Clear Thinkers favorite Arnold Kling has been doing extensive research on health care finance issues over the past couple of years and, as noted in this insightful TCS Daily op-ed, he is coming to the conclusion that one of the main problems with the U.S. health care finance system is that most Americans simply do not want to pay for true health insurance:

What we are left with, then, is that people do not want real health insurance. I would gladly take a health insurance policy with a $10,000 deductible per individual, and I suspect that many of my wise, risk-averse TCS readers would, too. But we are in a tiny minority! Most people do not want to be responsible for the first $10,000 in medical expenses, and most people believe that an insurance policy that is expected to pay no claims 95 percent of the time is a bad deal.

I am willing to claim that no insurance market in history ever arose because of spontaneous demand on the part of consumers. Maritime insurance, which was one of the first forms of insurance, was demanded by creditors as a condition for lending money to shippers. Life insurance also initially arose to meet the needs of creditors who were lending money to pensioners. Homeowners’ insurance is standard because it protects mortgage lenders. Collision insurance for autos is optional if you own yours free and clear, but not if you still owe money to the finance company. . .
What we call health insurance also arose to meet the needs of creditors. In this case, the creditors were doctors and hospitals, who wanted assurance that they would be paid for service. Comprehensive, first-dollar health coverage, which is not really health insurance, protects suppliers, not consumers.
For the most part, people buy insurance because it is mandated by others. Insurance does not have a large natural market.

Read the entire piece, in which Kling goes on to endorse mandatory catastrophic health insurance, but concedes that most Americans will not embrace such a proposal because they mistakenly continue to believe that employer-based health insurance provides them something for free or at least at far lesser cost than they would pay directly.
Meanwhile, over at the Journal Report, Joseph Antos, who was former assistant director for health and human resources at the Congressional Budget Office, John C. Goodman, founder and president of the National Center for Policy Analysis, and Robert Reischauer, president of the Urban Institute and vice chair of the Medicare Payment Advisory Commission discuss the issue of whether introducing wide-scale consumer choice back into the health care finance industry can have a large beneficial effect on the current inefficiencies in that system. I highly recommend both Kling’s piece and the Journal Report for provocative thoughts on the problems confronting America’s creaking system of health care finance.