While I’m essentially in agreement with your thesis — health insurance isn’t insurance. There is one problem with Elmo not having some sort of coverage. If he is in an accident or is diagnosed with a serious disease without insurance then we (society) are going to insist he be treated anyway regardless of his ability to pay so we’re going to pick up the cost.
Which then brings us to the issue of catastrophic coverage (the good old Major Med) — in both places I’ve worked it hasn’t been a good deal for me because the employer subsidy was set up in such a manner that the employer paid a couple of hundred less a month for catastrophic vs standard coverage but I would save maybe $50/month for family coverage because my company is subsidizing the standard more than the catastrophic. Saving $600 vs a several thousand dollar deductible wasn’t a good deal considering I would use most of that $600 with just a couple of doctor visits at which point I am left with no savings and just risk. However if my company paid X (say the cost of the catastrophic) and said choose your coverage then the deal would be better — save $2400 (the difference in cost between catastrophic and standard) vs a possible several thousand dollar risk and I’m more likely to take it. Especially since I know my normal bills don’t amount to $2400 so I can expect to save money. This works for my employer because the cost of 100% of the catastrophic is less than the subsidized cost of the standard. It works for me because I’m betting I won’t run up more than $2400 in bills and if I do I know what my exposure is. So now I still have coverage against the brain tumor, car accident, etc but I’m responsible for most of my day to day.
