Where do you draw the line on individual vs population subset risk levels?
The insurer must decide what subset (s) of the population a person fits into, preexisting conditions are a factor that would almost certainly weigh heavily on the risk factor for that subset.
Are you proposing that it is irrelevant with regards to an individual's risk if they have diabetes, for example? Or are you simply arguing that we aren't comfortable with the costs it would require for an individual with diabetes to get health insurance if that factor is considered?
I fall into the latter personally and would prefer a real solution to health care that isn't some form of insurance. As long as it is insurance, though, the former seems impractical.
Insurance is a simple business: collect enough money so that in the long run you earn more than you pay out.
American health insurance generally does this in two broad ways. (1) Insure a large enough population group that averages hold and you can price based on actuarial/statistical probabilities. (2) Negotiate deals with provider groups so that they get something they want and you can bound their prices.
Neither of those things are contingent on knowing anything about individuals.
Insurers will generally pick {more randomly-selected customers} over {knowing more about each customer} any day of the week.
Maybe I'm misreading you, but you seem to want insurance that's accurately priced to exactly your circumstances and health (say, how custom high value property insurance is sold).
That doesn't solve insurer's concentrated tail risk problem though, and it means you're fucked if you ever develop a complicated condition, like cancer.
I have multiple actuaries in my family that work primarily in the insurance industry. I can assure you they are tasked with determining individual risk rather than risk of an entire pool of people with no regard for the individual.
The insurer must decide what subset (s) of the population a person fits into, preexisting conditions are a factor that would almost certainly weigh heavily on the risk factor for that subset.
Are you proposing that it is irrelevant with regards to an individual's risk if they have diabetes, for example? Or are you simply arguing that we aren't comfortable with the costs it would require for an individual with diabetes to get health insurance if that factor is considered?
I fall into the latter personally and would prefer a real solution to health care that isn't some form of insurance. As long as it is insurance, though, the former seems impractical.