I don't like the US healthcare/insurance system, but my objection to the article is that it fundamentally misunderstands the point of insurance. Insurance is fundamentally a transfer of wealth from those who do not experience misfortune (in this case, poor health) to those who do experience misfortune (so they can pay for it). In the case of healthcare, old people are much more likely to experience misfortune than the young, which means that health insurance -- no matter how you structure it -- is essentially a transfer of wealth from the young and healthy to the old and sick.
The only way insurance works is if enough people pay into it, ideally everyone. European countries work with mandated insurance (either through taxes, or a legal requirement) to fund the system sufficiently.
Catastrophic-only insurance is a nice idea and is truer to the idea of insurance as a protective measure, but healthcare costs are so high in the US compared with other countries, and the frequency at which non-routine care is necessary is also very high -- partly because Americans lead such unhealthy lives, particularly in terms of diet (and here we have a separate food industry problem) -- that the costs for the "catastrophic-only" insurance have to be quite high. We see this in the "Bronze" level plans. And if people are paying that much per month, it starts to make sense to pay a bit more and get some of the more routine care covered rather than pay so much for nothing really (unless there's a catastrophe).
Bear in mind that "catastrophe" is not just cancer. It's almost any non-routine care. I had surgery this year for a hernia -- the bill was $30,000. I was insured so that's not what I paid. But my point is, an unexpected $30K can easily put a household in a serious financial bind given that Americans don't have much in the way of savings.
The only way insurance works is if enough people pay into it, ideally everyone. European countries work with mandated insurance (either through taxes, or a legal requirement) to fund the system sufficiently.
Catastrophic-only insurance is a nice idea and is truer to the idea of insurance as a protective measure, but healthcare costs are so high in the US compared with other countries, and the frequency at which non-routine care is necessary is also very high -- partly because Americans lead such unhealthy lives, particularly in terms of diet (and here we have a separate food industry problem) -- that the costs for the "catastrophic-only" insurance have to be quite high. We see this in the "Bronze" level plans. And if people are paying that much per month, it starts to make sense to pay a bit more and get some of the more routine care covered rather than pay so much for nothing really (unless there's a catastrophe).
Bear in mind that "catastrophe" is not just cancer. It's almost any non-routine care. I had surgery this year for a hernia -- the bill was $30,000. I was insured so that's not what I paid. But my point is, an unexpected $30K can easily put a household in a serious financial bind given that Americans don't have much in the way of savings.