious to anyone. The government does not have any extra money! In fact, our government owes $9 trillion, give or take a few billion. That is what we call the national debt, but really, it is not owed by the government; it is owed by you and me. Every time some politician gets another bright idea to give away a million dollars here or $250,000 there, it comes out of your pocket. Don't just believe me; ask your pocket.

The second fallacy may be more subtle. What is being called "health insurance" by the politicians is nothing of the sort. As we have already established, insurance is a financial gamble where you put money at risk on the chance that you will reap a reward later. Notice the word "risk." But the only one assuming any risk in the "feel-good" version of insurance being proposed by Clinton, Obama, Edwards and the gang is the American taxpayer. What they are talking about is "free health care," not insurance. But it is only free for the sick person; instead of them paying for their own care, you and I pay for it.

That's a nice, pleasant sentiment, and I wholly support the government establishing an independent agency like the Postal Service which can accept charitable contributions to be used to pay for health care. Everyone who thinks they have extra money that they don't need for their own families can send a check to the Charitable Health Service, and people who are sick can apply for money to be given out on the basis of need. A voluntary system of this sort, which clearly would have the backing of the entire Democratic Party, should be able to ensure that everyone can get health care, even illegal immigrants.

Which brings us to the unstated third fallacy of the health-care debate, the one which is pivotal and sadly which is accepted as truth by the vast majority of people. It is this: If there is something that is good for me, I am entitled to it, whether I can afford it or not.

Is there a medicine available that might extend my life by a month or two? I want it, even if it costs $200,000 per month. Is there a treatment which might, just possibly, give me a better chance to survive the lung cancer I got because I chose to smoke for 30 years? I want it, even if it costs $2 million. And I don't want to pay for it, so let's call it "health insurance." That way I can have it and not feel guilty for taking the free ride. Am I too sick to be insurable? Tough. I still want it. Am I not human?

But the fact of the matter is we cannot have everything we want just because it is good for us or just because we are human. Modern science has already doubled the average life expectancy in just over a century - without free health insurance! But if we expect every person to have the right to take advantage of every form of medical care ever invented, then we may as well just send ourselves to debtor's prison today, because we can't afford it. Or maybe we should just send ourselves to the asylum - because we are clearly insane. (At least there will be no cost for our care!)

Of course, pointing out that not everyone in the world can afford the same level of health care makes me a horrible person. I am well aware of that, so please let's get beyond the name-calling and into the facts of the argument. The fact is, there are many things in this world which would be good for us, but we accept that we cannot afford them, and move on with our lives.

For instance, it would have been good for me to be able to attend an Ivy League college, but my family couldn't pay the bill. It would be good for me (and my circulation) if I could afford to fly first-class, but I can't, so I ride in economy and stand up every half hour or so to stretch my legs. It would be good for me to eat steak every night (all right, maybe not good for me, but very tasty), yet I eat ramen about three nights a week and steak maybe once a month because it suits my budget better. I even think it would be good for me to be riding in a 2008 BMW instead of a 1996 Saturn, but my checkbook says otherwise.

This used to be called living within one's means. Today, it is called being a chump. I don't care what they call it. The fact of the matter is there ain't no such thing as a free lunch. All of that "free" health care is costing somebody plenty. If you want that somebody to be you, then call your senators and congressman and tell them to vote for national health insurance and send the bill to your house.

But opt me out. I can't afford it.

Frank Miele is managing editor of the Daily Inter Lake. E-mail responses may be sent to edit@dailyinterlake.com.