>>16907121being able to opt out of insurance is only half the reason the american health system is so screwed
the other half is turning it into a for-profit business and then sabotage every attempt for the "free market" (we assume americans believe in it since it's their argument for making it for profit in the first place) to correct for flaws.
if your doctor charges $100k to kill you, you can't exactly go to the next hospital and negotiate a better service