Medical issues that are directly traceable to individual actions (pregnancy, for instance) are overwhelmingly the exception, not the rule. There is no feasible direct accounting for individual contributions to costs, nor any way of predicting them in the future on anything resembling an individual basis. Someone who eats too much sugary food might contract serious diabetes and become a major burden on the health system, or they might die suddenly of a heart attack and cost it nothing. Someone who bikes to work and spends their free time camping might save the system thousands by their healthy lifestyle, or cost it tens of thousands when they're hit by a car and require a prosthetic limb.
Medical costs swing wildly and are highly unpredictable. Dealing with them on an individual basis is very difficult, especially because comparison shopping is unfeasible. If I don't like a chocolate bar, I just don't buy that type again. But by the time you know that your health insurance wasn't adequate to your needs, it's already too late. The incentive for the insurance companies is always to give you the coverage you don't need, rather than the coverage you do. They're the ones who can hire the world's best actuaries to figure it out, whereas the consumer has little choice in the matter (none, if they are insured through their employer.)
-Jester
Afterthought: In Alberta, neither cosmetic surgery nor LAZIK eye surgery are covered by public plans. They are voluntary, one-off procedures that more closely resemble ordinary goods or services. Single-payer systems are neither necessary nor useful for such things. But they are the exception, not the rule. People do not have heart attacks, develop cancer, break bones, suffer strokes, or contract influenza at their own convenience.
Medical costs swing wildly and are highly unpredictable. Dealing with them on an individual basis is very difficult, especially because comparison shopping is unfeasible. If I don't like a chocolate bar, I just don't buy that type again. But by the time you know that your health insurance wasn't adequate to your needs, it's already too late. The incentive for the insurance companies is always to give you the coverage you don't need, rather than the coverage you do. They're the ones who can hire the world's best actuaries to figure it out, whereas the consumer has little choice in the matter (none, if they are insured through their employer.)
-Jester
Afterthought: In Alberta, neither cosmetic surgery nor LAZIK eye surgery are covered by public plans. They are voluntary, one-off procedures that more closely resemble ordinary goods or services. Single-payer systems are neither necessary nor useful for such things. But they are the exception, not the rule. People do not have heart attacks, develop cancer, break bones, suffer strokes, or contract influenza at their own convenience.