Ronald, we can attribute America’s lack of responsibility to the creation of HIPPA by Ted Kennedy and his accomplice Kassabaum. Until then, health insurance did price according to health conditions of the insured, but afterward HIPPA assured portability, and installed adverse selection into insurance. So, Americans came to beleive that they could buy insurance after getting sick by having a group insurance product. Now, congressional testiminy late 2009 indicated that 74% of claim dollars are the result of tobacco or obesity, or unmanaged diabetes. Until government programs, (AKA PPACA, MEDICARE, MEDICAID) assess higher costs to the claims drivers, healthcare costs will spiral out of control, driven by patients who won’t follow medical advice goddess, and turn in their big, repeated claims.