BlueMan

Actually, most insurance companies do (or at least used to) "rate up" for factors such as overweight, smoker, prior history, etc. Another problem with Healthcare being so expensive is a number of government intrusions into health insurance that try to prevent them from doing so, cuz "it's not fair". It -should- be reasonably expected that someone who could reasonably be assumed to dip into the insurance pool more should pay more for the privelege, but there's too many people who cry that it's unfair that the smoking, overweight, 50 yr old with diabetes and a history of heart disease does not recieve the same rate as the 20 yr old nonsmoker who probably works out regularly and eats right, and has no history of disease. The government listens, passes a law, and the usual result is a reduction in coverage for all, and higher premiums/deductibles/coinsurance percentages, copays, because it's just a cold fact that an insurance company cannot stay in business if it spends more than it makes.

Another issue, in addition to the abovementioned illegals who recieve service and don't pay (in addition to indigents and just-plain deadbeats), your healthcare costs are driven up to subsidize Medicare, which in many cases does not even pay enough to cover the providers expenses, much less allow them to make a reasonable profit (Surprise! a doctor's practice is a -business-, where people expect to be able to make a living!). This is purely anecdotal, but my boss (I work for a Health plan for union employees) told me of a conversation he had with an anesthesiologist who stated that he had given a women a local anesthetic in a shot, and the Medicare payment hadn't even covered the cost of the materials used to administer the drug, much less allow him to be paid for his services. Thus, he has to charge everyone else more to make up the difference.