The libertarian me likes that, but the practical me says there's no f*(king way that would work given the rampant excuses the public has for being inbetween coverages or whatever. Hypothetically. Lets say you choose not to carry health insurance, and you're T-boned by someone. The medics on scene have to make a call whether to treat you or not - by not carrying insurance, there's no guarantee they'll get paid, nor will the hospital. The accident wasn't your fault, but they don't know that. The cops on scene are still gathering statements from witnesses and reconstructing the accident. So, do they treat you under the assumption you have insurance, or do they not? Does the 'at fault' party have to carry additional insurance to pay for medical bills for the 'under insured' other party? What if the accident was YOUR fault? You made your bed by choosing no insurance, you wanna lie in it now? I mean, there's so many what-if's that are eliminated if you make the assumption people are covered.