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On the Third Hand: Protest

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I received an op-ed from Dr. Elizabeth Lee Vliet, a past board member of AAPS, that turned out to be a good editorial.

AAPS is so conservative that it’s about as skeptical of the concept of managed care as of government health programs.

The people who write its editorials are smart people who always make an interest, difficult-to-refute argument. Whether you agree with them or disagree with them, they do a great job of making their case.

The subject line for the email promoting Vliet’s latest op-ed — “Obamacare: To Enroll or Not to Enroll? That is the Question” — almost led me to have a serious health care incident.

It turned out that Vliet was recommending that people save their own money; look for high-value, budget-conscious, cash-only medical practices; and buy very-high-deductible catastrophic insurance to protect themselves against true catastrophes.

On the one hand, that seems like truly sensible advice. It seems as if it always makes obvious sense for anyone who’s any good at budgeting to save as much as possible and buy the insurance policy with the highest deductible that they can stand.

The most cost-effective insurance leaves us able to function after a disaster hits, not comfortable.

On the other hand, one thing that worries me is that the headlines and subject lines on a lot of anti-Patient Protection and Affordable Care Act op-eds and press releases seem to suggest that people should protest PPACA by not having any health insurance. People have to read the fine print to see that the author wants them to protect themselves with a combination of savings and non-PPACA-compliant insurance products, not to truly go bare.

To me, it seems as if that’s a horrible mistake. Whatever people think about PPACA or health insurance, responsible people should do what they can to protect themselves against illness or injury, to reduce the odds that they will soak up charity care, or get no care, simply because of an avoidable failure to plan.

On the third hand, one of my arguments about PPACA is that our health finance system has been tottering for years, and thumping it on the head with PPACA might be as good a way to smash it as any other.

Maybe if we all just went bare that would be a simple, albeit, extreme and scary, way to thump the health finance system with one heckuva hammer…. 

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