UHC is very standard in the US. Most people won't have a choice. Sometimes I wonder if it's worth it to save up cash and litigate after ER visits than to pay for health insurance.
To your point, one should not have to optimize to be judgment proof in order to exist in their country, and that’s why (at least for myself) I’m optimizing to get out. There are so many other welcoming countries to expats, there’s no reason to stay if you have means and a network of colleagues that can ensure you can work remotely in perpetuity.
One of the issue is that a most of the healthcare issues that young, healthy people run into are surprisingly cheap. But the big costs come from chronic and elderly care. Who are the people who can't afford it. So it always seems like young, healthy people can get a better deal, but then who will pay for them when they're old?