I am 54 years old. I (and my employer) have paid 'in' to private insurance for 33 years and my parents paid in to the system before that. I have claimed 'back' essentially nothing.
At 52, I lost my job. My current small business employer can not provide affordable coverage for me, and certainly not for my wife and child. So, I paid in to the system for many decades and have no means to continue to participate, let alone receive benefits based on that contribution. Neither conservative nor liberals should find that fair.
Insurance works based on a notion of a group, where, over many years, many pay 'in' to the system while over fewer years, a portion make claims on the system. It works great in principle. Some will pay more 'in' than they claim and some will claim more than they pay. The whole concept completely breaks down when a person is forced out of the system, especially after paying 'in' for so long.
A market of competitive private companies can not implement a fair long term group insurance system. People switch jobs, by choice or not. Employers switch providers. Why should a new company pay claims when the old company collected decades of premiums? They shouldn't. They can't. Its economically impossible. The new company must pay claims based on their current, short term, income from premiums. How come this simple math seems to be absent from the debate this year?
Competition between many insurance providers may help to prevent monopolistic profiteering, but it goes against the simple math that says insurance only works economically with very large pools of people and where the distribution of old and young in each group is relatively equal.
We should not be arguing about free markets and capitalism for the few powerful insurance companies, but rather taking advantage of capitalism to nurture competition amongst all health providers, from doctors to pharmaceutical companies, equipment manufacturers, hospitals, etc.
This logic leads me to believe that a single pool into which you pay over a lifetime or some fixed period of time, and from which one can never be removed, is the only viable system. Premiums are not based on age. The concept of preexisting conditions is eliminated since you are born into it - good genes or not. Single payer and either government run or a non-profit civilian organization.
Only then can other issues of merit be addressed, such as providing incentives for healthy living choices like exercise, nutrition, and not smoking.