Our paper on how few assets California families have suggests a broader distinction between health coverage and other types of insurance.
Insurance is typically bought to protect one assets, in case of a flood, fire, earthquake, a lawsuit, car crash, etc. You have an asset, you want to insure it, so if you lose it, you get some money back. When I bought a house, I got insurance so that if we lost it, we could not start from scratch to replace it. I also got life insurance at that time, so that if I died, my family could retain our home without the resource of my income. But typically, people of lower incomes or few assets don’t have insurance, not just because they didn’t have the money to buy insurance, but because by definition they don’t have significant assets to protect.
We appropriately ask much more of health coverage. We ask that it facilitate us to get the care we need, so we can stay healthy, manage chronic conditions, and deal with the sudden emergency. It’s different.
That’s why the high-deductible coverage doesn’t make sense for many, even if it does in other types of insurance, which are geared toward smaller fractions of the population. The oft-made comparison to car insurance misses the point, that it is focused on a self-selected subsection of the population.