I believe you mean "overall health" as in a continuum of the living being life health. What I mean by insurance is a contract that specifies what risks can be i

I believe you mean "overall health" as in a continuum of the living being life health. What I mean by insurance is a contract that specifies what risks can be insurance, up to what limit and how much it will cost. You unlikely to have problems to insure a new car bought off the dealer lot. You will likely have problems insuring a very old car, with missing brakes and flat tires. Similarly, health insurance is quite possible for healthy folks in their 20ies-40ies (maybe? just an example of the age range). And, like you said, insurance payout becomes likely certain and potentially unlimited if you try to insure someone who is 90 old. All that doesn't mean that health insurance can not exists as a thing. It just means that insurance is a tool that applicable to a specific scenarios and not a blanket solution for health care. And what discussions happens in the US, somehow it is either health insurance takes care of everything, or it is government takes care of everything. I think there is a place for both tools (and perhaps even more others i can't think of right now). EDIT: another thing that bothers me about health insurances in the USA - it is expected that insurance is involved in every single case of working with health care providers. I do not think annual flu shots is a risk that needs to be insured (it is known, and can be planned upfront for). Similarly, a visit to the family practice with a cold or ear infection does not need to be insured. Bringing back car example - it would be like bundling annual oil change, or a flat tire into standard car insurance everyone have to have... In my opinion, health insurance has its place to insure unknown/unlikely events, not routine stuff. Why it matters, in my opinion. A significant chunk of costs is in administration - both on hospital and insurance sides. And these routine visits are likely getting a large chunk of it. More importantly, when patient pays directly to the health care provider - they are much likely to be more picky about quality, costs, convenience combination, unlike going through the insurance scenario, where the decision is mostly about "who is in the network, and how close they are". Missing such a direct relationship between patients and providers, in my opinion, puts upward pressure on prices (in addition to everything else).