kev, you ask the right question "why should i pay" but you draw the wrong conclusion. you think the solution is to regulate. that path is a dangerous one. who decides what is considered dangerous behavior?
This is an interesting question for 2 reasons but I need to establish the base of my argument first:
Kathy's been arguing that we need to keep our current system of private health insurance because it is market based and gives people the most freedom. Now, I've pointed out a basic flaw in this system: namely that it has no mechanism for adjusting premiums based risk associated with different lifestyle choices. The result is that people with low risk lifestyles foot the bill for people with higher risk lifestyles. My premium goes up when a smoker in my plan gets cancer.
1) above you ask, who decides what's risky. Insurance companies already decide what's risky. Any time you buy insurance, your premium is based on an actuary's assessment of risk. When you purchase a homeowners policy they look at your home, where it's located, what kind of wiring and heating system it has, etc, and make a calculated assessment of risk. They already do this for life insurance products, too. So the lifestyle risk tables already exist. So if you have a life insurance policy, you've already accepted this risk adjustment in one form. It's illogical to argue that it's applicable for life insurance but not applicable for health insurance.
2) You don't offer any way out of this problem. If regulation isn't the solution, what is? Ok, I've gone down the dangerous path of government regulation. I have heard this over and over. But solve the problem without government regulation that forces risk adjustment or laws the govern behavior. Personal responsibilty won't get the job done because not all people are responsible.
if you are going to adjust health insurance for risk, fine. you might also consider withholding care from those who have no insurance.
Thank you for making my point. As a moral society, I think many of us are unwilling to withhold care from someone who has been in a car wreck simply because they don't have insurance. The feds have made it illegal.
So what's the best way to share the burden of paying for that care?
Right now, people who have health insurance are paying for it through higher charges. People who have Medicaid, or Medicare or no coverage are not paying for it at all. We need to spread that cost across the entire population, just like we do the cost of roads. A consumption tax or some other form of national tax to fund a single payer system designed to provide emergency care and a set of basic preventive services that I've advocated elsewhere is really the only logical answer.