Should we insure our health the same way we insure cars?

I'd say yes. I carry my car insurance through State Farm and my health insurance through Blue Cross. They're completely different companies and neither one plays in the other's sandbox. But does that really make them different? After some thought I'd venture 'no' as an answer to that question. 

Most of us know that when it comes to insurance coverage for car accidents, the fewer you have the cheaper it is, and the older your car the less you pay. Health insurance puts a slightly different spin on the subject-- while it's true that your rates go up for priors, they also go up the older you are. Some might make a case for the priors based on an unhealthy lifestyle and to some extent I'd agree; if you spend a lot of time hanging your butt over the void attached to an 11mm kernmantle rope wearing nothing but shorts, sneakers a t-shirt and a helmet (maybe some really good sunblock), you're intentionally risking a trip to the emergency room and for that you should pay extra. If you're so bad at it that you've messed yourself up at least once in the past doing it, you should pay a lot extra.

But I've got to admit that getting old is not a personal choice. I could argue that it is a lifestyle, but not one that most would choose to pursue. Getting old just happens.  Old people don't get sick because they want to. They don't die because they want to. Everyone gets old.

The point here is that the punitive model employed by insurance companies to vehicle operations, plant safety and malpractice doesn't apply to basic healthcare because there's no way to modify your behavior in any way that makes you less likely to get old. You're getting old. Period. Over time large amounts of empirical evidence, along with some pretty well documented clinical trials, suggest very very strongly that you will end up having something necessary to keep your tail wagging break on you, and that the likelihood of that event increases directly with age. At some point, everybody's heart stops beating because it just got tired and wore out. 

Are there things you can do to improve your chances? Sure. You can stop smoking, drinking and eating. Don't expose yourself to sunlight. After that you can stop having sex with strangers. Don't jump out of working airplanes. Avoid complete submersion in water for extended periods. I'd talk about driving fast and passing on blind corners but that's already covered under auto insurance. I don't think these problems are unmanageable for the elderly; I personally intend to stop having sex with strangers right after my 60th birthday.

You can't stop getting old, and it's for this reason alone that I've decided to support government management of basic health care. I could be very wrong about this since it wouldn't surprise me to see a government managed program use lifestyle related criteria as a justification for denying service. We are after all, a society of health nazis. But I'm already convinced that the private sector will not voluntarily agree that it is fundamentally immoral to charge unsupportable fees for care of the elderly as if it was somehow their fault that they'd gotten old-- get a clue folks, they're old because THEY'VE BEEN PAYING HEALTH CARE PREMIUMS, MEDICARE, MEDICAID AND SOCIAL SECURITY FOR THE PAST 60 YEARS!

Unless private industry addresses this issue directly, I find myself having no choice but to advocate public sector competition. 

And that leaves a disgusting taste in my mouth.