Bear with bandages and medical stuff.

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The Congressional Budget Office has released its score on the new American Health Care Act, and the numbers are not good. This is to be expected, as the bill fails to do anything to actually improve the health care market. But the point most news outlets are highlighting is that the bill is predicted to cause 24 million people to lose their health insurance by 2026.

While I have no wish to defend the bill in any way (it is a pile of garbage that should be set on fire), the CBO score illustrates the difficulties in trying to roll back government. Everyone makes the mistake of placing health insurance as the end-all, be-all goal of public policy, which is a bit like missing the forest for the trees. What’s more, people have come to regard health insurance as crucial to their well being (if not a “human right”), and consequently howl with despair at the vaguest hint that it might be taken away from them.

Because people have become so fixated on health insurance coverage, and because they can’t tell the difference between health insurance and health care, we have reached a point where any policy change that could disrupt insurance markets are demagogued as “taking away people’s health care,” even when that is not the case.

… it’s easy to provide health insurance to everyone as long as you don’t care whether the insurance policies are actually effective.

What’s important to realize is that health insurance is not an end in itself, but a means to health care — which is, in turn, a means to good health and a long life. If you have good health, you don’t need health care, and if you have health care, you don’t need health insurance. Failing to see this simple truth is a big part of why our health care system is such a mess right now.

Imagine a policy aimed at getting everyone in America car insurance, while not only neglecting to consider whether people owned cars, but actively making it more difficult to buy them. This is effectively what Obamacare has done for the health care market. By focusing solely on insurance coverage, the law and its architects forgot to consider whether people would have access to actual health care.

When health insurance is the sole goal, perverse incentives end up harming patients. This is because it’s easy to provide health insurance to everyone as long as you don’t care whether the insurance policies are actually effective. This is why we see policies under Obamacare with deductibles so high as to be practically useless for many Americans. You’re technically “covered,” but the only way to take advantage of that coverage is to first spend thousands of dollars out of your own pocket — a luxury not available to most people.

We have to get over this mindset if we are ever going to reform health care in a way that benefits consumers. There are many things we could do to improve access to health care. We could reduce the barriers to entry to allow more people to become doctors. We could legalize alternative forms of care, like retail clinics and nurse practitioners.

We could promote price competition and transparency. We could invest in services like telemedicine, and roll back regulations that prevent new medical devices and pharmaceuticals from coming to market. We could reduce the power of the American Medical Association, which primarily exists to protect doctors from competition. We could abolish certificate of need laws, which prevent health care providers from obtaining the equipment they need.

But we will never make progress in any of these areas so long as we maintain this single-minded fixation on health insurance coverage.

In an ideal world, health insurance would be as unnecessary as clothing insurance is now. No market for clothing insurance exists, because everyone can afford clothing already.

The goal in health care policy should not be to increase the role of health insurance, but to eliminate its need by making health care so inexpensive and widely available that even the poorest among us can afford it.

Logan Albright is a researcher for Conservative Review and Director of Research for Free the People. You can follow him on Twitter @loganalbright73.

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