Insurance companies and HMOs (including Kaiser) know the odds. Scott is going to get the same rate escalation everywhere. Maybe Blue Cross won't hit him until he's 50, but I'll bet $225/month will seem cheap to him 5 years from now. That's why so many of us in this country cling to health care by a thread. If they lose their job, or their employer contributions, then they're entering the biggest gamble of their lives. One accident, one illness, and you can rack up $50,000 in medical bills in one day.