I don't agree, I just thought it was an interesting read.

I think your analysis points up one big problem with this debate--it is easy to find problems with the current system (and it's pretty easy to see how the author's personal experience biases his slant on things), but it's a lot more difficult to figure out something that would acually SOLVE any of the problems.

I do agree with characterizing three levels of health care:
1. Basic,
2. Elective, and
3. Catastrophic.

I prefer the French approach to dealing with those three levels to his approach. They use universal, private sector health insurance for basic care, government umbrella coverage for truly catastrophic situations, and allow a variety of free-market approaches to elective care--self funding, private insurance, employer provided insurance (spending accounts would also work well here, but I'm not sure whether they have them).

I can justify universal primary care becuase that's the level at which there are some serious societal benefits to keeping everyone free of things like swine flu or smallpox. There are doc-in-the-boxes selling prepaid primary care packages for $87/month; something like that is affordable across the board. I think we can achieve significant savings in the primary care area by maximizing the use of nurse practitioners and other paraprofessionals. Docs are bailing out of family practice these days; let them concentrate on specialties.

I think the government umbrella works well for truly catastrophic situations, because the governement is the one entity with sufficient resources not to be bankrupted by a catastrophe, and because taking that burden off the insurance companies gives them freedom to become much more creative in structuring elective care solutions.

The more like a free market we can make elective care, the more LASIX-type success stories we are going to see.