About 30 years ago my employer (in energy services) offered a revolutionary plan called "flexible benefits."
For health insurance, if you wanted higher deductibles (essentially self-insuring for routine items) you got less money deducted from your check.
Likewise if you took less sick days, you got a net benefit. It was done by setting a single number of paid time-off days per year. Take it as sick, as holiday, or as vacation; or not at all. You could accumulate this, and get paid upon leaving the firm.
Employees loved it (except high sick time users).
My guess is on the health insurance item, Obamacare and associated complications render such freedom and flexibility almost impossible to administer.
One thing which reflects changes in society, is the idea a n adult remains on mommy's and daddy's insurance to the age of 26.
I thought we gave them voting at 18.