1) The cycles of life, such as birth and dying. 

2) Accidental and intentional injuries, such as work accidents, assault, suicide attempts. 

3) Environmental sources, such as skin cancer or the indifferent disposal of industrial chemicals. 

4) Intent to deceive, from medical quacks and fraudulent billing. 

5) Dangerous lifestyles, such as x-sports, distracted and impaired driving, sexual promiscuity, and substance abuse, including obesity. 

While some of these expenses are unavoidable, America is at cross-purposes with herself when it comes to personal freedom versus healthcare. 

We want to express ourselves though our bodies, yet we don’t want personal responsibility for the medical bills these personal choices generate. 

I told my kids when they got a little older, 

"If you do something dumb that makes us go to the emergency room, you have to pay the deductible out of your own pocket." 

They were more careful after that.