A Market solution for pre-existing conditions?

Page 2 - Seeking answers? Join the AnandTech community: where nearly half-a-million members share solutions and discuss the latest tech.

0marTheZealot

Golden Member
Apr 5, 2004
1,692
0
0
Originally posted by: Patranus
There is a market solution right now...

...YOU PAY MORE...

Just like a driver with several DUIs, it is not that they can't get auto insurance, they can, but it costs more.

You have to remember that of the "40 million uninsured" if you take away the illegal immigrants and the people who can afford insurance but CHOOSE to spend their money elsewhere there are only 10 to 15 million people who really lack insurance to forces outside of their control....

...yes that is only 3% to 4% of the total population....

You can control whether or not you get a DUI. If you never drink and drive, you'll never get a DUI.

The same is not true for medical conditions. You can live a perfectly healthy life, then get struck with cancer or heart disease or diabetes, etc etc. You have be to absolutely thick to think there is any sort of parallel between DUIs and pre-existing medical conditions.

Medical insurance has no analogy with car insurance or with any other form of insurance really.
 

QuantumPion

Diamond Member
Jun 27, 2005
6,010
1
76
Originally posted by: 0marTheZealot
Originally posted by: Patranus
There is a market solution right now...

...YOU PAY MORE...

Just like a driver with several DUIs, it is not that they can't get auto insurance, they can, but it costs more.

You have to remember that of the "40 million uninsured" if you take away the illegal immigrants and the people who can afford insurance but CHOOSE to spend their money elsewhere there are only 10 to 15 million people who really lack insurance to forces outside of their control....

...yes that is only 3% to 4% of the total population....

You can control whether or not you get a DUI. If you never drink and drive, you'll never get a DUI.

The same is not true for medical conditions. You can live a perfectly healthy life, then get struck with cancer or heart disease or diabetes, etc etc. You have be to absolutely thick to think there is any sort of parallel between DUIs and pre-existing medical conditions.

Medical insurance has no analogy with car insurance or with any other form of insurance really.

Last time I checked, everybody dies eventually.
 

Atreus21

Lifer
Aug 21, 2007
12,001
571
126
Originally posted by: Athena
Originally posted by: Fingolfin269
Because we would make it a requirement. If you don't join up you go to jail. Serious business.
It's true that "some people" think that the "invisible hand" of the market could somehow fix things (even though Adam Smith himself felt that doctors were an exception to his theory)...

Entirely my stupidity if this is true, but can you link to this? I honestly didn't know this.
 

Martin

Lifer
Jan 15, 2000
29,178
1
81
Originally posted by: Genx87
I really dont have an answer for pre-existing conditions. It may be they need to go on medicaid or medicare. What % of people out there are hit with pre-existing conditions?

So... you spend your life paying insurance, then you come down with an expensive illness, the company drop you, then then Medicare picks up the tab.


Of course, the companies won't abuse such a scheme, they are far too moral to do something like this :roll:
 

heyheybooboo

Diamond Member
Jun 29, 2007
6,278
0
0
Originally posted by: Pens1566
How did Texas' Tort Reform help their healthcare costs? Just curious ....

Texas has the highest rate of uninsured in the nation and , afaik, still home to the highest per capita health care costs in the US.
 

SammyJr

Golden Member
Feb 27, 2008
1,708
0
0
Originally posted by: MotF Bane
Originally posted by: ZeGermans
Me for one.

A need for psychological help counts as a pre-existing condition? I didn't know that.

You joke, but it is. People with Depression, Bipolar Disorder, Schizophrenia, and other mental illnesses are almost uninsurable with a private plan.
 

Pens1566

Lifer
Oct 11, 2005
14,024
11,731
136
Originally posted by: heyheybooboo
Originally posted by: Pens1566
How did Texas' Tort Reform help their healthcare costs? Just curious ....

Texas has the highest rate of uninsured in the nation and , afaik, still home to the highest per capita health care costs in the US.

Yep, kind of what I was getting at :)
 

SammyJr

Golden Member
Feb 27, 2008
1,708
0
0
Originally posted by: Patranus
There is a market solution right now...

...YOU PAY MORE...

Just like a driver with several DUIs, it is not that they can't get auto insurance, they can, but it costs more.

You have to remember that of the "40 million uninsured" if you take away the illegal immigrants and the people who can afford insurance but CHOOSE to spend their money elsewhere there are only 10 to 15 million people who really lack insurance to forces outside of their control....

...yes that is only 3% to 4% of the total population....

Get cancer and see how you feel about that. Everything is rosey when it isn't happening to you.
 

heyheybooboo

Diamond Member
Jun 29, 2007
6,278
0
0
Originally posted by: Patranus
Originally posted by: 0marTheZealot
You can control whether or not you get a DUI. If you never drink and drive, you'll never get a DUI.

What if you are an 'alcoholic' which has some genetic components?

Originally posted by: JSt0rm01
can you back up those statistics?

http://www.cbo.gov/doc.cfm?index=4210

Not even close.


The number of people with health insurance increased to 253.4 million in 2007 (up from 249.8 million in 2006).
(PDF) - pg. 19

... primarily due to the number of people covered by government health insurance (increased to 83.0 million, up from 80.3 million in 2006). The percentage of people covered by private health insurance was 67.5 percent, down from 67.9 percent in 2006.


36 million Americans have no health insurance. Enrollment in 'private' and 'employment-based' insurance plans is declining.

The report linked above does not indicate how many of these 9.7 million uninsured 'foreign nationals' were illegal aliens, or legal permanent residents, or people studying or working in the United States. This number is in addition to the 36 million uninsured Americans.


Nice 'Ass-Facts' yah got there :disgust:



PS - The new Census Bureau report for 2008 will be out this month.





 

fskimospy

Elite Member
Mar 10, 2006
88,233
55,781
136
Originally posted by: TheSkinsFan
Originally posted by: rudder
What if my religion forbids me from seeing a doctor? Will the government force me to buy insurance against my religious beliefs?
Given the nature of the current reform proposals, it's almost guaranteed that you'd at least be hit with a tax penalty, if not worse further down the road.

Some folks, like Hillary Clinton for example, want healthcare reform to eventually include some sort of "enforcement mechanism."

Remember her fun-filled ideas?
"We will have an enforcement mechanism, whether it?s [garnishing people's wages] or it?s some other mechanism through the tax system or automatic enrollments?

I sincerely doubt that she's the only one who wants to implement such things.

No you wouldn't be hit by a tax penalty. It's not 'almost guaranteed' in any way, shape, or form. In fact, it's the exact opposite. The government cannot tax you for exercising your religious beliefs.

Please go do some reading on the first amendment, particularly in reference to Jehova's Witnesses and you will see there is a long history of tax exemptions for religious liberty in this country.
 

Fingolfin269

Lifer
Feb 28, 2003
17,948
34
91
Originally posted by: SammyJr
Originally posted by: Patranus
There is a market solution right now...

...YOU PAY MORE...

Just like a driver with several DUIs, it is not that they can't get auto insurance, they can, but it costs more.

You have to remember that of the "40 million uninsured" if you take away the illegal immigrants and the people who can afford insurance but CHOOSE to spend their money elsewhere there are only 10 to 15 million people who really lack insurance to forces outside of their control....

...yes that is only 3% to 4% of the total population....

Get cancer and see how you feel about that. Everything is rosey when it isn't happening to you.

Didn't Fear Tactics get canceled?
 

JSt0rm

Lifer
Sep 5, 2000
27,399
3,948
126
Originally posted by: heyheybooboo
Originally posted by: Patranus
Originally posted by: 0marTheZealot
You can control whether or not you get a DUI. If you never drink and drive, you'll never get a DUI.

What if you are an 'alcoholic' which has some genetic components?

Originally posted by: JSt0rm01
can you back up those statistics?

http://www.cbo.gov/doc.cfm?index=4210

Not even close.


The number of people with health insurance increased to 253.4 million in 2007 (up from 249.8 million in 2006).
(PDF) - pg. 19

... primarily due to the number of people covered by government health insurance (increased to 83.0 million, up from 80.3 million in 2006). The percentage of people covered by private health insurance was 67.5 percent, down from 67.9 percent in 2006.


36 million Americans have no health insurance. Enrollment in 'private' and 'employment-based' insurance plans is declining.

The report linked above does not indicate how many of these 9.7 million uninsured 'foreign nationals' were illegal aliens, or legal permanent residents, or people studying or working in the United States.


Nice 'Ass-Facts' yah got there :disgust:



PS - The new Census Bureau report for 2008 will be out this month.

Thansk for digging through that. Figures he would lie. Isn't that a vacationable offense?
 

Pens1566

Lifer
Oct 11, 2005
14,024
11,731
136
Originally posted by: Fingolfin269
Originally posted by: SammyJr
Originally posted by: Patranus
There is a market solution right now...

...YOU PAY MORE...

Just like a driver with several DUIs, it is not that they can't get auto insurance, they can, but it costs more.

You have to remember that of the "40 million uninsured" if you take away the illegal immigrants and the people who can afford insurance but CHOOSE to spend their money elsewhere there are only 10 to 15 million people who really lack insurance to forces outside of their control....

...yes that is only 3% to 4% of the total population....

Get cancer and see how you feel about that. Everything is rosey when it isn't happening to you.

Didn't Fear Tactics get canceled?

Replaced by the sequel "Death Panel".
 

Patranus

Diamond Member
Apr 15, 2007
9,280
0
0
Originally posted by: JSt0rm01
The report linked above does not indicate how many of these 9.7 million uninsured 'foreign nationals' were illegal aliens, or legal permanent residents, or people studying or working in the United States.


Nice 'Ass-Facts' yah got there :disgust:



PS - The new Census Bureau report for 2008 will be out this month.

Thansk for digging through that. Figures he would lie. Isn't that a vacationable offense?[/quote]

Try reading the entire document. All of the state are there in a nice little table.
 

fskimospy

Elite Member
Mar 10, 2006
88,233
55,781
136
Originally posted by: QuantumPion
Originally posted by: Modelworks
Insurance came into existence to pay for unexpected expenses that someone could not normally afford. If you look at the history of medicine, before insurance, people actually paid cash for services. It was no different than paying someone to paint your house.

Somewhere along the way someone realized they could make a bundle and prices increased to the point that insurance was no longer about unexpected expenses but everyday expenses. Imagine if car repair and maintenance increased to the point that an oil change was $500. That is what happened to health care.

They really should just change it from insurance companies to medical brokers, because that is all they are. They act as a go between from the patient to the doctor negotiating for the best price for what the patient can pay. It isn't insurance anymore. The old insurance model cannot work with pre-existing conditions, it just isn't possible. You can't insure a house that is sitting halfway over a river for flood insurance and expect to make a profit. The insurance model only works when you have less claims than you have money being paid in premiums and pre-existing conditions nullify that.

Exactly. The purpose of insurance is to cover your medical expenses if you are in an auto accident or get appendicitis. In an ideal system, if you have a heart condition or cancer or diabetes (e.g. something that is a known condition and requires long-term expenses), you should pay for it yourself using an HSA or loan.

The problem is that the government has interfered with the health care industry so destructively that the cost of treatments has increased to ridiculous levels that no one can afford, unless they have an insurance plan which pays for it. Thus everyone demands to be covered by insurance for everything. Which causes the prices to become even more astronomical.

There are other major problems with our health care, but these can be easily fixed if the Democrats were interested in actually fixing health care, rather then socialize it for their own power. These two are: health care for poor/old people. Replace medicare/medicaid with government-provided HSA's (or even better, contribution-matched). That way, people will be responsible for the price they pay for care. Second: tort reform. This is self-explanatory but will never happen as long as the lawyers dump billions in contributions to congress to keep themselves in business.

How this car analogy keeps circulating is beyond me. It's hilariously wrong. In addition, the red herring about tort reform never seems to die no matter how repeatedly it is debunked.

First: tort reform. Tort costs in both malpractice premiums and payouts from lawsuits comprise less than 2% of US spending on health care annually. Even if you eliminated them entirely (which would be horrendous), you would not make a meaningful impact on health care costs. Some people then bring up defensive medicine. The CBO (that so many people around here like to cite) has studied the issue and found no statistically significant impact on defensive medicine costs in areas that have enacted tort reform.

Long story short: tort reform will change virtually nothing. It's a political talking point.

Now: the horrible car insurance analogy. Car insurance works that way because we as a society are willing to allow people to be struck with the consequences of not having their insurance, or not having enough money to fix their car. They simply don't have one then, and they take the bus to work. For health insurance, we as a society (because we are not animals) have decided that if someone is sick and we can help them, we will do so regardless of their ability to pay. That means that the fundamental structure of risk/reward is completely different for health insurance. Routine care is a long term money saver in many cases, not a driver of costs.

Until you're willing to sign legislation to allow sick and injured people to die when we could save them, the car analogy is worthless.
 

SammyJr

Golden Member
Feb 27, 2008
1,708
0
0
Originally posted by: QuantumPion
Originally posted by: Modelworks
Insurance came into existence to pay for unexpected expenses that someone could not normally afford. If you look at the history of medicine, before insurance, people actually paid cash for services. It was no different than paying someone to paint your house.

Somewhere along the way someone realized they could make a bundle and prices increased to the point that insurance was no longer about unexpected expenses but everyday expenses. Imagine if car repair and maintenance increased to the point that an oil change was $500. That is what happened to health care.

They really should just change it from insurance companies to medical brokers, because that is all they are. They act as a go between from the patient to the doctor negotiating for the best price for what the patient can pay. It isn't insurance anymore. The old insurance model cannot work with pre-existing conditions, it just isn't possible. You can't insure a house that is sitting halfway over a river for flood insurance and expect to make a profit. The insurance model only works when you have less claims than you have money being paid in premiums and pre-existing conditions nullify that.

Exactly. The purpose of insurance is to cover your medical expenses if you are in an auto accident or get appendicitis. In an ideal system, if you have a heart condition or cancer or diabetes (e.g. something that is a known condition and requires long-term expenses), you should pay for it yourself using an HSA or loan.

Ideally, you'd have thousands of dollars to put away each for your health care. How many have that?

The problem is that the government has interfered with the health care industry so destructively that the cost of treatments has increased to ridiculous levels that no one can afford, unless they have an insurance plan which pays for it. Thus everyone demands to be covered by insurance for everything. Which causes the prices to become even more astronomical.

You're right. All of the shiny new diagnostic tools, medications, surgical procedures, and education would be really, really cheap if not for that durn Government. Never mind that Government pays for a lot of the research and education via the NIH and the various University systems.

Yes, the answer to to remove Government completely from health care. It would be great to depend on the private sector to do all the research out of the kindness of their heart. It would be even better if only rich people could become doctors. And damned if I want some Government man making sure my doctor is actually an MD and not a hocus pocus naturopath or chiropractor or witch doctor.

There are other major problems with our health care, but these can be easily fixed if the Democrats were interested in actually fixing health care, rather then socialize it for their own power. These two are: health care for poor/old people. Replace medicare/medicaid with government-provided HSA's (or even better, contribution-matched). That way, people will be responsible for the price they pay for care.

LOL. Contribution matched HSAs for old folks? You do realize that the vast majority of the elderly are on fixed incomes. They're too old to work. How much are they going to put in? I have an answer. $0.

Same thing for the poor. They're poor! Net contribution to an HSA: $0.

You HSA pushers act like people just have money falling out of their ass to put in these things. And hell, my wife just got an MRI on her knee. $4000. How long would someone at McDonald's have to put in an HSA for that?

You're probably young, single, fit, and healthy. Remember how you are now and in 30 years after you've lived life and see how you feel about all of this.

Everybody should be paying in, starting from when they start working. You don't need it at 18 or 30 or even 40, but once you hit 50, you start using it. Everyone does. Everyone gets sick eventually. Its the human condition. And god help you if you have a child born with medical problems.

Second: tort reform. This is self-explanatory but will never happen as long as the lawyers dump billions in contributions to congress to keep themselves in business.

Illinois has tort reform. Hasn't reduced any bills for anyone, not doctors, not hospitals, not consumers.

We don't need tort reform, we need a national EMR. We need people to analyze the data. That way when some shyster lawyer says something, the defense can pull out a statistical analysis showing that the lawyer is full of shit. When the shyster lawyers realize they can't present bullshit anymore, then they'll stop. What is left will be the real malpractice and the bad doctors need to stop practicing.
 

Special K

Diamond Member
Jun 18, 2000
7,098
0
76
Originally posted by: 0marTheZealot
Originally posted by: Patranus
There is a market solution right now...

...YOU PAY MORE...

Just like a driver with several DUIs, it is not that they can't get auto insurance, they can, but it costs more.

You have to remember that of the "40 million uninsured" if you take away the illegal immigrants and the people who can afford insurance but CHOOSE to spend their money elsewhere there are only 10 to 15 million people who really lack insurance to forces outside of their control....

...yes that is only 3% to 4% of the total population....

You can control whether or not you get a DUI. If you never drink and drive, you'll never get a DUI.

The same is not true for medical conditions. You can live a perfectly healthy life, then get struck with cancer or heart disease or diabetes, etc etc. You have be to absolutely thick to think there is any sort of parallel between DUIs and pre-existing medical conditions.

Medical insurance has no analogy with car insurance or with any other form of insurance really.

I wouldn't say it has no analogy with car insurance, as people can certainly develop medical conditions as a result of their own bad health habits.

The trouble is differetiating between conditions caused as a result of neglect vs. those caused by genetics. Honestly I think that's too complex of an issue to make conclusive statements about. It just seems like people should somehow be held accountable to do what they can to remain healthy.
 

JSt0rm

Lifer
Sep 5, 2000
27,399
3,948
126
Originally posted by: Patranus
Try reading the entire document. All of the state are there in a nice little table.

How about you point out exactly where you are talking about. html link please.
 
Feb 19, 2001
20,155
23
81
I know the whole 2% tort reform crap, but this really just accounts for lawsuit payments and litigation costs. If you look at research done on the left and the right, studies show that extra tests are a HUGE burden on health costs.

When you look at survey showing doctors ordering extra tests to cover their asses, then you realize that a lot of this is due to fears of malpractice. Tort reform, if done right, can not only put an end to frivolous lawsuits but also start reducing the number of extra tests we do. Since this is one of the biggest expenditures in the industry, maybe we can cut down on this cost big time. It's a lot more than 2% when you look at the big picture.
 

heyheybooboo

Diamond Member
Jun 29, 2007
6,278
0
0
Originally posted by: JSt0rm01
Originally posted by: heyheybooboo
Originally posted by: Patranus
Originally posted by: 0marTheZealot
You can control whether or not you get a DUI. If you never drink and drive, you'll never get a DUI.

What if you are an 'alcoholic' which has some genetic components?

Originally posted by: JSt0rm01
can you back up those statistics?

http://www.cbo.gov/doc.cfm?index=4210

Not even close.


The number of people with health insurance increased to 253.4 million in 2007 (up from 249.8 million in 2006).
(PDF) - pg. 19

... primarily due to the number of people covered by government health insurance (increased to 83.0 million, up from 80.3 million in 2006). The percentage of people covered by private health insurance was 67.5 percent, down from 67.9 percent in 2006.


36 million Americans have no health insurance. Enrollment in 'private' and 'employment-based' insurance plans is declining.

The report linked above does not indicate how many of these 9.7 million uninsured 'foreign nationals' were illegal aliens, or legal permanent residents, or people studying or working in the United States.


Nice 'Ass-Facts' yah got there :disgust:



PS - The new Census Bureau report for 2008 will be out this month.

Thansk for digging through that. Figures he would lie. Isn't that a vacationable offense?


What is interesting is that he p'wnd himself by citing the CBO study.


1998 Uninsured Entire Year: 31 million (CBO 2003 study - Patranus)

2007 Uninsured Entire Year: 36 million (Census Bureau: August, 2008)


What is even better is that the study he cites notes that during a calendar year as many as 60 million people lack insurance at any time during the year.

The point which he is incapable of making (due to his trolling and obfuscation) is that 'generally' 80% of these folks are 'hard-core' uninsured.
 

fskimospy

Elite Member
Mar 10, 2006
88,233
55,781
136
Originally posted by: DLeRium
I know the whole 2% tort reform crap, but this really just accounts for lawsuit payments and litigation costs. If you look at research done on the left and the right, studies show that extra tests are a HUGE burden on health costs.

When you look at survey showing doctors ordering extra tests to cover their asses, then you realize that a lot of this is due to fears of malpractice. Tort reform, if done right, can not only put an end to frivolous lawsuits but also start reducing the number of extra tests we do. Since this is one of the biggest expenditures in the industry, maybe we can cut down on this cost big time. It's a lot more than 2% when you look at the big picture.

No, in fact that was specifically addressed in my post. It is called 'defensive medicine'.

As I have linked in other threads, the CBO specifically researched this.

However, when CBO applied the methods used in the study of Medicare patients hospitalized for two types of heart disease to a broader set of ailments, it found no evidence that restrictions on tort liability reduce medical spending. Moreover, using a different set of data, CBO found no statistically significant difference in per capita health care spending between states with and without limits on malpractice torts.

So no, tort reform will most likely do almost nothing.
 
Oct 30, 2004
11,442
32
91
Originally posted by: eskimospyHow this car analogy keeps circulating is beyond me. It's hilariously wrong. In addition, the red herring about tort reform never seems to die no matter how repeatedly it is debunked.

First: tort reform. Tort costs in both malpractice premiums and payouts from lawsuits comprise less than 2% of US spending on health care annually. Even if you eliminated them entirely (which would be horrendous), you would not make a meaningful impact on health care costs. Some people then bring up defensive medicine. The CBO (that so many people around here like to cite) has studied the issue and found no statistically significant impact on defensive medicine costs in areas that have enacted tort reform.

Long story short: tort reform will change virtually nothing. It's a political talking point.

What the tort reformers are also missing is that one of the purposes of the tort system is to reduce overall costs. Very simply, if medical providers know that they are liable for negligence and recklessness they'll act more cautiously, reducing the number of expensive errors and the costly damage done to people. If you eliminate the tort system, expenses might actually increase as a result of increased carelessness.

Until you're willing to sign legislation to allow sick and injured people to die when we could save them, the car analogy is worthless.

OMG! The Capitalists have created Death Panels and now they want to pull the plug on Grandma! Somebody call Sarah Palin!
 

QuantumPion

Diamond Member
Jun 27, 2005
6,010
1
76
Originally posted by: eskimospy
Originally posted by: QuantumPion
Originally posted by: Modelworks
Insurance came into existence to pay for unexpected expenses that someone could not normally afford. If you look at the history of medicine, before insurance, people actually paid cash for services. It was no different than paying someone to paint your house.

Somewhere along the way someone realized they could make a bundle and prices increased to the point that insurance was no longer about unexpected expenses but everyday expenses. Imagine if car repair and maintenance increased to the point that an oil change was $500. That is what happened to health care.

They really should just change it from insurance companies to medical brokers, because that is all they are. They act as a go between from the patient to the doctor negotiating for the best price for what the patient can pay. It isn't insurance anymore. The old insurance model cannot work with pre-existing conditions, it just isn't possible. You can't insure a house that is sitting halfway over a river for flood insurance and expect to make a profit. The insurance model only works when you have less claims than you have money being paid in premiums and pre-existing conditions nullify that.

Exactly. The purpose of insurance is to cover your medical expenses if you are in an auto accident or get appendicitis. In an ideal system, if you have a heart condition or cancer or diabetes (e.g. something that is a known condition and requires long-term expenses), you should pay for it yourself using an HSA or loan.

The problem is that the government has interfered with the health care industry so destructively that the cost of treatments has increased to ridiculous levels that no one can afford, unless they have an insurance plan which pays for it. Thus everyone demands to be covered by insurance for everything. Which causes the prices to become even more astronomical.

There are other major problems with our health care, but these can be easily fixed if the Democrats were interested in actually fixing health care, rather then socialize it for their own power. These two are: health care for poor/old people. Replace medicare/medicaid with government-provided HSA's (or even better, contribution-matched). That way, people will be responsible for the price they pay for care. Second: tort reform. This is self-explanatory but will never happen as long as the lawyers dump billions in contributions to congress to keep themselves in business.

How this car analogy keeps circulating is beyond me. It's hilariously wrong. In addition, the red herring about tort reform never seems to die no matter how repeatedly it is debunked.

First: tort reform. Tort costs in both malpractice premiums and payouts from lawsuits comprise less than 2% of US spending on health care annually. Even if you eliminated them entirely (which would be horrendous), you would not make a meaningful impact on health care costs. Some people then bring up defensive medicine. The CBO (that so many people around here like to cite) has studied the issue and found no statistically significant impact on defensive medicine costs in areas that have enacted tort reform.

That 2% only covers the lawsuits themselves. It doesn't cover the enormous amount of excess tests, unnecessary procedures, doctor shopping, over-medication, and poor health care decisions doctors and insurance companies make to avoid being the target of frivolous lawsuits.

Now: the horrible car insurance analogy. Car insurance works that way because we as a society are willing to allow people to be struck with the consequences of not having their insurance, or not having enough money to fix their car. They simply don't have one then, and they take the bus to work. For health insurance, we as a society (because we are not animals) have decided that if someone is sick and we can help them, we will do so regardless of their ability to pay. That means that the fundamental structure of risk/reward is completely different for health insurance. Routine care is a long term money saver in many cases, not a driver of costs.

Until you're willing to sign legislation to allow sick and injured people to die when we could save them, the car analogy is worthless.

That is what Obama is proposing, in his own words on national television.

Oh, and just because your ideals say that society should pay for everyone's health care costs, does not change the reality of the nature of insurance. They are completely separate issues.