11/01/2013 11:42 am ET Updated Jan 23, 2014

Keeping Your Crappy Health Care Plan

The mainstream media's running around like a child with a shiny new toy (story): some people won't be able to keep their insurance because of the Affordable Care Act. They are practically screaming "Liar, liar, pants on fire" at President Obama. This allows them to pat themselves on the back for "balanced coverage" of American politics. If you've been reporting what a gigantic mistake the Republicans have made of things for the past month, now it's time to headline equally negative stories about Democrats.

The media have taken the bait, and reduced an important policy debate to the bite-size of what fits on cable news in between stories about celebrity break-ups and new diet books. The idea they are parroting fits on a bumper sticker. "I want to keep my health plan!" In so doing, they have done us all a disservice, for the millionth time.

It sounds like an easy story: the president promised, and then, oh no he didn't! People are getting notices that their sacred right to keep whatever crappy non-health care plan they have is being taken away by big government. What's really going on is a redefining of what " care" means, as in The Affordable Care Act. It's not The Affordable Crappy Health Care Act, it's the Affordable Care Act. And if you think an insurance plan with a huge deductible that only allows you to see your doctor twice a year is really "care," then you've been duped by Big Insurance.

Insurance companies are more than happy to take a small chunk of your money every month, in return for giving the smallest possible coverage. It's a great deal for them, but if you get more than a cold a year, it's a bad idea for the consumer. And the Affordable Care Act has stepped in and said, "Look, this is not real insurance. Instead, you can buy cheaper insurance (especially if you qualify for one of the many subsidies) that will give you unlimited doctor's visits, cover maternity care, and in general give you real peace of mind."

But the libertarians protest: "I have a God-given right to choose the crappiest insurance, and pay a relatively small amount of my paycheck to get it." Here's the real public policy debate that almost nobody's talking about: What happens to this happy libertarian when she or he gets cancer, or hit by a car? Insurance companies know that people under 40 don't believe these things will happen to them, but we all know better, don't we? And who pays for the libertarian with a crappy non-health care plan who gets cancer or hit by a car? Why, we do. Because they will go to the emergency room, the most expensive kind of care there is, and that cost gets pushed onto all of us.

So I have a simple solution for libertarians who want the freedom to keep their crappy non-health care: let them sign a binding document that they will never use the emergency room unless they can afford to pay for the full bill themselves. Let them sign a binding document that says if they get cancer and go broke trying to pay their medical bills, that they won't declare bankruptcy, which will also pass cost increases onto all of us. And while we're at it, if libertarians want the freedom to drive their motorcycles without a helmet, let them sign a binding document that their brain surgeries will be totally paid for by the freedom-loving motorcyclist and her or his family.

Freedom's just another word for "let the other people pay for my health care when I get a catastrophic illness." Put that on a bumper sticker.