Long time readers of this blog will no doubt know about High Deductible Health Plans. These plans force the insured to pay thousands of dollars for medical care out of pocket before the insurer begins to pay for care. This - according to proponents - gives the insured some skin in the game and this is supposed to promote prudent use of medical services.

Except when it doesn't.

Anyone who has dealt with mental illness or substance abuse - either their own or another's - can testify that people with these conditions are almost certain to seek care too little and too late.

It is not surprising that people with high deductible plans - faced with a large bill for mental health services - often discontinue treatment. They are fine anyway and can deal with this on their own. Naturally this leads to more emergency admissions, suicide attempts and lasting physical damage.

I suppose that we will get this right eventually when we achieve the final libertarian utopia and grant everyone the freedom to die in the streets without care.

Remember to vote. It might just stop the libertarian revolution.