and the insurance companies execs are laughing all the way to the bank. Spread the risk across 330 million people, and everyone but the insurance companies have more net money in their pocket, with much less of the relentless fear of having one unexpected healthcare catastrophe wiping you out financially.

And, Iki is also right that those overweight smokers may end up paying for your "big family" with the huge costs of childbirth, and the possible million $ NICU baby (you got admit, if you have seven of then your "chances" of costing the system are higher than the morbidly obese person who can't have children). And then there's paying for your anxiety treatments over being a Type A person, followed by vitamin prozac for your depression along with therapy sessions, when 4 of your 8 kids become teenagers. Or perhaps your cancer that comes from your genetic makeup that neither you nor I (paying premiums) have any control over, much like many obese people who are genetically pre-disposed to Metabolic Syndrome. Furthermore, I may be indirectly paying for many of your other poor choices in areas of high risk recreational activities (you snowboard, play football?), driving fast (increases my auto insurance), finance (did you buy presents MADE IN CHINA??? - just an example), politics, environmental diligence (got an electric car?), garbage disposal (do you compost), real estate (did you help cause the housing bubble?). And what about when you get old, get cancer, or have a skiing accident? Should we just say "too bad for you?" It just goes on and on and on.

But the reality is that a single payer system (not necessarily run by the government) may be the lesser of evils, unless you only look at it from your own set of blinders - blinders that only recognize where you may end up covering some of the direct or indirect costs of other people, while being oblivious to where you may be costing other people. When we help care for our fellow man, we often help ourselves in the process. Consider the concept that one of the marks of a civilized society is how they care for their OLD, their YOUNG, and their INFIRM (whether they partially bring it on themselves or not), and we are doing a very poor job of that in this country largely because of attitudes like those that foster the "every-man-for-himself" way of thinking. A single payer system would allow us assure more dignified end-of-life care for the elderly, better acute and preventative care for our kids, and better catastrophic coverage for the infirm, whether it be for diabetes and obesity, or for unexpected things like cancer, and severe trauma / sickness. And, in doing all that, the costs would be substantially lower for everyone, and the money would be redirected out of the hands of the insurance industry and in to lower premiums for everyone else. It's not rocket science, but you can see why the insurance industry is willing to spend billiions in propaganda to keep things the way they are.

That's not to say that reigning in pharmaceutical and other monopolies, the liability dogs, government mandates / waste, and a few other key healthcare cost drivers (I could go on and on) wouldn't ALSO help, but it's not an either / or - it's an ALL OF THE ABOVE.