bearishgurl: why not have the same rate for everyone, but tax cigarettes, booze, and junk food more highly at the state level? Put the money in a fund to help defray insurance costs.

That seems like the minimally invasive way of changing behavior. The doctor checkup to get insurance at a reasonable price turns doctors into gatekeepers that PREVENT their patients from getting care at a reasonable price.

Note that developed countries which have state-controlled insurance systems generally have a higher life expectancy than the US.