Key points: 1. Insurance should be reserved for significant expenses but not routine ones. Not paying for minor expenses distorts incentives in system. 2. Rei

Key points: 1. Insurance should be reserved for significant expenses but not routine ones. Not paying for minor expenses distorts incentives in system. 2. Reimbursements distort market signals; for example there should be high demand for geriatricians given our aging population but Medicare makes it a less profitable specialty. If seniors paid directly there would be more geriatricians. 3. The patient is not the customer, the insurance company or Medicare is. This creates further distortions in care.