All insurance, whether homeowners, automobile or health insurance operates on the principle of shared risk.

As mentioned above, if you have a house fire, an auto wreck or cancer, the bills are really paid by the members of the group who did NOT have a house fire, or auto wreck or cancer bill.  The money has to come from somewhere.

In health insurance there need to be many healthy people paying into the program to cover each person that has a serious illness each year.  Is that "unfair" to the healthy folks? Not at all. That is the principle of shared risk and they might be the ones to get a serious illness or injury next year.

In auto insurance every driver is required by law to have auto insurance, at least liability insurance.

Almost everyone who buys a home has a mortgage from a lender who also always requires home owners insurance.

The difference in health insurance is that in the past there is no requirement to get heath insurance. Especially the younger, healthier people tend to not carry any health insurance.

If younger, healthy people don't get at least some health insurance, the pool of people in the health care shared risk group gets smaller, older and more likely to file a claim each year. This shrinking "shared risk" pool along with dramatically increasing costs of treatment for those who do need to file a claim means that health care costs for those who do purchase it continue to go up dramatically each year. This cost increase for the remaining pool of people results in even more of the younger, healthier people dropping out of the shared risk pool, further increasing the cost for those that do buy health insurance.

And so it continues in a death spiral until no one can afford health insurance and when you get sick you go to the emergency room where we all pay for it, or you die.

The only way out of this death spiral is to require everyone to have some sort of health insurance, increasing the shared risk pool and theoretically and eventually lowering costs for everyone and allowing those with existing conditions to also obtain insurance.

The problem occurs when folks, mostly younger, healthier folks, who don't like being required to have health insurance, even though they are required to have home owners insurance and auto insurance, end up being able to avoid joining the shared risk pool.  Then the death spiral resumes.