Yes, it is certainly possible to say the rich and poor have different preferences and that the rich want a lot of expensive coverage while the poor have other priorities. But there are other plausible and reasonable interpretations of this fact, to include the notion that people in general really do ‘want’ the benefits of lots of health insurance, but that many lower income folks simply aren’t that good at deferring gratification to invest in the optimal and time-consistent amount of insurance for themselves, which is really not that much different from saying that they also under-invest in savings for themselves in general, which is not a very controversial proposition.

Health insurance is a big crapshoot payoff. The poor might have different demand curves for risky purchases versus sure-thing payoffs and their curves may change shape depending on their income.

My solution is that people be required to put money every year in a savings account they can’t touch except to for medical expenses, but give them some freedom over how it’s invested.

The basic idea is, people should have to finance insurance agai st their own stupidity. In as much as government intervention in the healthcare market is justified by poor choices by consumers, the intervention should not be redistributive, like other entitlements.