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by _delirium 5250 days ago
Health also has significant variance in outcomes, much more than the variance in dental costs, so it makes sense to pool risk. However, the fact that events aren't uncorrelated like a lightning strike makes it hard to deal with as an "insurance", the usual risk-pooling strategy, because in many cases the event has already happened, so no sane insurer would insure against it (how is it insurance if it has an 100% chance of occurring?).

For example, an American friend of mine has a congenital heart defect which will over his lifetime cost probably $1m or so; I had better luck and was not born with one. It seems sort of problematic imo that this sort of thing isn't risk-pooled across the population. It's already bad enough that he has to have surgeries/etc. for it, but due to our health system it also impacts areas of his life that shouldn't be affected, like choice of career. For example, he can never start a startup or do freelance/consulting work, because he wouldn't be able to buy individual health insurance; so he has to work at a large company with a good group-health plan, and can never be unemployed for longer than the 18-month COBRA limit.