My husband and I own a small business and, due to a pre-existing heart condition, I am having a hard time obtaining health insurance. The companies that are willing to offer a policy want us to pay exorbitant premiums.

You have a lot of company, if that’s any consolation. In fact, we’ll be hearing a lot about health insurance over the next several months as the campaign season unfolds. I hope that our country’s best minds are able to put together a series of solutions — in all likelihood market-based with some government oversight — so that individuals and families like yours don’t fall through the cracks.

As the politicians and think tanks ponder this issue, let’s review the purpose of insurance and options available for most of us when it comes to health insurance. The primary purpose of insurance is to allow large numbers of people to pool together resources in the form of premiums. In this way, when something bad happens to a few of them, adequate resources will be available to meet the expenses.

Insurance provides a way to manage risk. While not speaking directly of insurance, Scripture does say, “Know well the condition of your flocks, and give attention to your herds” (Proverbs 27:23).

Sometimes people make the mistake of thinking that insurance should cover all of their costs, but that’s not really the role of insurance. Instead, it is designed to reduce the risk of catastrophic loss. That’s especially important when it comes to medical costs, since most of us are literally one major illness away from bankruptcy.

The employer-based system that has been in place for decades provides most Americans with reasonable insurance options. Certainly, employers continue to modify the plans to place more responsibility and cost onto the employee. This is a natural response to the rapidly escalating medical costs companies have seen over the last couple of decades, and the globally competitive environment. Government-subsidized programs are available to assist the needs of the elderly and the poor.

But medical insurance can be a greater challenge for people who are self-employed or whose employers don’t provide a group plan. In these cases, both availability and cost become formidable issues.

Naturally, for-profit insurance companies want to “cherry pick” the clients they are willing to cover. A person who has a history of poor health or pre-existing conditions is a higher risk for making major claims, so that person is a less desirable client. The Health Insurance Portability and Accountability Act of 1996 has made some progress in taking away some of these roadblocks, but more work needs to be done.

If you are self employed, or your employer doesn’t offer health insurance, two reasonable options include high-deductible plans and health-savings accounts. These are designed to work hand-in-hand. In a high-deductible plan, you take responsibility for most doctor visits but are covered if catastrophic illness or injury strikes.

In order to help you pay your day-to-day expenses, the government, through a health-savings account, allows you to save money tax-free to cover current and future qualified medical expenses.

While many employer plans will be more “benefit-rich,” at least these two options provide a solid safety net for self-employed workers like you. God love you.


Phil Lenahan is President of Veritas Financial Ministries (VeritasFinancialMinistries.com).