actually the super wealthy often self-insure as premiums are often a waste of money and one for which they can find a better use for the money.
This libertarian thing with the mandate is just plain dumb. The only way that you can eliminate the mandate and have it work is to protect hospitals so that if someone without insurance shows up at the ER in a coma after a car accident, then the hospital is OBLIGATED or REQUIRED to let them die. Otherwise the cost for the uninsured just gets passed on to the insured.
It's weird that you say there is only one way to make it work (which is death) and then post an alternative that is that the insured cover the cost. It seems like that's backward. The one way it works is to pass along the cost, otherwise... death.
I specifically amended my take. My point is that anyone with enough money to insure themselves wouldn't do it. What this seems to relate to is young healthy people who don't want to pay for insurance, at least not until they need it.
My "death" example is the worst case of course. It could apply to many things where an uninsured shows up at the ER with some form of catastrophic injury or illness and does not have the ability to pay. Without the mandate, and assuming that they are not in a coma, they could sign up for insurance on the spot and just say "pre-existing condition".
It just doesn't work without mandate and no one has ever provided a answer to my question about the person who decided not to get insurance but has a car accident and needs long term care to stay alive. Who is going to pay for that? How is that going to work? I will tell you the answer, it will be either taxpayers or people who buy insurance (passed along by higher costs/rates).
only foolish ones would and I doubt there's many who do. a smart wealthy person would find premiums for a good coverage a drop in the bucket (if they weren't already getting covered through their job/companies) but even if they didn't want to pay that kind of premium they'd be smart enough to get a 'catastrophic' coverage -- for example a policy that had a $10,000 deductible before it paid. probably cost like $1000 in premiums per family member.
if they only incur $1000 in medical expenses for a family of 3, well, that's $4000 for the year out of their pocket. less than a premium for a good coverage. however, if one member of the family has an accident, surgery or needs to be admitted to a hospital for even just 2 days, they'd be looking at bills starting at about $20,000. complete self-insurance would be foolish.
if you have a number of examples of the super wealthy that self-insure, please share. one or two examples wouldn't prove much, expecially if you're picking Bill Gates or Steve Bezos (just picking a couple of super rich guys as examples - I highly doubt they self insure considering the companies they own)