Steve Karp explains in an American Thinker column why the national debate over health insurance ignores a larger challenge facing American health care.

The terms health insurance and medical care are often used interchangeably. They are, however, quite different concepts, and once understood, who benefits or loses becomes apparent.

For decades, Americans have been fed a lie that health insurance ensures receiving medical care. The truth is that there are many obstacles in our way when that care is needed. With the passage of the Affordable Care Act (ObamaCare), the old lie was advanced, not just in name but in deed. Under active debate is its repeal, hybridization or replacement. But are these just false choices?

Insurance is a product sold based on risk. While it can protect me from myself, it can also serve to protect me from you or you from me. So, what is health insurance protecting?

If, as the name implies. it insured health, then it would be selling preventative services for injury or illness. The problem is that injury is often unanticipated and there are few ways to prevent illness. The old adage that you don’t see a doctor when you are well by and large has more than a grain of truth.

So perhaps what we have is a misnomer and what pays our medical bills when we are injured or ill is actually medical insurance. The question though, no matter what it’s called, is how is it working out for us?

Part of the basic definition of insurance is an “agreement by which a person pays a company and the company promises to pay money if the person becomes injured.” ObamaCare requires that most of us purchase a health insurance policy or pay a ‘penalty’ for what we may not want, use, or find financially beneficial. So, what’s the motivation for requiring us to possess health insurance?

To understand human motivation is to acknowledge the role of money and power. Once that’s accepted, the question becomes “who stands to gain in forcing every citizen to have a health insurance policy, with its numerous exclusions, many of which can’t be anticipated, and which benefits mostly the underwriter, not the insured?”

The punchline is: not the average Joe. Though the list of who benefits is relatively short, those on it are quite powerful and from that power flows a stream of monetary gain. It arises from the creation of a law that’s purposely ill defined, nearly impossible to understand, and requires from here to eternity to clarify, thus ensuring job security.