What should be done about health insurance? The Gilbert plan

There was a moment in the last debate between John McCain and Barack Obama when the Republican candidate took Obama to task for his health care plan, calling it a "single payer system." "If you like that, you'll love Canada and England," McCain shot.

I would love Canada and England! I recently left my cushy job with benefits to hit the freelance lifestyle, with its attendant flexibility in spending waking hours with my three young children. I'm the primary breadwinner in my household, to boot, so I've been hemming and hawing over what I need in my budget. Cable's out, and I'm considering saying goodbye to the Blackberry (ohhh!). We don't drive, but I have a little in the budget for bike lights and the occasional replacement inner tube. I'll be honest: I wasn't thinking that much about health care costs. Maybe it was one of those fingers-in-the-ears moments, squeezing my eyes shut and saying "nahnahnahnahnah!" every time the topic came up.

I got my COBRA paperwork today, and just for health care, I'd be spending $1,036 a month; more than my mortgage payment (if you exclude taxes). I wrote about this on a local mamas' site, threatening to go without insurance and pay out of pocket for well baby visits and such, and was immediately begged (literally "please please PLEASE") to buy health insurance. I started griping about the costs and the cheated feeling I have: essentially I'm being asked to pay thousands each year to protect me from total bankruptcy, should there be a health crisis in my family. Tracy Coenen suggested I post here about what I'd like instead.

It turns out, neither Obama's nor McCain's plan would be ideal (though, for the record, McCain's would be completely unhelpful, especially for parents who work for small businesses). Instead, here is how I'd structure the health care system: