Essentially everyone needs insurance in the long run but because of the way things are currently set up individuals sometimes look at it as a short term question. We have annual insurance policies so sometimes people think of it as "do I need insurance in the next year". If you are young and healthy there is a pretty good chance that you may not need/want insurance in the next year.
We need to take a longer term approach to healthcare. Essentially you need to be paying into the system even though you don't need/want it now because you will need/want it later. If you only signed up for insurance when you need it you are a net drain on the system. It would almost be like if you could choose not to pay into social security but could still opt to take money out of the system when you needed it. This is one of the big reasons why a mandate is important.
This guy gets it. In addition to that, even for younger people one of the big problems is that health spending is EXTREMELY high variance. Your total health spending for a decade could be 200,000 - 8 years of near $0, one year of $20,000 and 1 year of $180,000.
