I think I said this to the other guy, but I’ll repeat, our current system isn’t perfect.

I feel you. There is probably no happy solution to the problem that bodies break down and people get sick. It is a fact that is always going to suck, and throwing money at it sometimes makes it suck less, and sometimes makes it suck the same amount but expensively.

I’m certainly not against the idea that I could say, for instance, “charge me less, and I’ll pay any visioncare costs out of my own pocket” (which, in a manner of speaking, I already do, by opting into high-deductible, low-premium plans, and by choosing not to be part of my employer’s add-on optometry plan). I could see doing that with a pre-existing condition (which is not actually an option, but if we’re dreaming up healthcare plans) where somebody could say “look, insure me for everything but my asthma, as part of your regular insurance pool, and charge me the normal rate, but I pay asthma stuff out of pocket (or pick up some just asthma secondary insurance with a higher risk group).”

But what we’ve seen in practice is that excluding pre-existing conditions does a great job of incentivizing extremely risky behavior like not disclosing your health status, or not seeking early treatment. And that kind of stuff destabilizes the whole market. I think you only get around that by eating a certain (predictable) amount of risk and extending what amounts to whistleblower protections.