My coverage is my own - I either have it or I don’t. I’m not in charge of the financials of the insurance company, it’s the insurance company that manages the funds. I’m under no delusion that this is a singular account from which only I can make claims - that’s not how insurance works. If I wanted to do that, I would just open a rainy day account - if I just want to use my own money, I can do that without a middleman, what I’m paying for is a specific service. The point of insurance is a calculated bet between me and the insurance company, the bet being that whatever I would’ve paid out of pocket, they will pay less for the same procedures. The benefit for me is that regardless of how long I’ve had the plan, it covers me all the same - the benefit for the insurance company is that I give them money for, for the most part, absolutely nothing and they get to manage, invest or otherwise multiply the capital they collect. This is different from a government scheme which has no competition, generally doesn’t invest money and operates on the premise that the coverage it provides now will be paid for by taxing the next generation which doesn’t need much medical attention on account of their age. This kind of program can only exist with a positive population growth - right now population is stagnant and market growth is very slow.
You can observe this interaction in the U.S. as we speak. The young people paying for Social Security now are paying into a fund that is on the brink of bankruptcy and without significant reform it will become insolvent within the foreseeable future - the latest estimate is by 2033. The fund’s insolvency was accelerated by massive expenses caused by the COVID-19 pandemic. The cynical part of me expected COVID-19 to save the Social Security fund as it primarily wipes out the elderly and people with severe pre-existing conditions who not only need the most care, but also are the beneficiaries of Social Security cheques. What I didn’t take into account, or rather didn’t expect, was that the economy might also collapse under current leadership. Higher unemployment equals less Social Security contributions, and with no contributions the engine is running on fumes, so it’s swings and roundabouts until the situation stabilises. Either way, expect massive changes in how American safety nets operate within the next decade, possibly sooner if the trajectory doesn’t change.