President Obama and Sen. John Barrasso (R- WY) got into a very interesting back-and-forward during the bipartisan health care summit. Barrasso tried to defend catastrophic insurance saying it makes people the “best consumers of health care.” Obama thought that was insufficient for many lower middle class Americans. The important thing is that this is not really the debate because Barrasso does not even want to help all Americans get catastrophic coverage.
If Barrasso actually thought there were great merits to people only having catastrophic insurance, why does he not submit a bill to that effect? It would be easy to write a bill to provide Americans with, at minimum, catastrophic insurance. The cost would be relatively cheap compared to the current Senate bill. It could even be written to be a fairly good bill.
Singapore has a system with universal catastrophic insurance, which you can opt-out of, combined with special health saving accounts. The country has some impressive health statistics, although that probably has a lot to do with their healthy lifestyle and relative young population--but it does show such a system is workable.
The problem is that Barrasso is not really arguing for the policy merits of making sure all Americans have catastrophic insurance (and only catastrophic insurance), or making the moral case that providing it is all the government should be required to do. In the current system, millions of Americans can't even get catastrophic coverage. Millions of Americans are denied even this limited coverage because of pre-existing conditions or because they can't afford it. There also exists a problem where millions of Americans think that they have catastrophic coverage, but really don't. They will have their policy recisioned when they actually get sick, find out that their policy does not really cover their specific catastrophic illness, or get dropped when their coverage exceed the lifetime limit. No bill Barrasso has proposed would solve these problems, no bill offered by Barrasso takes a step toward making catastrophic insurance available and workable for all Americans.
Barrasso did not argue for just providing Americans with catastrophic insurance, he just argued that the government should not try to help people who currently can only get actual catastrophic insurance get better insurance. The people who can't even get that are out of luck. If Barrasso really thinks that catastrophic insurance combined with health savings accounts is such a great idea, he should put together a bill to provide all uninsured Americans with exactly that. I bet he could easily get bipartisan support and see his bill become law. The biggest thing stopping Republicans from seeing their solution to universal health insurance become law is that they refuse to even create a solution.