As for #2, I think the tax incentives make it prohibitive to offer nonconforming plans to those who want to resist. In a weird way, that’s some of what the Hobby Lobby litigation was about — you faced crazy high fines if you wanted to opt out of these “protections.”

What many folks don’t realize is that your premium is, effectively, the amount necessary to subsidize others in your pool who exceed the deductible. The premium will always, necessarily look like a waste to most people, not a “fair expense.” But it is fair, given the level and cost of heath care the market demands.