Here is some example math:
1. Unhealthy person pays $10
2. Health person pays $10
3. Health insurance plan reimburses $15 to care for (1)
4. Health insurance plan pays $2 to care for (2)
5. Health insurance plan pockets $3 for profit
I am fine with (5) but why should I pay $10 to fund care for a person that choses to live life overweight and out-of-shape while consuming a poor diet.
HSA and product differentiation is the answer. I want the HSA to pocket the balance between the lower premium and the cost to care for my lifestyle (it is low). Health care differentiation would also allow me to chose a really low deductible plan that bundles only the goods and services that are right for me - don't need all the bells and whistles or a big basket of goods and services.
This is fair. If a person choses to live an unhealthy life, they can then pay for the care required to mitigate their self-created issues.

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