Karl Marx once said, in defense of Communism:

"The idea that individuals are going to have enough knowledge, and enough savvy, and enough insight, and frankly enough guts to make choices all by themselves is pretty much a pipe dream."

No, not really.  That was ABC's medical correspondent, Dr. Tim Johnson, a few days ago.   The story was about a family, the Joneses who have a daughter diagnosed with ADHD, and their struggles to pay for her medication.  His above comment was a response to a statement about McCain's healthcare plan:

"John McCain thinks they should be in charge," McCain's senior policy adviser, Doug Holtz-Eakin, told "Good Morning America." "So specifically, under his proposal, they'd be able to go to another HMO, maybe even an HMO in Delaware or Kansas or West Virginia -- places where ADHD is covered by law."  The ability to purchase insurance from out of state and carry it from job to job is a key component of the McCain plan."

Hey, sounds pretty good to me.  But it gets even better:

"The McCain campaign added that the senator would give a $5,000 tax credit to every American, allowing each to buy his or her own insurance."

Or does it?

"ABC News' medical correspondent Dr. Tim Johnson thinks it will not help much."

Really?  The only reason I haven't switched from my current health insurance to a Health Savings Account (with an accompanying $30-$50/month high-deductible health insurance plan) that will allow me to save the money I don't spend on healthcare every year, up to $5,000 in an IRA, cover me for all costs in the case of catastrophic health issues, and will never, ever, cost me, out of pocket, more than about $5,000 a year (as an individual) is...  Drumroll please...

I need about $5,000.

See, the idea is that you start a Health Savings Account.  It's like a "second IRA," where you can contribute some maximum amount each year, and from which your healthcare costs are taken.  Some HSAs even provide you with debit cards that can be used at your doctor's office.  Whatever you don't spend, it's yours!  It's taken from your HSA.  Anything more than that is covered by your High-Deductible Healthcare Plan (HDHP).  Now, don't get too excited - most HSA's, since they bring along with them the tax benefits of a normal IRA, require that you purchase, and provide proof of, an "HSA-Compatible insurance plan." 

HDHPs are relatively inexpensive - for a single person, you can find them for less than a hundred bucks a month.  For yourself and your family they're a bit more expensive.  If you shop around a bit, you can even find plans that'll cover 100% of the cost of any medical care defined (by the insurance company, of course) as "Preventative," including routine checkups, and things like that.

The actual dollar amounts vary over time as they're adjusted by inflation and other factors, but the equation has remained more or less steady over the lifetime of this alternative to traditional health insurance:  The annual deductible for most HDHP's matches, to the dollar, the annual maxium contribution to your HSA.  So, all you have to do is to choose to invest that maximum HSA contribution (which a person working at McDonald's could do) every year, and pay your monthly HDHP premiums (it costs about as much as having a cell phone or internet).

Now, the only trick is the first year...  Unless you already have an HSA containing the maximum annual contribution, you're going to be paying purely out-of-pocket for your medical expenses that first year (up to the maximum deductible), plus making your contributions for next year into your HSA.  This lack of "startup funds" is the reason I've opted to stall my transition to an HSA+HDHP, while I'm still eligible for healthcare that's cheaper (but only because *you,* taxpayers, are subsidizing it).

McCain's $5,000, "that will not help much," according to ABC, is actually all we need to free ourselves from third-party insurance, and take control of our healthcare expenses.  The fiction is that it's all just too complicated for us to make rational choices about health insurance, and it's all too expensive for us to afford.

Well, I've made a rational choice about the future of health insurance for my family and me, it's not that expensive at all, and all that I have to do is to have the discipline to save a little bit of money each year.  We save money for cars, TVs, XBOXes, vacations, retirement, and a bunch of other things that don't mean squat if we're not healthy.  Why is it such a stretch to think that we should save money (that we might even get to keep) for our health, and the health of our family?

One final word from Dr. Tim Johnson, ABC's medical correspondent about health insurance:

"It's much easier for people to have group insurance through their employer who does the hard legwork in negotiating with the insurance companies."

Hey, I just did most of the "hard legwork" in figuring this out, and I'm sure not your employer.  There's no "group" involved, just you and your family.  Don't take my word for this - do your own research and make your own decisions.  The links I've provided are just a start.  Just do an internet search for terms like "HDHP" and "HSA."

John McCain thinks that you "should be in charge," of your own health, and that's the right answer.