I just read a list serve comment by a woman who had an insurance issue over the cost of her son's physical exam for high school football. The details aren't important.

My question is as follows:

Hypothetically, an insurance policy provides one free physical exam every year.  The cost is spread out among all the policy holders, all of whom are entitled to one physical every year.

They won't all avail themselves of that, but if they did, the insurer would theoretically pay out the same as it collected in premiums, less copays or deductibles, wherein it would realize a profit. Since many people won't take the physicals, the profit will go up...and maybe the premiums would even be adjusted downward slightly once the state insurance commissioner weighed in.

Still, individual policy holders would, at worst, break even if they just paid for the physical out of pocket. Then might even save money by removing the insurance company profit from the calculation.

So why are such routine and predictable things part of a health insurance policy? Shouldn't insurance be to spread the risk around over things that can't be anticipated, like being attacked by a Grizzly?