Dr. Mike Walden, North Carolina Cooperative Extension economist in the College of Agriculture and Life Sciences at N.C. State University, responds:

"Well, let's first look at the notion of insurance. The idea of insurance was originally to make small payments - that is, the person insured would make small payments - to buy an insurance policy that would come in and pay for unexpected large payments. So for example, let's say you're making payments to your health insurance policy. You're paying, say, $100 a month. What that guards against is the cost of major surgery, where you may have a bill that costs $30,000. So in that case, the insurance steps in and pays it. So that was sort of the initial notion of insurance. And you can apply that to auto insurance, life insurance, liability insurance, any kind of insurance. We've sort of been moving away from that to where - at least in the health insurance area - we now want health insurance to pay for planned health expenditures, that is, not unexpected but planned health expenditures, many of which are not catastrophic. A good example would be vision tests, which North Carolina's public health insurance at least did cover at one time. Now this is fine, but what it does is increase the cost to the insurance companies, and therefore, premiums, and the cost to the consumer or to whomever, maybe the state. Premiums on that health insurance policy have to go up. So I think one thing that we have to decide as a country is what we want health insurance to do. Do we just want to reserve it for those unexpected, catastrophic expenses or do we want it to pay also those planned small expenses. It makes a big difference which you choose on the cost of insurance."