But if you follow a "no tickie, no washie" policy, relatives, activists, and clergy watching someone die that could be saved will commence an uproar that will reverse the situation as well as ending the political careers of those responsible. So, you are in the sad situation of paying everyone else's freight until the ACA cuts in.
By the way, Stan, you have an internet connection. Look up the health care cost vs outcome for Uganda and France. Try the UK , Germany, Canada Japan and others. You'll find the good ol' USA is down the list a fair bit. The present system is costing a mint and getting us less.