"We must decide soon whether an individuals costs for access to medical care is to be determined at birth, or not."
All that you say is exciting. But I am not sure this question isn't already resolved just based on things we can already figure.
We can already diagnose many diseases at birth and we have already made the choice to cover such people. We - hopefully - don't burden a kid born with CP with massive medical bills. That's the person the insurance we all pay is there to cover. Fortunately, those who are not sick don't cost much. So the money we pay goes to those who need it.
The point of a decent health insurance system is to share the costs across the population so that those unlucky enough to be sick don't also get disproportionately exposed to cost.
This is the model every advanced economy has chosen. Finally, after Obamacare. We do so without regard to a person's state of health. Previously, of course, the US system sought to discriminate between those who are well and those with existing conditions. Essentially it was a health insurance system that was designed to exclude people with health problems. Which was not just nasty. It turns out it was also costly.
The only health payment variable you usually see in a modern, caring and efficient economy is based on a person's income.
The nice thing about most sorts of medicine is that they are not something most people want to consume more than they have to. The tendency to demand medical care amongst the healthy is not great.
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