This story caught my interest today because the company I work for changed our insurance to United last year. Now I wonder who it is that is being insured.

How William McGuire earned that fat paycheck | Chron.com – Houston Chronicle: “Moral hazard theory, which has governed health insurance since the 1950s is, quite simply, backward. In a lengthy piece in the New Yorker last year, Malcolm Gladwell, author of The Tipping Point, noted that Americans spend almost two and a half times as much per capita on health care as the median for the industrialized world.

‘Americans have fewer doctors per capita than most Western countries,’ Gladwell wrote. ‘We go to the doctor less than people in other Western countries. We get admitted to the hospital less frequently than people in other Western countries. We are less satisfied with our health care than our counterparts in other countries. American life expectancy is lower than the Western average. Childhood-immunization rates in the United States are lower than average. Infant-mortality rates are in the 19th percentile of industrialized nations.’

And on top of all that, the U.S. spends almost $400 billion a year, about $1,000 per capita, on health-care-related paperwork and administration, Gladwell found.”

In other words, for all we’re spending, we are getting nowhere. In fact, we’re losing ground. Because while “consumer-directed plans” may have the feel of greater control, they — and related programs such as the various pretax spending accounts — are nothing more than an effort to shift more costs to us.

That doesn’t… advance the cause of medicine. It doesn’t advance public health.