Companies do this all the time. My sister worked at a major oil company that laid off all the pregnant women and new moms out on maternity leave within her department. (To be fair, they also laid off about 1/3 of the rest of the company as well.) It's totally illegal, but if you've just been laid off and have a new baby on the way are you really going to have the money or energy to fight a lawsuit? And even if 10% of people affected did, it's cheaper for the company to settle for $500K or so than to pay the salaries of all the people they fired.

Data seems to agree: in 2007 the usage of COBRA was 10%: http://www.cnn.com/2009/HEALTH/01/23/cobra.health.insurance/

We are all people. We all get sick sometimes. Sicknesses can last a long time, or a short time. Sick people need help. Help the sick people. Pay what you can (a reasonable amount) into a common pool and take what you need (only as much as you need)

If you have an elective health insurance system where people choose whether or not and when to participate, it implies this restriction.

Say you have private health insurance companies but don't allow them to prohibit members based on pre-existing conditions. Everyone will simply not get health insurance to avoid paying the premiums until the day they need it. That would make health insurance companies completely unviable financially.

This is why Obamacare both eliminated the pre-existing condition restriction and mandated people get health coverage. You can't have one without the other or you get the free-rider problem.

This is another reason why healthcare should just be universal. It doesn't work at all like an actual efficient market product.

If that sounds unfair to an insurer, that's great--now they know how we feel about it.

Insurers want to deny pre-existing conditions because they don't want to add already-sick people to their risk pool. They wouldn't have to, if the previous insurer was still on the hook for that diagnosis. But they'd never agree to that, because it exposes them to some of the same insolvency risk due to medical bankruptcy that some patients have to face.

Surely "what you can" should be relative to both your income and your need. We'd need to supervise the system to make sure people aren't taking advantage or else the whole system goes broke.

> into a common pool

We could also invest the money in the pool to make some extra cash and reduce what people need to pay in, we'd have to have an organization do that too.

> (only as much as you need)

How can we know what people need? We'd have to charge a token amount for office visits and medication so that people aren't frivolous with their medical visits, while perhaps guaranteeing an out of pocket limit in case of extreme illness. We'd also need some kind of system to verify that people are only taking what they need.

I think you just invented health insurance.

One way is like we do today -- highly-paid positions often come with high-quality insurance, which is (ime) fairly expensive and low-paid positions have less expensive insurance that is a bit worse (all this on average, I'm sure there are outliers).

We are in different pools today but I don't see how that's meaningfully different than everyone being in one pool if the individual pools are large enough and you can't discriminate the population of the pools.

  pre-existing conditions could disqualify you from insurance

Under Obamacare, people can go with no coverage at all and, once diagnosed, then get care paid for without penalty. It's like letting people drive without insurance, then making insurance companies write retroactive policies for them after an at-fault collision.

https://www.theatlantic.com/business/archive/2011/06/why-has...

"There were supposed to be millions of people who were uninsurable because of pre-existing conditions. We heard lengthy testimony about their terrible plight. I don't think it's too strong to say that this fear--that you could get sick and no one would insure you, that's right, you, Mr. & Mrs. Middle-Class Voter--was one of the main reasons offered for the health care overhaul. It was estimated by Medicare's Chief Actuary that around 400,000 would sign up (the CBO estimated 200,000, but only because they assumed that HHS would use its authority to limit enrollment in order to stay within the $5 billion budgeted for the program). So where are all the uninsurable people?"

So if this is accurate, that is the size of risk pool isn't that large. Wouldn't be better to create a special program for people who fall into this category?

Why? The only difference between "people who have already been diagnosed with cancer" and "people who are going to be diagnosed with cancer" is that you know who the first group is. The second group is hidden among the "healthy" people.

But both groups will need the same treatment.

So the reason for a special program would be to help the people that need it and not mess with the entire country insurance.