And yet we've never let insurance companies do this, because it's wrong.There's a big difference. People with no familial cancer history do get cancer, and if you opted out, you'd save money and the insurance company would have less risk, quid pro quo, because there is a chance of you getting cancer.
And its only in theory because we've always had laws to prevent them from doing such things.In theory, yes, assuming of course that an insurer was willing to design an a la carte plan like that for you. You'd be saving some money in premiums in exchange for the insurance company saving on actuarial risk regarding the things you assumed wouldn't happen to you (but still could).
All of this goes away if we simply require everyone to have insurance all the time. That way they pay into the system BEFORE they have those problems that make them "unlucky souls." I'm thinking its moral to allow "unlucky souls" to lack opportunities in some cases--not everyone is smart enough to be a doctor or an engineer. But when it comes to health, being an "unlucky soul" is just unconscionable.The extremely expensive plans would be a result of adverse selection and the group of unlucky souls left over after adverse selection whose health care costs are already known to be immense on an ongoing basis. These types of people are uninsurable, from a private sector actuarial standpoint. They aren't in need of "insurance" in the first place, i.e. they aren't looking to protect against unknown, relatively unlikely possible future events, they're looking for someone to pay for their health care now. The entire private sector insurance model falls apart for people like this. No system of private insurance works for those who would be left holding the bag and have no choice other than "incredibly expensive plans." There is no actuarial math that fixes their situation or causes any private sector insurance plan to work for these people.
This will become even an even more acute problem when genetic testing will let us know a great deal more about the relative risks that various insureds might pose. The fact that we know women have health issues that men do not, but not who will likely get cancer, is a happenstance of our moment in history.
You're right that health insurance isn't really insurance--it's an alternate way of paying for health care. But uninsured people are a risk for everyone, just as uninsured drivers are a risk for everyone. We should require everyone to have insurance.Then the private for-profit insurance model falls apart.
No, for fundamental reasons related to what you and most Americans believe health insurance should do, which run counter to the way insurance actually works.