This NY Times story on long-distance runners and medical insurers provides a case study on why productive reform of the U.S. health care finance sector so difficult.

As noted many times on this blog, long-distance running is not healthy. Thus, as the article notes, medical insurers are beginning to balk at insuring long-distance runners.

However, the myth that long-distance running is healthy remains firmly implanted in the American psyche. So, the medical insurers – not wanting to be perceived as refusing to cover injuries resulting from supposedly healthy activity – are trying to figure out ways to cover the runners.

And, of course, Obamacare is going to require that insurers cover consumers who engage in injury-causing activities.

Meanwhile, the runners delude themselves that they are engaging in a healthy activity while advocating that insurers essentially provide them insulation (rather than real insurance) from the cost of dealing with the unhealthy effects of their activity.

Don’t get me wrong. Folks should be able to enjoy long-distance running as either exercise or a recreational activity (those are two different things, but that’s for another post). My anecdotal observation is that most runners don’t actually appear to enjoy the activity — the delusion that the benefits of long-distance running outweigh the costs apparently pushes them through the displeasure.

But if folks elect to take the risk of injury from long-distance running, then they should have to bear the cost of at least the non-catastrophic damages resulting from that risk. And insurers should be free to elect not to cover consumers who engage in such risky behavior. Shifting the cost of that risk to insurers (who pass it along to the rest of us) simply encourages runners to avoid confronting the myth that they are engaging in healthy activity.

As the late Milton Friedman was fond of saying, consumers will consume as much health care as they can so long as someone else is paying for it.