Just over a week ago, the Los Angeles Times carried a story about the struggles some consumers face with their high-deductible health insurance plans.

The Times reports on a couple that bought a policy with a $2,500 annual deductible and a $335 monthly premium. "We were just looking for something [with a premium] we could afford," Nancy Warrington said. "The high deductible didn't even dawn on me."

"The insurance was a mixed blessing," the Times reports. "Although it covered Nancy's appendicitis, Todd's back injury and an assortment of other medical needs over the years, the annual deductible also saddled the San Diego couple with more than $10,000 in debt."

Caveat emptor. The Warringtons made a decision to purchase insurance with premiums they could afford in order to have insurance protection for potential major medical bills that they likely couldn't afford. That's how real insurance works. Their policy no doubt protected them from tens of thousands of dollars in medical bills, but not from the deductible they agreed to.

When people buy homeowner's and car insurance, they don't buy insurance that covers having their plumbing fixed or their oil changed because they know that would be too expensive. Instead, they pay for routine maintenance themselves, knowing they have insurance to protect them if they have a fire or a major accident.

People with high-deductible insurance are making a similar trade off. Most people would rather have policies with low-deductibles and low co-payments, but few families can afford the $10,000 or more in annual premiums the insurance would cost. Those with high-deductible policies generally save money on lower premiums, but that means being prepared to pay some costs out of pocket.

The last quote of the article captures why we have the problems we do in the health sector:

The Times reports that a San Fernando woman "had a dizzy spell [last year] but put off going to the emergency room partly out of financial concern, she said. It turned out to be nothing serious."

"Still," she said, "there should be no consideration of dollar figures when it comes to your health."

Simply put, the attitude many people have regarding health care is: Someone else should pay.

Can we have all of the medical care we could ever want for free, no strings attached? Single-payer advocates who write to me passionately believe that is the case.

What's Latin for, "There's no free lunch"?