Obamacare vs Free Market Solutions

[Dr Q]

Question on Obamacare from a town hall:
https://www.facebook.com/politico/photos/a.62440786679.82359.62317591679/10154306881441680/?type=3&theater

Response from a person who thinks repeal won't be so bad:
"Most people who have a serious event or condition that don't have insurance go the ER anyway and are helped."

My response:
Let me tell you about one such person, an employee of mine before Obamacare was available. She had cervical cancer and no insurance. When the pain got bad, I drove her to the hospital, and left her at the door of the ER. Luckily, they took her in and gave her some pain meds, even did some tests to confirm it was cancer. She died a few weeks later.  

The ER is no substitute for regular preventative health care, and no way to get the treatments needed for cancer.

More from the same person:
"Allow people to simply go without insurance if they so choose."

My response:
And what do we do when they get sick and change their minds? Refuse to give them care? Take care of them at someone else's expense? Whose expense? Pre-Obamacare, that expense fell on individuals like me. Being self-employed, I had to buy insurance as an individual - high premiums, high deductibles, and when I did need care I had to pay the inflated price that doctors bill to get a fair price after the insurance company discount - typically two or three times the price they would otherwise charge.  $5000 to remove a malignant growth on my left ear lobe.

[Dr Q]

Imagine a total free market, with no government regulations, penalties, or subsidies.  Imagine also that we have advanced technology that allows insurance companies to check your DNA and predict the cost of your healthcare.  "Sorry, you have a 90% chance of cancer in the next 5 years.  Your premiums will be ten times what others are paying."  Would such a system be fair?  Is there a difference between Democrats and Republicans on this question? 

[Dr Q]

The big advantage of Obamacare over the previous free-market solutions was that it allowed self-employed and small-business people like myself to get insurance at the same rates as everyone else with group insurance.  The big advantage of group insurance is that people with pre-existing conditions are not excluded.  Whatever we do to reform healthcare, we must not allow free-market forces to save money by excluding people.  That might be a small advantage for young and healthy people, but sooner or later they too will have a pre-existing condition.