“But we also have the responsibility to control the expenses and look out for the group.”
Voluntary insurance pools face the same ultimate problem as any other insurance system : what happens as the membership ages? As I noted in a post above, healthier the lifestyle you live, on the average the higher your lifetime healthcare costs.
So a system that can work well if the majority of its membership is under 50 will be headed for financial difficulty as the age distribution shifts upwards, and the “responsibility to control the expenses and look out for the group” becomes increasingly pressing problem.
Conceivably the members of a voluntary association who shared very similar underlying principles and values might be able to have a more rational discussion of the financial realities and might be able to reach a greater degree of consensus on what that “responsibility” entailed; for example the individuals might be more willing to forgo the last few months of heroic treatment for cancer as an altruistic strategy for the greater good.
But humans being humans, I wouldn’t count on it.
Christian Healthcare Ministries the group my wife and I are members of was founded in 1981... and allowed people to share over a billion dollars in healthcare expenses. I would assume that in the 36 years that the organization has been in existence that the average age of the members stabilized long ago. I do not think that this is the explanation as to why the "premiums" are so much lower for the "coverage" received.
for example the individuals might be more willing to forgo the last few months of heroic treatment for cancer as an altruistic strategy for the greater good.
No one is being asked to forgo heroic treatments for any conditions that I am aware of. I am not sure that you have a great understanding of where the true waste is in our healthcare system. For whatever reason... health cost sharing ministries are able to offer far greater benefit for far less expense than traditional insurance. Maybe just maybe this should be explored further by our brilliant leadership?