This gets to the core of Milton Friedmans criticism of the healthcare system. PAtients might ask themselves that but they get healthcare services through the employer, so they show little to no elasticity between insurance companies and their premiums.
If you untied healthcare from employers, then you would unleash a massive competitive force, where if one insurance outperforms another one, patients will react as you say. But today, changing insurance companies would mean changing jobs.
Healthcare insurance is different. What you would see is that insurance companies would compete for the healthiest demographic and offer them the best rates but no one would cover people outside of that demographic or they would charge ridiculous rates.
And this is because healthcare is not an insurance! It should be instead thought of as a societal contribution (via a tax) for the benefit of universal healthcare.
Framing healthcare under the microscope of insurance causes the boxed-in solutions currently in existence.
That would actually be a good force. It is insanity that a 20 year old pays the same that a 50 year old, or that someone that exercises, does his check-up, etc pays the same as someone that never goes to the doctor, doesnt take care of himself etc etc. Even car insurance does this.
The point of insurance is to manage risk, not to reward it.
And then there is the whole pre-existing condition thing. How dare someone be born with handicap, get cancer, etc. Would you be okay if your insurance tripled or was completely denied if you were diagnosed with cancer? And why should a woman have to pay into an insurance pool that pays out for prostate exams?
Car insurance is mostly based on things you can control -- at fault car accidents, tickets, etc.
You pay your insurance against cancer before you get it.
A more complicated pre-existing condition would be maybe for kids, young adults whose parents didnt give coverage for , etc. But you could use subsidies to manage those cases and it would be a blip in the budget. If someone deliberately avoided insurance and the catches an expensive disease, he should be toast, because thats the gamble he made and the result of it.
Please also keep in mind that in a state run system, if a treatment is very expensive the state will not give it and thats it. Thats one of the reasons why public healthcare is often cheaper, because it says no to many treatments, which is not something easy to accept for americans.
You pay your insurance against cancer before you get it.
That’s not how things worked pre ACA. The insurance company could drop you after a certain point even if you had paid for coverage.
Also, before the ACA, if your cancer was in remission and then five years later, even if you had continuing coverage, and you tried to get insurance on your own, you couldn’t get it.
A more complicated pre-existing condition would be maybe for kids, young adults whose parents didnt give coverage for , etc.
That’s also not how things worked pre ACA. If you had insurance that you bought yourself and not through your employer and you had a kid who was born with a birth defect, the insurance company wouldn’t cover you.
In vs out of network, deductibles, and co-insurance can also complicate the calculus