A Reuters article about the flaws in job-based health care is some interesting reading. As an employee (and former employer) in the Bay Area who switches jobs often, I've often complained about the fact that my health care is attached to my job. Every time I switch companies, I have to redo my health care, I may have to change doctors if they aren't in the plans I'm offered, I may have hassles from the insurance company about covering pre-existing conditions. And if I want to start my own company, I have to pay COBRA fees to keep my existing coverage, or get my own personal coverage, or get my startup to offer health care.

One idea some friends of mine kicked around was starting a Credit Union or Professional Organization (or using one of the existing ones) to provide health care for its members. Increasingly, however, I'm thinking the only way to really do this is universal care. I know its going to suck, but when you look at all of the competing pressures, I don't know how else to do it. For instance, younger single people have few problems, so they are more likely to opt-out of the system. But if they do, that leaves just the more expensive people in the system, raising rates for everyone. Maybe individual coverage (like auto insurance) would work if we have laws requiring people to have health coverage, but then you might have companies which target "good health" people like some insurance companies target "good drivers". Where "good health" doesn't just mean "in good shape, doesn't smoke", but could mean "has good genes" or "is single under 30". Universal coverage means "everyone gets coverage" and payment is based on taxes, which means "ability to pay", and that ends up being pretty "fair" as these things go. Of course, then you get crappy government service, and crackpots (some are even doctors) in Sacramento or Washington determining what health care is good for you, and want "violates the sanctity of life" or they just don't want to provide because keeping some military base open (that the military wants to close) is more important than health care.