Pre Obamacare I could not even shop for insurance as my pre-existing condition would force me into an insurance pool where my rates would more than double. Cobra is a temporary solution to bridge people going from employer provided insurance plans to a private plan. Rates are going to be extremely high with Cobra but no one should stay with it for more than a few months.
For general care I need a policy. For emergency medical care when traveling I use a different type of insurance or take the risk of having to pay my own bills should I go into an emergency room for any reason.