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Your analysis is far from complete. To an economist, subscribing to insurance of any form is nothing more than betting (say $1000) that a catastrophe (flood, sickness) that costs (say, $100,000) will befall you. If it does, you win. If it doesn't, you lose.

The analysis is no different from that for Roulette. But the big differences arise from the facts that:

1. The expected return from a monthly spin with a $1000 bet on roulette is some $960.

2. The expected return from a monthly spin with a $1000 premium paid for health insurance is far below $800 (which is Obamacare's minimum "loss-ratio" calculated and kept secret by insurance companies. You will get much less than that in real benefits you can appreciate when ill).

3. Nobody is forced by the feds to play roulette, while Obamacare pretends to force all Amerikans to pay for health insurance, even if they're living in Ulan Bator.

5. Playing roulette is fun, and if you're living in Ulan Bator, you can play it there. Paying for compulsory health insurance is no fun, and if you're living in Ulan Bator, you get NOTHING, but merely subsidize the health care of somebody in Aspen or Miami Beach.


You ask, "How, precisely, is anyone's distinctive vision of the good life thwarted by a requirement to buy medical insurance?"

What do you call the situation of an sick American living in France or Brazil, who not only is liable for income tax on all income wherever earned but also liable to pay for health insurance for distant services $1200 worth of travel away, if not"thwarted." That's the way Medicare works now: You pay for 45 years and get NOTHING in return.

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