Here's what I said:

>>Because insurers wouldn't [agree to insure older people], you say? Just as they wouldn't once your 45-year-old got sick, pushing costs far in excess of premium.

I was talking about your 45-year-old, not cost sharing, since it's the 45 year old with an expensive illness who is at risk of non-renewal or resilement, not all the policyholders. Of course the problem under the ACA was that insurers no longer could resile or label it a pre-existing condition, but individual mandate was not enforced. So you can be sure everybody with an expensive condition claimed their guaranteed insurance, but not enough healthy others insured to share the cost. Once the distortion of insurer subsidies was exhausted, there's only one direction price can go.

>>But as I said, I haven't decided that forcing insurers to take high-risk insureds - with resultant higher premiums for lower risk insureds- is a good idea.

This is a primary reason for the ACA death spiral- that too many healthy people agreed with you and with individual mandate at first postponed and then limply enforced, some policies ended up dominated by sick people consuming more than they contribute. Raising the price simply caused more well people to drop out, making it worse. To stay in business the insurers actually had no choice but to exit the policy and in some cases, the state.
...
>>If someone worth over several millions can't get insurance because of health history, that's one thing.
>>If someone without the wherewithal to pay for care can't get it that's something else entirely.

So Medicaid needs to be expanded again, to cover people who are worth less than - 5 million? 8 million? If so, you might as well advocate single payer care whose simplicity saves a fortune rather than trying to lock out the top few %. Who cares if you also cover the occasional 1%er who could pay for their own care; levy the contribution across all income streams and their neighbors' contributions will cover the cost of an occasional transplant.

>>We need to be mindful that care- not insurance- is what saves people.

Yes, but the care has to be paid for. As an aside: of those dozens of other first world nations paying far less than the US for single payer systems that cover everybody, not a single one seems anxious to repeal.