If everyone wants to insure themselves against some low probability medical and financial catastrophe, the annual cost might be very reasonable when spread around the pool.
Regulation and standardization insure that, when competitors meet, everyone will have trained for the same event, and the results can be compared across competitions.
Thus, we could be heading toward a system where large corporations continue to self-insure while requiring their employees enroll in an ACO while everyone else is on a government plan that requires patient membership in an ACO.