The core problem with “Health Care Reform” in many wonk tanks is their solutions are predicated upon the notion that any solution must come from the top down, rather than bottom up. Apparently, this virus also exists in some closets in the Heritage Foundation.

For starters, if one honestly tosses out all the disguises and masks surrounding “health care reform” one uncovers this question is all about “health care financing”, not health care reform. Dive a little deeper and one discovers the core financing issue forks into at least two roads as far as those not paying into the system goes — those who have limited means, and those who could pay, but chose not to.

The individual mandate only applies to this second group AND makes the FALSE assumption that one must prepay into coverage to get care. Yes, boys and girls, the Supremes have already ruled on this — those in need must get care.

The real issue is how to get Bubba, who has the means to pay for care but choose not to, to pay for Bubba’s care. Seems like at this point, the only folks in the room must have been insurance geeks, as the only solutions are about Bubba (beyond their will) prepay for his care — otherwise known as insurance. Yet, if there had any honest banker in left in the room, at least one other solution might have been offered — let Bubba post pay for his care thru some sort of loan. Or perhaps the banker and carrier might have had a lunch and figured out how to offer a combo package that mixed in paying off the loan for uncovered care, and coverage for the duration of the loan. Perhaps a truly creative goup might figure out how to amortize the time Bubba was not paying his share for catastrophic coverage into the mix and toss Bubba’s expenses into a pool.

In other words, there all all sorts of market place options available to help stabilize the health care financing social marketplaces. Additionally, these solutions don’t require a top down federal law solution. Rather it would seem prudently eliminate federal (and state) laws that restrict the market from adapting more flexible payment systems for care. Responsible solutions do require systems and markets that promote, if not reward, personal responsibility to take charge of financing one’s own health care. In other words, proper solutions focus will “promote the general welfare” rather than mandate it.