kollelman,
Additionally, due to the government being a guaranteed payer, rates are artificially high, since there is really no competition.
Not sure what you mean here. Can you explain more? How is the government a guaranteed payer?
There can be a pool for high risk people – just like car insurance.
And insurance rates would be sky-high for those unfortunate enough to be delegated to the high risk group, if insurance companies even offered coverage to them (now required by the ACA). And that’s a lot worse than paying more for car insurance for your 16 year old, because sick people need medical care a whole lot more than teenagers need to drive. Health care and driving cars are not really comparable things, despite it sounding good in print.