re: Covering preexisting conditions...

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Insurance is insurance against catastrophic events. If you don’t want it, don't buy it, unless contractually required (in financing a house or car or driving on American streets) and, if you suddenly get an illness or have an accident, only get the medical care you can personally pay for.

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You'd be surprised how little healthcare many people can actually afford without a payer supplement. For the majority of Americans that would mean no access to any advanced diagnostic imaging, inpatient care, cancer care of any type, and surgical services. I'm just not sure how what you're suggesting would work in practice. A good chunk of those folks will see that as something they'd want the government to intervene about.