In the last two days, there have been over a dozen messages on the town meeting mailing list talking about town employee health insurance, and whether or not the Town could save money if Town employees joined the State's insurance program.
Sigh. That conversation wouldn't be necessary in a world where employees were responsible for buying their own health insurance. Each Town employee would be free to choose the best insurance plan for their individual situation, weighing the costs and benefits and deciding what was best for them (I'd choose a very-high-deductible low-cost policy that only covered catastrophic costs; maybe you'd choose an expensive "all-you-can-eat" policy that paid for eyeglasses and weekly massages).
It also wouldn't be necessary if we had something like Britain's National Health Service (in that case, some government panel would decide whether eyeglasses and weekly massages were "essential health services" or not). The more I learn about our health care and health insurance systems, the more I'm convinced that we would be better off with either a completely free-market system OR a so-called "single-payer" system. Right now, we have a "50% socialized" system (the government, through Medicare and Medicaid, pays about half of all medical costs).
Massachusetts has started a trend that I hope will continue-- states experimenting with different solutions to the health care problem. The Federal government needs to loosen it's grip on Federal Medicare/Medicaid dollars, and allow states to try different approaches to solving the health care crisis. Some will succeed, some will fail, but maybe by the time my children are sending their children to college we'll have a more rational health care system in this country.