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Here’s a thought experiment: What if healthcare insurance is fundamentally the wrong model for managing most healthcare? Insurance works best when it covers the unexpected—the tail-risk events that hit you out of nowhere. But the reality is that much of healthcare isn’t unexpected at all. Take cancer as an example. The initial diagnosis and treatment are undeniably shocking—a classic insurance-worthy moment. But what about the next five or ten years of follow-up care? That’s not surprising. It’s predictable. Should insurance, a system designed for surprises, really foot the bill for something so foreseeable? Here’s the argument: health insurance should cover the initial shock—like a cancer diagnosis or a torn hamstring during a sports match. But once the acute phase passes, predictable, long-term care (like cancer surveillance or diabetes management) should be handled differently—perhaps through government funding. Consider chronic illnesses. If someone with poorly controlled diabetes develops retinal disease or vascular complications, is that surprising? Not really. It’s almost inevitable. Asking insurers to cover these predictable outcomes results in inflated premiums and financial inefficiency. The same logic applies to other chronic conditions. A smoker with diabetes developing vascular disease? It’s not a question of “if” but “when.” Why pretend this is an insurable risk? Here’s the punchline: if we separate the unexpected from the inevitable in healthcare, we might just create a more efficient system. Insurance should handle the surprises. Government funding should manage the predictable. And the sooner we recognize that most of healthcare isn’t a surprise, the sooner we can build a system that works for everyone. Here’s a thought experiment: What if healthcare insurance is fundamentally the wrong model for managing most healthcare? Insurance works best when it covers the unexpected—the *tail-risk events* that hit you out of nowhere. But the reality is that much of healthcare isn’t unexpected at all. Take cancer as an example. The initial diagnosis and treatment are undeniably shocking—a classic insurance-worthy moment. But what about the next five or ten years of follow-up care? That’s not surprising. It’s predictable. Should insurance, a system designed for surprises, really foot the bill for something so foreseeable? Here’s the argument: health insurance should cover the initial shock—like a cancer diagnosis or a torn hamstring during a sports match. But once the acute phase passes, predictable, long-term care (like cancer surveillance or diabetes management) should be handled differently—perhaps through government funding. Consider chronic illnesses. If someone with poorly controlled diabetes develops retinal disease or vascular complications, is that surprising? Not really. It’s almost inevitable. Asking insurers to cover these predictable outcomes results in inflated premiums and financial inefficiency. The same logic applies to other chronic conditions. A smoker with diabetes developing vascular disease? It’s not a question of “if” but “when.” Why pretend this is an insurable risk? Here’s the punchline: if we separate the *unexpected* from the *inevitable* in healthcare, we might just create a more efficient system. Insurance should handle the surprises. Government funding should manage the predictable. And the sooner we recognize that most of healthcare isn’t a surprise, the sooner we can build a system that works for everyone.