When one has an accident or comes down with a serious illness, should the first question be: “Do you have insurance? Does it cover this?” Uncertainty or worry can make one hesitate to take preventive measures just to save expenses. A young American friend, a professor in Canada, recently visited and said it was so nice not to have to worry about costs when she was diagnosed with cancer.

Insurance spreads with other people the costs involved for certain risks. Thus insurance companies limit the obligations and liabilities to be covered. Auto or fire or business insurance make sense. I was very grateful for insurance replacing our roof after hail damage.

But health insurance poses a problem because it does not and cannot control all the risks that may arise. Catastrophic illness or injury, which may come to anyone rich or poor, imposes obligations on a company which it might not have anticipated or been able to underwrite. Any insurance company must operate as a business within reasonable or possible resources. Insurance has a role where risks are more clearly identified and indemnified. Insurance is hardly the model for health.

Many advocate requiring everyone carry health insurance. A subsidy could pay for those unable to afford coverage. Who then will pay for those who cannot buy health insurance? Failure of some people to have health insurance has driven greater numbers to use emergency rooms. This is great, but who pays for these facilities and staff? The hospital or the “government” (namely, us)?

The idea of risk with health is different from that in auto or house or business insurance. The individual can be prudent and have a role in maintaining good health, but cancer, coughs, appendicitis, curvature of the spine, arthritis, mental illness, etc., impose themselves without regard to statistics. Early detection, care or prevention saves money. Every newborn (and mother) deserves pre- and post-natal care. We all benefit from healthy citizens. They work, pay taxes, make for good life.

Many industries, medical associations, unions and many in the public are calling for a national health care system. Industry wanted health coverage because it made its workers more dependable and it was a positive inducement for employment. But now health insurance is a disadvantage with many foreign countries.

Critics of a national health care system raise several points. 1) We want to choose our own doctors and hospitals. In reality some insurance executives determine which resources we may access. We really don’t have completely free access now. A good plan would require some primary point for coordinating information and authorization.

2) Many contend that people in other countries have to wait and wait for help. We must admit that many times we schedule appointments for a time in the future. My next surgery was scheduled for six weeks in the future. Many are the stories of having to wait even with our insurance system.

3) Quality in other countries is inferior. Can we assume the various national health care programs would intend to diminish quality? Our standards for medical care must not be compromised.

4) Cost. How many trillion dollars will it take? We know that Americans pay more per person for the care we receive compared to other countries. We spend $1 out of every $6 for health care. Also, many reports claim up to 30 percent of health care costs are absorbed by nonmedical services, such as paperwork, records and reports to insurance or Medicare and Medicaid, and executive salaries.

My expenditures for health care come to thousands of dollars — and we have been relatively very healthy. If one expects increases in taxes for health care, there will be some offset for what we are now paying through other avenues.

I believe we have the knowledge and ability to devise a national health care system for all people to cost less than the present, a system better than we have today and better than even our Canadian neighbors have.

We need national health care – NOT national health insurance.