 The real choices of some people to forego coverage actually make things worse for those who need insurance and prefer to buy it, and they create the need to fund subsidies for the foregone insurance purchase. We shall call “free riders” those who—for whatever reason—do not share in the cost of the health system but can share its benefits (needed health care) when ill. Suppose further that free riders can share the benefits of the health system by meeting some modest penalty for remaining uninsured. In short, free riders can pocket the cost of insurance minus the penalty, but still get care when they need it. Put another way, the health system must be ready to treat all people, free riders or not, because that is the choice of society. (We are assuming that few people would allow Free Riders to die in the streets, which would happen if they are not allowed to get care when they need it and have not purchased health care insurance.) Free riders thus get a good bargain—some might say an incentive to free load—if they are given needed care when they join a system they did not contribute to, except for facing a modest punishment for not joining earlier.