The problem is that people that need care would choose a more expensive plan that pays out for chronic conditions, and those that don't would choose the less expensive plan. Some may think this is fair and others think it is unfair, but regardless it is the underlying problem that reform has tried to address. People want to pay nothing for health insurance when they are healthy, but then switch to having others pay the bills when they are unhealthy. When people are allowed to gamble, then we end up with people declaring bankruptcy or getting their care from the ER when they have a life-threatening crisis. These actions are signs of a non-functional health care system.