Right but you'll quickly see that analogy doesn't work in another way. With car insurance, its possible I can pay into it my entire life and NEVER have an accident (my current trajectory). I deserve a lower rate!

With health insurance, you are 100% guaranteed to become sick and die, at some point. So the options are either, everyone pays in and it covers everyone, or it only covers a small subset of issues, and everyone gets dropped when they get really sick (the prior state). The latter is definitely cheaper, because its cheaper to let people die / let them suffer than it is to keep them alive / healthy. That is effectively the choice to make.