Yes, there are those who I am sure choose to gamble and go without health insurance. They are healthy and then are suddenly hit with a devastating illness and can indeed end up destitute. I still feel very sorry for those people. I guess one can say "yeah, you took the risk, so tough." I don't quite feel that way, but I understand that viewpoint.
I am much more concerned with the MANY people (and YOU know THEY exist) who have lost their insurance due to being downsized or whatever. They are one illness away from disaster. Many folks here would be in deep you-know-what without MediCare. I would certainly be facing severe hardship (I've had surgery, SRT, and soon HT) without my insurance that I have at work (which I have found is not quite as great as I thought it was, but still relatively good).
It's a question of what we value as a society first and how to accomplish that. I do think there are some things best handled by government, including a nationalized health care system. But the first issue is do we value such a system and the second issue (if the answer is yes) is how to implement this.
Frankly, I think the multitude consisting of every other industrialized country has gotten it right. We do need a nationalized system of health care. I am amazed by those who have theirs, but seem to turn their backs on those less fortunate. I guess that makes me some kind of bleeding heart. But I don't see it that way.