Facebook Friend Mike Smith talks about a relative of his who complains about the cost of Lipitor:

Relative: “The cost of Lipitor is killing me and my friends.”
Me: “You are kidding, right?”
Relative: (shocked) “What do you mean? Lipitor is very expensive!”
Me: Compared to what? A heart attack might kill you. And, even if it doesn’t, it costs far, far more than Lipitor.”
Relative: “Well, Lipitor is just too expensive!”

Did a little research. Omitting the possibility of death, a major heart attack costs $1,000,000 and a minor heart attack $760,000. Generic Lipitor in the 10mg size, without insurance, has a national average cost of about $425/year when purchased 90 days at a time. Yes, it cost more when it was under patent but even then it was much less than 1% of the cost of a heart attack.

The conversation was what I call “magical thinking*.” While emotions are understandable when comes to health care, we often have things backward. Instead of heralding the invention of statins, their lifesaving properties, and the money they save (compared to heart attacks), we denigrate both the drugs (“too expensive”) and their creators (“greedy!”). We single out medical companies for extra taxes. So, we get layoffs and less innovation when we need more innovation and more jobs. http://www.nytimes.com/2013/10/02/business/merck-plans-to-lay-off-8500-workers.html

Instead of insuring against big hazards (cancer, heart attack, etc.), we want 100% of our fees and medicine covered every time we have an allergy or cold.

This is nonsenseand we have to stop thinking this way. Yes, healthcare is emotional. But, I fear, without a change in thinking, someone could create a $10 pill that cured all cancer and people would be picketing with signs complaining about “profiting from peoples’ misery.” Even in nations with single-payer (government) insurance, everyone has to pay something. There is no free lunch.

With smartphones, internet, and technology there is a real chance that we can improve healthcare and make it affordable. We need to be encouraging, not taxing, innovation!

So, before I offer any other suggestions, I must exhort everyone to stop with the magical thinking. Quality health care is not, and will never be, free. …

The entire theory of “insurance” is for many to pay a (relatively) small amount so that a (relatively) rare catastrophic loss will not bankrupt a person or family. Health insurance works nothing like this, so it is not “insurance.” It is very possible my home will never have a fire or tornado. It is impossible I could live a normal lifespan without ever seeing a physician.

So, why do we think it is a good idea to have “insurance” pay for a visit to a physician or a common cold or allergy for which little can be done anyway (colds and allergies cannot be cured) other than treating symptoms? This is nuts. We have to rethink this. Life has expenses. In my world, getting an annual allergy shot should not be part of “insurance.” And, an (relatively) inexpensive physician assistant would handle this to keep costs down. Fixing this would seem relatively simple, at least in concept. But, emotions get in the way.

Many liberals accurately point out that the U.S. is the only first-world nation without some type of national health program. They see it as unjust because they believe everyone has a right to be cared for when seriously ill. …

Conservatives, who have been unfairly and illegally attacked by the IRS, will never accept it as OC enforcer since the Administration has not prosecuted a single one of the wrongdoers. This breach of civic trust makes, for C’s, Obamacare a non-starter. Yesterday’s new Christian Science Monitor poll showed 57% against Obamacare, so neither political party would pay a price for the delay. Besides, President Obama has (without authorization of Congress) waived the start of the business mandate, so the precedent exists.

We should adopt the plan of a Democrat, Bill Bradley, from when he ran for President. Every U.S. citizen and permanent legal resident should be able to purchase either an individual or family policy from the same set of policies available to federal employees and their families. There are something like 20 plans with lots of choice and lots of tailoring options.

For those who are poor, there should be a means-tested voucher (no cash value) that can only be used to purchase a policy. It would be administered by existing state welfare agencies. No new giant bureaucracy. Low cost. The voucher pays for a policy that insures against major illnesses not every time someone has a cold unless someone wants to voluntarily pay more.

Repeal Obamacare but ONLY when we can simultaneously replace it with a plan of along the lines of the above. It should be named, in the best sense of the term, The Democratic Party Health Plan. It was proposed by a D, they deserve the credit. The R’s have done a lousy job in this area of governance.

The plan will have the same restrictions (i.e., other than in an open enrollment period) as the federal employees’ plan: you can’t buy a policy the day after being diagnosed with cancer as the federal employees have. Fraud is a criminal offense. Any connection between the IRS and health care MUST be severed. …

The tax on medical devices will be repealed. We need more innovation, not less. The U.S. Department of Defense has DARPA, which offers prizes to innovation they deem useful. Perhaps we do the same in healthcare for innovations that improve care for the same or lower cost or provide the same level of care for less cost.

Yes, there is the issue of people refusing to buy a policy. Fine, if they have refused a policy, let them go bankrupt if they have major medical they cannot afford. It is time we get back to a concept of individual responsibility. It is time for “tough love.” President Reagan was right: If we subsidize irresponsible (not buying a policy) behavior we will get more of it.

Smith, who is not a political blogger, nonetheless has a few more political things to say: