by Patrick Appel

A reader writes:

Dustin Chambers wrote:

"Health insurance should not cover basic or routine medical services, but instead should cover major illnesses, surgeries, etc."

Think just a little bit about real-life healthcare choices and you quickly see why Chambers is wrong. You get laid off from your job, so you decide to skip your $20 prescription for high blood pressure meds this month and buy your kids groceries instead, and the next thing you know you've had a stroke, which will make you less productive for life and will cost your catastrophic-only insurer tens of thousands of dollars in immediate costs.

It's obviously better not just for the individual patient-consumer, but for everybody in the insurance pool or everybody in the economy, to spend a little more in routine care and thus avoid catastrophic illness and cost.

This does not mean there's no room for competition. Require all insurers to cover routine care and medications, and let them compete on other factors -- cheaper premiums, better customer service, more extensive provider networks, better-quality doctors (there's a concept), access to specialists without prior approvals, etc.

I'm all for preventative medicine and avoiding catastrophic illness, though the research I've seen says it doesn't save money, so I'm not sure how sound this reader's rationale is.