A lot of people aren't very diligent. It just so happens the old mantra of "every 3,000 miles" doesn't apply to newer cars, so when people forget and do it at 6,000 or 8,000, there aren't any negative effects.

And I would say people don't change their oil because they know their engine will die if they go too long. They do it because it's been ingrained in their head as required maintenance, and that sort of thing is normally taken care of nowadays in a much larger package that includes filters and belts (because people vaguely remember about oil, but they're clueless about the other things.)

I'm not the one you were responding to, but my point here is that people aren't going to ensure prevention without a ton of conditioning or some greater authority forcing them to do so. The voter turnout for Australia, where people are forced by law to vote, was 93% in 2010.[0] In the USA? 41%.[1] People can't be asked to run over to their local elementary school for 20 minutes and pick the first name that pops into their head once every four years, so I doubt any sort of repercussion not mandated by law will have an effect.

[0]: http://www.idea.int/vt/countryview.cfm?id=15

[1]: http://www.idea.int/vt/countryview.cfm?id=231

Frankly, reports from doctor-friends who work in ERs indicates that a large part of costs are treating people who are dealing with preventable often drug-related problems that create emergencies because the people involved are basically incapable of prevention. Seeing other people on the street homeless is apparently not enough incentive to keep people from becoming homeless themselves. I have no idea why seeing other people dying from internal bleeding because they didn't have the foresight to buy medical insurance to get the appropriate medication to treat their issue would curb behavioral patterns which seem to be flawed at a very fundamental level.

> In your case I am wondering why exactly is that we can't turn people away - in aggregate it is likely to save more lives since seeing people dying would be an excellent motivating factor for others to make sure they pay their health care insurance

How exactly does this help people in emergency situations? Or those who go undiagnosed with a condition despite having a primary care physician? What about those folks with a disability that makes it difficult for them to access health care? What about people who are discouraged from getting health care because of discrimination? What about people who live in rural areas far from some kinds of medical treatment?

Bottom line is that death is not a motivator for people in the way you think it is. Even if it was, what kind of society threatens its members with death for failing to participate in your model vision of capitalism?

Aside from all the obvious issues with poor people or people who just don't like the idea of insurance, I want to know how turning people away works with employed, well-paid, insured people like me who might just be coming in without ID after some sort of accident or medical emergency.