Here's an analogy:
According to your logic, I am being parsimonious and stupid by not opting into windstorm coverage insurance on my home, even though I live in an area that has a historically negligible incidence of large-scale tornado damage. On the other hand, floods are very common where I live, and thus, flood and water damage insurance is critical.
If someone is living in the midwest, it would be the exact opposite of my scenario.
According to what you are saying, as an analogy, all of us should pay more for all of these insurances, even though statistically, our needs are different.
edit: Not positive on windstorm coverage - will need to look the specifics, it may be mandated by my state. But I remember there was a couple of them that didn't apply to my region, can't remember right now, but my point is that people pick and choose insurance coverage based on their need.
Realizing that you need to protect your house against tornadoes and extreme weather damage if you live in the southern Midwest, or against snow if you live around here - and sometimes to choose
a house that's built solidly enough, down to the foundations, to stand up to most kinds of weather, even if there are more pretty-looking and affordable homes around - that's nowhere near rocket science. Those issues are fairly easy to understand and put into practice. But mastering a whole range of diseases and possible dysfunctions, from throat infections and allergies to AIDS, respiratory ailments, blood diseases and brain tumour, knowing what kind of damage they might incur, how easy or hard they are to diagnose with certainty, what you have to ask for in an insurance and how to make sure they're included, that really is expert knowledge.
Some people would probably be ready to sign away coverage of treatment for "loosely related side effects of venereal ailments that are not part of such ailment proper" only to find they had dropped just about any coverage of AIDS from their insurance. They wouldn't know until the day they or someone in the family is showing definite signs of the syndrome. How many people know on the spot what "venereal disease" is? How many are aware that HIV in itself is just the door-opener for most of the really serious diseases that are part of a full-blown AIDS journey? - lung ailments, all sorts of cancer and general weakness are not directly caused by the HIV virus, but by other diseases. And how many would be able to spot that this kind of language implied AIDS at all?
Anyway, most people do not expect to ever get hit by such a disease and if they notice what such a phrase was about, they could easily convince themselves that "only gays, junkies and hookers catch that one - I'm safe". If you're in your twenties or thirties and a bit of tight on money, and you're in a situation where the pricing of your insurance provider means you have to chip some off your insuirance cover, that would probably be one that many people wouyld be ready to sign away. Knowing about these things and much more, and being able to weigh them across the board, that's expert knowledge. It's not something you can expect most people to have at the point they shop for health insurances, especially not young adult people, or even to acquire. But the state will have it if it stands as the ┤backer and the heavyweight negotiating partner for health care.
Call me clueless if you like, but I don't think it's reasonable or fair that people should be left standing without coverage when they, or their child, are hit by AIDS, some difficult-to-diagnose breathing ailment or an unusual kind of cancer that very rarely happens in that age segment. "You signed these papers yourself and they do not cover that disease" is a really nasty answer when the prospect they face is a painful death and nothing like the proper health care. The answer to that kind of issue isn't to make people beg at local charities or try to sell their story to the newspapers to arouse pity, but to make sure that the baseline level of what's included in people's health insurance is high enough to cover these things, and that no part of it can be signed away by the individual holder of the insurance.
I've been following this discussion, it's been interesting, but I have some questions to bring up too. I'm not sure if these are true, so I'd like to know from people who have studied it.
From what I have heard, some groups of people will be getting subsidies from the government in order to be able to afford the ACA coverage
I haven't been following the discussion on pricing and government subsidies in the general news media in detail, but I've heard a couple times that under the ACA, some large groups of people who would not be able to pay for their health insurance deals - and some of whom might not be able to pay *any* kind of insurance at the present time, whether on their house or on their car or on their basic health - those people would have most or all of their premiums paid through government subsidies. Maybe that intention has been trimmed a bit from when the law package was first drafted back in 2009/10, but it would still be the option today for many millions of people who used not to be able to afford proper health insurance. I think that makes it a major step forward.
But I can see the counter-argument coming that "we can't afford it as a nation".