[mikeash]

Costs might come down in a free market system, but many chronic conditions will remain unaffordable to treat even after, say, an order of magnitude reduction in costs.

As for paying more in insurance premiums than you'd pay for treatment, that's only if insurance companies are allowed to account for your chronic condition when determining premiums. If you forbid insurance companies from charging more for existing conditions (as the ACA does) then that doesn't apply, and healthy people subsidize the costs.