>>Insurance. ...and if you have the mandate you keep the problem from repeating ...duhh!

Can we not discuss without insults?

Sammie does have a point. Insurance is not a hand to mouth proposition, there's huge underwriting science involving investment of surpluses in good years to generate wealth to cover future predictable outgoings and disasters.

Health Insurance in the US is not actually insurance and there's almost no underwriting. It's a hand to mouth proposition, with surpluses mostly distributed as dividends- not least because once you hit 65, you're covered by one of the world's most expensive socialized healthcare schemes called Medicare, towards whose costs the insurers don't underwrite a bean.

There's also the curious mindset that many people calculate their healthcare consumption and unless it exceeds the premium, they feel out of pocket. Compare with fire insurance where people hope to pay for decades without ever needing to call on their insurance. If you want to know why premiums are so high in US healthcare, that's not a bad start.

The US is not alone re underwriting: there's been very little underwriting in most of the universal schemes. As populations age, the system creaks under the weight of expectation, often from family, that there's no expense too great for the taxpayer to bear to try to help granny live forever.

What the GOP once called "death panels" already exist, in the form of nameless clerks in distant offices exerting control over availability. Instead, society needs to take more interest in spending and help make decisions on rationing- since all healthcare needs rationing or it will cheerfully consume the entire GDP.

FWIW, I agree with Obama that there needs to be a floor, a minimum level of healthcare cover you must take to save society from the spectacle of diabetics dying because they sacrificed their meds to some other family need (which once happened in real life to a VFP luminary, fwiw, may she rest in peace.) Ditto your accident: in NZ I think I pay a few hundred dollars a year towards a mandatory accident compensation scheme that covers all care, income protection during recovery and any liability costs for anybody injured in NZ. FWIW this scheme underwrote so successfully during the good years when assert values boomed that premiums have been falling. So IMHO accident, catastrophe and chronic/life-changing diseases ought to be mandatory. If people want to self-insure incidental doctors' visits or dental, let them. That works elsewhere, with targeted assistance for those who can't afford a doctor's office visit. Also fwiw, according to some math I did a while back: had the US begun proper underrwiting for Medicare in the 1970s, the scheme would be close to self-funding now, iow no burden on the taxpayer. Health insurance for the young and healthy could have been even easier. In this respect, Sammie is correct that a generation that punished tax increases and celebrated its own prowess in accumulating private assets, truly didn't pay its own way and now expects rich Ponzi benefits- though that's in Medicare, not the ACA.