So...How are people supposed to find out something is wrong with them if they can't even afford to swing by a doctor's office in the first place? How do the people, who are not covered by any sort of health insurance in your proposed non universal healthcare situation, get better healthcare? Non universal healthcare implies there will be people who do not have access to healthcare.

So lets say you incentivize healthy living, seems sensible enough right? If you're healthy in the first place, you won't need to utilize health services as much as a terminal patient.

How do you then make up for the lack of contributions made by the healthy counterparts? The problem with that is you end up with sick people bearing the burnt of the costs and ending up with a pre-aca situation. Eventually financial toxicity will devour those requiring the highest utilization of medical services.

How do you also delineate between healthy and unhealthy bodies? Say you have a 30 to 50 year old patient who eats healthy, exercises regularly, gainfully employed, and is diagnosed with something like glioblastoma or another type of cancer, what do you do then? The reality is that there are things that you are exposed to in your environment that could cause these diseases to occur inspite of a lifetime of healthy life choices. Of course healthy life choices can mitigate the risk of these diseases quite drastically, but nevertheless these diseases do occur in otherwise healthy individuals.

Now you know they'll require more treatment then they would have prior to their diagnosis, do you then jack their rates up in order to compensate for their greater usage of healthcare?

Let's also look at the reasons why people abuse their bodies. Do people go around saying, hey I want to get heart disease, lung cancer, diabetes, dementia, obesity, cirrhosis, and an overall piss poor quality of life? Or are they completely oblivious to the detrimental ramifications of their actions because their socio economic background determined that they would get a piss poor education.

Its true that over utilizing expensive diagnostic tests and the latest litany of medical devices or elective surgeries don't result in better health outcomes. When people are advocating for universal healthcare I doubt they are advocating for the ability of people to get a MRI just for shit and giggles because they can. Id argue that a universal healthcare plan would incentivize cutting down on wasteful spending and that if implemented we'd see more efforts to ensure that diagnostic tests are being administered appropriately, with the most up to date protocols (very important for things like CT scans). Part of the reason why these tests are over utilized is that they tend to be cash cows under your fee for service models. With a government backed system you do run the option of running reimbursement controls to ensure that the abuse of potentially harmful diagnostic tests is reigned in.

While elective surgeries and whatever have you wont necessarily improve mortality rates, there is much to be gained by expanding access to basic healthcare services so that somebody who may be leading a less then ideal lifestyle may be given the chance to lead a healthier life. As it stands, there are people, who avoid the doctor's office due to financial constraints. And while you may say that they reaped what they sowed, the fact remains that their inability to seek routine medical care will end up costing society more than it would have cost to ensure that they had access to routine healthcare in the first place.