I don’t think the question is really whether insurance companies are a for profit business (it’s gambling actually), but whether health care and the drug industries are and/or should be the same. One doesn’t always choose to “consume a lot of health care”, as if we were consuming bon bons.. things happen, people get sick, so sick that they have no choice. For instance.. I cannot afford health care, so I forego it, but what happens one night if suddenly I get acute appendicitis, a life threatening event, and am forced to choose between death or going to the emergency room.. this one event can bankrupt some people...what is your suggestion there?
Just so you know, it takes me a bit to get to answering your biggest point, so please bear with me as I go from the trivial to the important.
I have to disagree with how you have re-stated the question ... “whether health care and the drug industries are and/or should be the same”
There are four primary players in US health care —
(1) patients and their families/caregivers,
(2) health care providers, primary and secondary,
(3) therapeutics creators and sellers [ pharmas, device manuf., diagnostics, and similar] and
(4) regulators/influencers (FDA, legislatures, courts/lawyers and similar).
To believe that BIG PHARMA and BIG HEALTH CARE are in cahoots in the same industry is a naive and media-driven position (IMHO). I encourage you to read “Saving Lives; Saving Money” by Newt Gingrich. The first half of that book will tell why our health care SYSTEM is broken, and also why you can’t point THE finger of blame at BIG anything. But enough on that for a second.
BTW, the fact that you do not get all the health care you want due to costs/budgets reinforces my point about consumption. While not trivial like bon bons, a great deal of our US health care consumer spend IS discretionary spend. But that is not the major point here either.
Now, to the big point - to your real question, ‘cuz I think it gets to the heart of the matter: “... but what happens one night if suddenly I get acute appendicitis, a life threatening event, and am forced to choose between death or going to the emergency room.. this one event can bankrupt some people...what is your suggestion there?”
THIS question *IS* the core question — does our society have the moral and fiscal obligation to provide health CARE for individuals who cannot afford it? Whether it is ‘providing’ a pediatric office visit and a prescription of Amoxicillin for a three year old’s otitis media, or emergency appendectomies, or diagnosising and repairing an abdominal aortic aneurysm, or transporting and treating TIA or stroke victims correctly within the golden hour, or MRIs for brain tumors, or experimental cancer therapy to keep a 15 year old girl alive for another two years, or heart transplants, or EVERYTHING.
Where do you draw the line? If you draw a line, you ARE effectively assigning the ‘indigent’ to death! You are effectively rationing! I don’t have the answer alone. *WE* have to decide what we want to do as a society and a culture. THAT to me is THE health care debate. We should not try to ‘fix’ or reform health care unless and until we address that.
As an aside - if you really did have a septic appendix and needed an appendectomy, you CANNOT be denied emergency, life-saving care, regardless of your ability to pay at the time. You will get the bills, and you’d have to work out an eventual agreement (likely negotiated) on what you’ll pay, but US emergency departments are covered up in indigent care — for real emergencies, sure, but mostly for doc-in-a-box issues for those unable to pay or those willing to take advantage of our societal largess.
[Urban hospitals ‘fail’ financially because their patient portfolio is skewed by legislation to be unsustainable — think of any urban public hospital— they are ground zero for this question. Rural hospitals/ secondary care and access to care there is a different issue, but we won’t go there today. ]
So to a point, our society has already codified its desire to varying degrees, to provide care whether you can pay or not. We have drawn certain lines. We cannot afford to have no lines, and conversely due to cost we MUST draw lines. But where to draw those lines is THE question.