Maybe it should be that way, however in practice it doesn't work. The ACA specifically requires free preventive services because research has shown that when patients have to pay they often skip it. And when they skip preventive care that causes the spread of infectious diseases, and allows small problems to turn into serious problems that are more difficult and expensive to treat. So this is important from a public health standpoint regardless of concerns over economic efficiency or personal responsibility.

https://www.healthcare.gov/coverage/preventive-care-benefits...

Preventative care that actually works is super cheap and not controversial (mostly vaccinations). This idea that we can save vast sums via preventative care is a fantasy. You may find anecdotes to support it, but the serious literature doesn't bear it out.

> Preventative care that actually works is super cheap

The same's true about car maintenance, but plenty of people drive on dying brake pads and stretch oil changes anyways. A hundred bucks for a checkup is still more than many folks are willing to pay. As an example, here's a kid who died for want of a $80 dental procedure: http://www.washingtonpost.com/wp-dyn/content/article/2007/02...

> not controversial (mostly vaccinations)

LOL.

Well they usually want to do more expensive procedures along with the dental extraction. I've been delaying mine a bit because they want to take it out then put in a bridge, which will cost $1800 (normally $6700, but I have good dental insurance). In fact the extraction will be free, the cost is all in the bridge. But now you've got me paranoid again. Damn.

from a personal standpoint i often skip preventive care even if its free. I am either just lazy or scared my doctor will tell me something bad.

I agree with this. Obamacare should have created rules for a national minimum policy, largely targeted at catastrophic incidents. Remove the ability of employers to buy coverage for their employees (a holdover from WWII staffing shortages) and let be more open and market driven.

We also need to reform pharma. When even K-mart has a pharmacy it shows how much money could be removed there.

Lastly, we need to change our perspective about aging. If you live long enough, you will (most likely) get cancer. This is how the body works, not specifically a "disease". We need to stop paying $1M for the 75 year old who gets brain cancer so that they can live for 2 extra months. Feel free to spend your own money but Medicare won't. They already have laws like this in France, etc.

> should

and minimum wage should be enough to live on, housing should be affordable a reasonable distance from where you work. but for some strange reason, the world doesn't work that way.

I suspect many will skip it entirely...there was a reason car insurance was made mandatory.