I don't often agree with Jim Marshal, but for the most part find his comments at least thoughtful and interesting. His plan for ending the use of private insurance, Medicare and Medicaid to pay for healthcare and how it would lower costs leaves me puzzled. Marshall wants to end government coverage for the elderly and poor and private insurance for the rest of us as well.

I don't want to use anyone else as an example so I will use myself. Unlike some people who support healthcare reform, I actually have private insurance that I would most likely keep in any case. Having been a very careful insulin-dependent diabetic for nearly 20 years now, I have avoided the major eye and limb problems so common with diabetes.

Having said that, however, the longer one is a diabetic the more difficult and expensive that process of maintenance becomes. And the technology has become more expensive, especially with things like insulin pumps, one of which I wear all the time. Roughly estimated, I suspect my diabetes expenses, not counting doctor visits, etc., probably run $500 a month.

What I am missing in the Marshall plan is how my paying that $500 a month (instead of my insurer) is going to make that go down? It isn't like I can decide to skip taking my insulin for a few days every week. Or that I can decide not to test my blood sugar (at $1 per test), since I could pass out while driving and injure myself or others.

If Marshall's plan is that if enough people can't afford health care, then prices would fall, I suppose that would work. But that's not health care reform; it is no health care at all.

Patrick Durusau is a resident of Covington. His columns appear regularly on Fridays.