>>In the land of the free the individual is everything. So "I'm not ill or old so why should I pay for health care I may never use".

Underwriting includes investment of surpluses to cover predictable future need. The whole system falls over if there are no surpluses because you only insure once you need a payout and the insurers aren't allowed to say "no." Either they go broke or premiums have to exceed the cost of care you'll consume +50% to cover admin and insurer profit.

If there's no national scheme, the individual mandate (meaning you must insure) is the cornerstone of an insurance healthcare system. But if you can't afford it and can't afford the penalties that are waived or postponed anyway, then the cracks start. Why would any economically savvy young person not decide "they can't afford it" or weasel their way into the galaxy of exceptions, if relatively small penalties are waived or postponed repeatedly and you are guaranteed insurance if you get sick and want a payout?