But how can insurance not be perverse? If it is not nationalized then it is a private company that needs to make profits. And when you have that incentive, it is all about stats and risk. I find it a difficult problem to mix with capitalism. I have been raised in Europe and for me it is natural that one can go to the doctor 'for free' (if you cannot pay for it); I am trying to reason how insurance would ever work unless (like in NL) insurers must accept everyone no matter what happened before. How would that work? Is it not better for the insurance company to have people without money die? How can that fit?