What informs or guides coverage policy?
The original purpose of any kind of insurance is to cover the kinds of risks that are low in probability (things that probably won’t happen to you) but would cost you large amounts of money of they do happen. Health insurance started out this way. But it has changed; most health plans now cover routine as well as extraordinary health care expenses. The biggest challenge in designing any kind of health insurance system is this: Most of the time a third party — not you or your doctor – but your employer or the government, for example – bears the cost of health care, including routine care, for you and your family. You pay only a certain amount or a percentage, which doesn’t change no matter how much or how little care you and/or your family members receive. Depending on your doctor’s fees, the price of your prescription drugs, the costs for your hospital care, etc., the total cost of your care (of which you pay only a small part) could just go up and up without any limits. If this were
