Health Insurance is one of smartest financial moves an individual or a family can make. As a result, the cost of measuring outcomes and costs is unnecessarily increased. The Duttons were doing all they could to earn a living and pay their taxes—taxes that helped provide free health care for people who did nothing to earn it. Meanwhile, they faced thousands of dollars in medical bills themselves.\n\nIf your plan requires a $15 co-payment that’s the amount you pay for an office visit, and the insurance company pays the remainder of the charges. While these prohibitions originally were limited to services reimbursed by the Medicare or Medicaid programs, recent legislation expanded the statute’s reach to any Federal healthcare program.\n\nThe current structure of health care delivery has been sustained for decades because it has rested on its own set of mutually reinforcing elements: organization by specialty with independent private-practice physicians; measurement of quality” defined as process compliance; cost accounting driven not by costs but by charges; fee-for-service payments by specialty with rampant cross-subsidies; delivery systems with duplicative service lines and little integration; fragmentation of patient populations such that most providers do not have critical masses of patients with a given medical condition; siloed IT systems around medical specialties; and others.\n\nThese are the problems at the foundation of our health-care system, resulting in a slow rot and requiring more and more money just to keep the system from collapsing. Larry, now seventy-four, has retired, and his pension, military benefits, and Medicare helped keep them afloat.\n\nThere was nothing natural or inevitable about the way our system developed: employer-based, comprehensive insurance crowded out alternative methods of paying for health-care expenses only because of a poorly considered tax benefit passed half a century ago.