In his commentary, "What used cars have to do with health insurance," (Oct. 20), Darrel J. Gaskin describes adverse selection and its effect on insurance rates. He goes on to describe what the insurance companies do to address adverse selection, how those "tools" affect rates and how the Affordable Care Act will solve these problems.

But I disagree with one sentence in his piece. "Insurers must issue policies to all prospective buyers, and all individuals must buy now and can't wait until they are sick." While the first part of this sentence is true, the second part is not. Individuals have the option of paying a fine instead of buying insurance. And the fine goes to the government, not to the insurance companies. As long as the fine is less than the cost of insurance, there will be those who will not buy insurance until they need it. Thus, adverse selection will still occur, to the detriment of the whole program.

Joseph Schaum