Just don't ask me to pay for somebody else's healthcare.

People like to take that potshot at proposals for a government role in expanding health care coverage. But you know, that's what all insurance is. We all pool our needs and we pool our funds, and somebody takes a cut for handling the paperwork. That is insurance 101, right? The lucky ones pay more than they take out; the poor bastards with health problems soak up some of the difference left after the paper shufflers pocket their share.

So pooling cost and pooling payments is happening now, and it will continue. The question is what's the best way?

A good way to start might be a claims-clearing process comparable to the Federal Reserve's check-clearing process. That federal intervention dramatically increased efficiency and liquidity by resolving the waste of non-standard exchanges between individual banks and standardizing stuff that should/could be simple.

That system would also present opportunities for private insurance companies to pool data on health risks and costs to encourage better care management at the doctor's office. And it would be a forum for them to pool the catastrophic risks that could sink any one of them individually. It seems reasonable for them to be more flexible about how risks get pooled in order to gain those benefits to themselves. One of the most stupid aspects of our system is the arbitrary designation of a risk pool as the people who happen to work for one company.

So the private companies can survive and continue to compete on rates and services. That appeals to me, as I dislike having my health insurance held hostage to my damn job. Seems like a basic legal framework for the process could go a long way to resolve the issues without institutionalizing the whole thing in a federal department.

Much as I worry about the idea of a health insurance system from the people who brought us the tax code, it could hardly be MORE fractured and wasteful than it is now.